Head And Neck Trauma Flashcards
what are the labeled fractures
Mandibular fractures
A = displaced
B = nondisplaced
What is the most common head and neck trauma injury
Nasal fractures
what is this?
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Dental occlusion
Mandibulomaxillary fixation
(MMF)
what joint cab be effected by mandibular fracture?
TMJ
may limit movement
What’s a concern with bilateral mandibular frx?
tongue floation = AW obstruction
what are some airway management considerations for this?
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Partial loss of mandible –
– Replacement free graft
– Vascular anastomoses
– Heat preservation
– Rheology ( goal = Hct 30%, too low decreases blood flow, too high less O2 carrying capacity)
– Postop overnight support
to prevent movement
– Tracheostomy
what is a Horizontal, maxillary mid face
separation
LeFort I frx
what is a Triangular [pyramidal],
nasomaxillary-zygomataic
separation
LeFort II frx
can have Ethmoid fracture —> CSF leak
what is Craniofacial disjunction
LeFort III frx
NOTE: Ethmoid fracture —> CSF leak
Which LeFort frx(s) get an anode ETT or Trach for airway management?
II and III
(but anode is not for long term management)
what is a major airway conern with this?
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Blow Out frx
may not be a BMV candidate
Things to think about with Larnygeal injuries
- Type of Injury
- – Blunt
- – Penetrating
- Type of Wound
- – Open
- – Closed
- Associated Injuries
- – Life-threatening
- – Affect airway management
- Level
- – Supraglottic
- – Infraglottic
- Airway Patency
- – Patent
- – Partially obstructed
- – Obstructed
Points of exam for laryngeal injury
- INSPECTION
- – Gross appearance: open wound, closed
- wound, contusion, deformity, ….
- – Pupils
- – Hemoptysis
- PALPATION
- – Trachea midline
- – Crepitus
- – Induration
- – Laryngeal mobility
- AUSCULTATION
- – Hoarseness
- – Air flow I
- Diagnostic Adjuncts
- CXR
- Trachea midline
- Barotrauma
- Fractures
- FFOB
- [Hemorrhage]
- Mirror
- Neck X-rays | Axial CT | MRI
- Internal airway mass (obstruction)
- External airway mass (compression)
- Airway interruption
- Larynx & trachea positions
- CXR
what is true of a “Shear-force injury”?
Interrupted airway
- – Hx: sudden deceleration
- » MVA
- » Fall
- » Blunt impact
- – Associated injury may be life-threatening
- » Aorta
- » Vena cava
- » Pulmonary artery
- – High index of suspicion
- » Hx
- » EKG
- » CXR (1st rib, scapula)
- – Assess: CTA, aortogram