Head, Face, Eyes, Ears, Nose, and Throat Flashcards
What observational signs may indicate a cerebral injury
- Disoriented, unable to tell what time, date, etc
- Blank or Vacant stare
- Slurred or incoherent speech
- Delayed verbal and motor responses
- Gross coordination disturbance
- Unable to focus
- Abnormal cognitive function (three word recall, etc)
What are some Eye Function tests you can perform if you suspect head injury
- Pupillary reflex (PEARL)
- Tracking - Eyes should track smoothly
- Vision - blurred indicates possible injury
What are signs/ symptoms and management of skull fractures
- Severe hedache and nausea
- May be unconscious
- Palpation may reveal defect
- May see blood in middle ear, ear canal, through the nose, ecchymosis around eyes (raccoon eyes), or Ecchymosis behind ears (battle sign)
- May see CSF in ear canal and nose
- Needs immediate hospitalization and referral to neurosurgeon
What are signs/ symptoms and management of Concussion (Mild TBI)
- Headache
- Feeling like in a fog
- Loss of consciousness or amnesia
- irritability
- slowed reaction times
- Grade of injury should be based on presence and overall duration of symptoms only after all concussion signs are resolved
- Athlete should be returned to play only when they are symptom free
What are coup and contrecoup injuries
- Coup: Injury that occurs on same side of the brain as the impact
- Contrecoup: Injury that occurs on the opposite side of the brain from where impact occurred
What are signs/ symptoms and management of Postconcussion syndrome
- persistent headache
- lack of concentration
- Anxiety
- Fatigue, etc
- No clear cut treatment
- Only return to play after ALL symptoms resolved
What are signs/ symptoms and management of Second Impact Syndrome
- Rapid swelling and herniation of the brain from a second head injury before the first head injury had resolved
- Condition worsens rapidly, dilated pupils, loss of eye movement and consciousness
- Life threatening, must be addressed within 5 minutes with decompression
- Best treatment is prevention
What are signs/ symptoms and management of Cerebral Contusion
- Injury to brain, involves small hemorrhages, result from impact injury
- Patient experience loss of consciousness but then regains consciousness and becomes alert
- Treatment varies; Only return to play once symptoms have resolved and CT is normal
What are signs/ symptoms and management of Malignant Brain Edema Syndrome
- Occurs in young population typically
- Life threatening
- Rapid neurological deterioration
- Treated in ER
What are signs/ symptoms and management of Epidural hematoma
- Tear in meningeal arteries, Blood accumulates in Epidural space
- May lose consciousness, regain consciousness, signs of head trauma (headache, nausea, etc)
- CT scan to diagnose
- Surgically relieve pressure to prevent death or permanent disability
What are signs/ symptoms and management of Subdural Hematoma
- Tear in vessels that bridge the dura mater in the brain
- Most common cause of death in athletes
- Show signs of head injury
- Life Threatening
- Immediate medical attention
What are signs/ symptoms and management of Migraine
- Type of headache happens in episodes or attacks
- Last 4-72 hours
- May be inherited, may be triggered by food, sensory stimuli, etc
- Severe headache, disrupts normal activity, throbbing, may be on one side
- Best management is prevention
- Prophylactic medications such as promethazine
What are signs/ symptoms and management of Scalp Injuries
- Lacerations, contusions, etc
- bleeding extensive
- Matted hair and dirt make it hard to visualize and treat
What are signs/ symptoms and management of Mandible Fracture
- Deformity, pain biting down, bleeding around teeth
- Requires immobilization with elastic bandage and reduction and fixation of the jaw by physician
- Recovery 4-6 weeks, full return 2-3 months with special head gear or mouthguard
What are signs/ symptoms and management of Mandibular Luxation
- Dislocation of the Jaw
- Locked open position, jaw movement almost impossible, overriding malocclusion of the teeth
- Reduction, Soft Diet, NSAIDS, analgesics
