Head And Neck Trauma Flashcards

0
Q

what are the labeled fractures

A

Mandibular fractures

A = displaced

B = nondisplaced

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1
Q

What is the most common head and neck trauma injury

A

Nasal fractures

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2
Q

what is this?

A

Dental occlusion

Mandibulomaxillary fixation

(MMF)

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3
Q

what joint cab be effected by mandibular fracture?

A

TMJ

may limit movement

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4
Q

What’s a concern with bilateral mandibular frx?

A

tongue floation = AW obstruction

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5
Q

what are some airway management considerations for this?

A

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

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6
Q

what is a Horizontal, maxillary mid face
separation

A

LeFort I frx

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7
Q

what is a Triangular [pyramidal],
nasomaxillary-zygomataic
separation

A

LeFort II frx

can have Ethmoid fracture —> CSF leak

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8
Q

what is Craniofacial disjunction

A

LeFort III frx

NOTE: Ethmoid fracture —> CSF leak

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9
Q

Which LeFort frx(s) get an anode ETT or Trach for airway management?

A

II and III

(but anode is not for long term management)

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10
Q

what is a major airway conern with this?

A

Blow Out frx

may not be a BMV candidate

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11
Q

Things to think about with Larnygeal injuries

A
  1. Type of Injury
    1. – Blunt
    2. – Penetrating
  2. Type of Wound
    1. – Open
    2. – Closed
  3. Associated Injuries
    1. – Life-threatening
    2. – Affect airway management
  4. Level
    1. – Supraglottic
    2. – Infraglottic
  5. Airway Patency
    1. – Patent
    2. – Partially obstructed
    3. – Obstructed
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12
Q

Points of exam for laryngeal injury

A
  1. INSPECTION
    1. – Gross appearance: open wound, closed
    2. wound, contusion, deformity, ….
    3. – Pupils
    4. – Hemoptysis
  2. PALPATION
    1. – Trachea midline
    2. – Crepitus
    3. – Induration
    4. – Laryngeal mobility
  3. AUSCULTATION
    1. – Hoarseness
    2. – Air flow I
  4. Diagnostic Adjuncts
    1. CXR
      1. Trachea midline
      2. Barotrauma
      3. Fractures
    2. FFOB
      1. [Hemorrhage]
      2. Mirror
    3. Neck X-rays | Axial CT | MRI
      1. Internal airway mass (obstruction)
      2. External airway mass (compression)
      3. Airway interruption
      4. Larynx & trachea positions
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13
Q

what is true of a “Shear-force injury”?

A

Interrupted airway

  1. – Hx: sudden deceleration
    1. » MVA
    2. » Fall
    3. » Blunt impact
  2. – Associated injury may be life-threatening
    1. » Aorta
    2. » Vena cava
    3. » Pulmonary artery
  3. – High index of suspicion
    1. » Hx
    2. » EKG
    3. » CXR (1st rib, scapula)
  4. – Assess: CTA, aortogram
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