head and neck trauma Flashcards
why are geriatric pts more vulnerable to trauma?
- fragile bones
- less soft tissue, muscle,and fat
- decreased collogen production for flexibility
what comorbitites contribute to a decreased ability for greiatric patients to compensate for trauma?
- reenal impairment
- loss of elasticity in blood vessels
- a decrease in effectiveness in hormones/neurotransmitters
geriatric patients show signs of shock much earlier than younger patients. why might the heart rate not increase appropriatly to compensate to trauma?
the patient might be on anti arrythmic drugs such as beta blockers or calcium channel blockers which lower the heart rate
how does beta blockers impact trauma compensation?
slows heartrate and prevents compensatory tachycardia
how does calcium channel blockers impact trauma compensation?
inhibit vasoconstriction
how does antiplatelets and anticoagulants impact trauma compensation?
hinders coagulation and increases risk of uncrontrolled bleeding
what is cerebral atrophy?
the brain tissue shrinks with age
what are implications of cerebral atrophy?
more room for blood and fluid to accumulate during a head trauma
complications with penetrating traumas?
exsanguination
aspyxiation
neurological deficits
complications with blunt trauma?
the risk of vascular damage like carotid artery injury which could lead to emboli or thrombi
why are antihypertensive medications problematic with compensation for trauma?
they could prevent the nessasary vasocontriction the heart needs to increase
blunt traumas can cause gowing hematomas. this poses the risk of what to develop?
they can compress ajacent structures causing airway obstruction or vascular compromise
crushing the hyoid bone can dirsupt what?
swalowing
crushing the thyroid cartilage can interefere with what?
the vocal cords
injuries to the pharynx or esophagus can lead to what?
mediastinitis
what conditions in geriatric patients put them at a higher risk for fluid overload with fluid administration?
heart failure or fibrotic changes in the heart, or renal inssuficiency
what are key concerns with neck injuries
- massive bleeding
- airway obstruction
- delayed cerebral infarction
what is the location of zone 1
between the clavical and cricoid cartilage
zone 1 contains vital structures such as?
- major vessels
- nerves
- trachea, esophagus, apex of lungs, thyroid gland
what major vessels are located in zone 1?
- arch of aorta
- braciocephalic artery
- carotid artery
- vertebral arteries
the nerve in zone one, if damaged can cause neuro deficits in the arm. this nerve is called?
brachial plexus
zone 1 is quite close to this cavitiy which is a major risk to hemorhage
the thoracic cavity
where is zone 2 of the neck located
from the cricoid to the mandibular angle of the jaw
which cranial nerves are at risk for damage in zone 2?
cranial nerves 10, 11, and 12
where is zone 3 located on the neck?
from the mandibular angle to the base of the skull
which cranial nerves are likly to get damaged in zone 3 of the neck?
7, 9, 10, 11, and 12
out of all the zones, c spine fractures are more common uin this area?
zone 3
what are potential consequences of mandibular fractures?
malocclusion and trismus
what is malocclusion
misalignment of teeth
mid face fractures (le forte fractures) invlove sites such as the maxilla and zygomatic floor. the MOI is often a high imact force. this could potentially effect what parts of the body?
the brain stem and spinal cord
what symptoms can zygomatic fractures produce?
- numbness
- altered vision
- epistaxsis ( anterior or posterior
orbital fracturs can result in subconjunctival hemmorrhage. what is this sign?
this is red eyes
telecanthus is a sign often associated with which type of le fort fracture
le forte 3
what is globe rupture
the loss of intraocular fluid and pressure
what are signs of globe rupture?
- irregular pupil shape
- conjuctival hemmorrhage
- possible loss of vision
what conditions can cause globe rupture?
- basal skull fracture
- orbital bone fracture
- retinal detachment
what is anophthalmos
posterior displacement of the eyeball within the orbit (sunken eyes)
why does anophthalmos happen?
results because of changes in globe volume and pressure
hyphema
blood in the anterior chamber of the eye
diplopia
blurry vision that occurs with severe eye injury
tympanic membrane perforation of the ear can cause what symptoms?
- severe pain
- hearing loss/deafness
- ringing in the ear (tinnitus)
what are complications for flail chest?
- impaired respiration and ventilations causing VQ mismatch
- atelectasis
what is the patho behind a pneumo thorax?
pleural pressure is normally negative to keep the lungs inflated. if the pleural pressure becomes equal to atmospheric pressure, the lung can collapse
becks triad is a sign of pericardial tamonade and pneumothorax. what is this triad?
- hypotension
- JVD
- muffled heart sounds
what is pericardial tamponade?
when lood fills up in the pericardial sac