- May have recurring episodes or TMJ Dysfunction
What are signs/ symptoms and management of Zygomatic Complex (Cheekbone) Fracture
- Direct blow to cheekbone, classified as “Lefort” fracture
- Deformity in cheek region
- Usually a nosebleed
- Complaint of seeing double (diplopia)
- Apply Ice and refer to physician
- Return to play 6-8 weeks, protective gear worn when return to play
What are signs/ symptoms and management of Maxillary Fracture
- Severe blow to upper jaw
- Pain while chewing, malocclusion, nosebleed, double vision
- Bleeding profuse, maintain airways
- Brain injury possible as well
- Transport to hospital immediately in upright forward leaning position
What are signs/ symptoms and management of Facial Lacerations
- Direct impact by sharp object or by indirect compressive force
- Substantial bleeding
- Referral for suturing
- Keep clean, use antibiotics
Define the three types of tooth fractures
- Uncomplicated crown fracture: Fracture line through dentin and enamel but not into pulp cavity or root
- Complicated crown fracture: Fracture line into pulp, not into roots
- Root Fracture: Fracture line through root
What are signs/ symptoms and management of Uncomplicated crown fracture
- No bleeding
- Pulp not exposed, no pain
- Can continue to play, see a dentist within 24-48 hours
- Keep tooth fragment in plastic bag
What are signs/ symptoms and management of Complicated crown fracture
- Bleeding from fracture
- Pulp chamber exposed, very painful
- Can continue to play, see a dentist within 24-48 hours
- Keep tooth fragment in plastic bag
- If bleeding, place gauze over broken tooth
What are signs/ symptoms and management of Root fracture
- Fracture below gum line
- Difficult to diagnose
- Bleeding from gum around the tooth, crown may be pushed back or loose
- Can continue to play, see a dentist as soon as possible after game
- Don’t push tooth back in place if displaced
- Dentist will fix and give brace for 3-4 months
- Should wear mouth guard while competing
Define Tooth subluxation, luxation, and avulsion
- Subluxation: tooth in normal place, slightly loose, little to no pain
- Luxation: very loose and moved forward or backward to intruded position
- Avulsion: Tooth knocked completely out
What are signs/ symptoms and management of Subluxed, Luxated, or Avulsed tooth
- Subluxed: Refer to dentist within 48 hours
- Luxation: Move tooth back to normal position if able to be moved easily; refer to dentist immediately
- Avulsed: Try to reimplant tooth; If unsuccessful tooth should be stored in “save a tooth” kit with Balanced Salt Solution or in milk or saline
- Can also be tucked between cheek and gum while patient transported to dentist
- Sooner the tooth is reimplanted the better
What are signs/ symptoms and management of Nasal fracture and chondral separation
- Profuse hemorrhage
- Immediate swelling, deformity, palpation may reveal abnormal mobility and crepitus
- Should control bleeding and refer to physician for x ray and reduction
What are signs/ symptoms and management of Deviated Septum
- Nose bleeding, Nasal pain
- Apply ice and refer to physician
- If not treated quickly can abscess and cause bone and cartilage loss and ultimately a difficult to correct deformity
What are signs/ symptoms and management of Epistaxis (Nosebleed)
- Nose is bleeding
- Resolves on its own usually, if persistent may require medical attention and cauterization
- Sit upright with cold compress over nose and ipsilateral carotid artery with compression x 5 minutes
- Place piece of rolled up gauze between upper lip and gum
- If unsuccessful can use an astringent or styptic, or corking with cotton pledget, make sure at least 1/2 inch sticks out from nose for removal
What are signs/ symptoms and management of Auricular Hematoma (Cauliflower ear)
- Hematoma, swelling of the ear
- If left untreated a keloid forms resembling cauliflower
- Prevent by applying petroleum jelly for friction reduction or wear ear guards
- Cold pack and compression with ace bandage to prevent swelling
- Once swelling occurs, aspiration by physician
What are signs/ symptoms and management of Rupture of Tympanic Membrane
- Fall or slap to unprotected ear or sudden change in underwater pressure
- Loud pop followed by pain in the ear, nausea, vomiting, dizziness
- Hearing loss
- Small to moderate perforations heal spontaneously in 1-2 weeks
What are signs/ symptoms and management of Otitis Externa (Swimmers ear)
- Infection in the ear caused by Pseudomonas Aeruginosa
- Complaints of pain, dizziness, itching, partial hearing loss
- Prevent by drying ears thoroughly, use ear drops containing mild acid and alcohol before and after swimming
- Antibiotics may be used for mild ear infection
What are signs/ symptoms and management of Otitis Media (Middle ear infection)
- Intense pain in ear, fluid draining, transient loss of hearing
- May also cause fever, headache, irritability, loss of appetite
- May use antibiotics but usually resolves within 24-72 hours
What are signs/ symptoms and management of Impacted Cerumen (earwax)
- Causes muffled hearing, no pain
- Irrigation with warm water and if not successful a physician can remove it
- Dont use cotton cuetip for it
What are signs/ symptoms and management of Orbital Hematoma
- Black eye, signs of more serious injury displayed by subconjunctival hemorrhage or faulty vision
- Cold application for at least half hour, 24 hour rest
- Dont blow nose after injury, may cause increased hemorrhage
What are signs/ symptoms and management of Orbital Fractures
- Blow to the eyeball forcing it posteriorly until blowout or rupture occurs in floor of the orbit
- Diplopia
- Restricted movement of eye
- Downward displacement of the eye
- pain and swelling
- X ray to confirm
- Should receive antibiotics to prevent infection, most treated surgically
What are signs/ symptoms and management of Foreign bodies in the eye
- Don’t rub or remove with fingers
- Close eye until initial pain resolved
- To remove from lower lid, depress tissue and wipe with sterile cotton applicator
- From Upper Lid, two ways
- Gently pull upper lid down over lower lid
- Or use a cotton applicator to remove while patient looks up and you pull eyelid back
What are signs/ symptoms and management of Corneal Abrasions and lacerations
- Cornea abraded when rubbing eye with foreign body in it
- Pain, watering of eye, photophobia, spasm of orbicular muscle
- Patch eye and send to physician
What are signs/ symptoms and management of Hyphema
- Blunt blow to eye causes collection of blood in anterior chamber of eye
- Blood visible in eye, settles inferiorly, vision partially blocked
- Major eye injury, can lead to problems of lens, choroid, or retina
- Immediately referred to physician, bed rest, patching, medication to reduce hemorrhage
What are signs/ symptoms and management of Ruptured Globe
- Blow to eye by object smaller than the eye orbit like golf or raquetball
- ORBITAL LEAKAGE, severe pain, decreased vision, diplopia, irregular pupils, increased intraocular pressure
- Immediate referral to ophthalmologist
What are signs/ symptoms and management of Retinal Detachment
- Blow to the eye can completely separate retina from underlying epithelia
- Detachment is painless
- Early signs include Speck floating before the eye, flashes of light, blurred vision.
- As this progresses complaint of a “curtain” falling over the field of vision
- Immediate referral to ophthalmologist
What are signs/ symptoms and management of Acute Conjunctivitis (Pink Eye)
- Caused by bacteria or allergens
- Eyelid swelling sometimes with purulent discharge, Itching
- Can be infectious
- Use 10 percent solution of sodium sulfacetamide
What are signs/ symptoms and management of Hordeolum (Stye and Blepharitis)
- Stye is Swollen sebaceous gland at edge of eyelid
- Blepharitis is infection of eyelash follicle
- Starts as erythema and develops into painful pustule
- Most will resolve in less than 4 weeks
- Use hot moist compresses
- Dont squeeze
- If recurrent, see ophthalmologist
What are signs/ symptoms and management of Throat Condition
- Blow to throat
- Spasmodic cough, hoarseness, difficulty swallowing
- If fracture of laryngeal cartilages is rare, but may cause expectoration of frothy blood
- If difficult breathing, go to ER
