Head/Face Lecture

Question 1

Which zone…

base of the neck

contains: subclavian, aortic arch, trachea, c-spine roots

Answer 1

Zone 1

Question 2

Which zone…

Midportion of neck (cricoid to mandible)

Contains: carotid/vertebral arteries, jugular vein, larynx, c-spine

Answer 2

Zone 2

Question 3

Which zone…

superior aspect of neck

Question 4

95% of penetrating traumas to the neck are from…

Answer 4

guns/knives

(5% are MVAs, sports, etc )

Question 5

Which zone…
clavicles to cricoid cartilage

Answer 5

zone 1

Question 6

which zone…
cricoid cartilage to angle of mandible

Answer 6

zone 2

Question 7

which zone…
angle of mandible to base of skull

Answer 7

Zone 3

Question 8

Hypotension in ED
Active arterial bleeding
Diminished cartoid pulse
Expanding hematoma
Thrill/bruit
Lateralizing signs
Hemothorax >1000 mL
Air or bubbling in wound
Hemoptysis
Hematemesis
Tracheal deviation

hard or soft signs of neck injury?

Answer 8

HARD!

(hard signs more often associated with significant injury)

Question 9

Hypotension in field
Hx of arterial bleeding
Unexplained bradycardia
Nonexpanding large hematoma
Apical capping on CXR
Stridor
Hoarseness
Vocal cord paralysis
Subcutaneous emphysema
VII cranial nerve injury

HARD or SOFT symptoms of neck injury?

Answer 9

Soft

Question 10

Proximal vertebral and carotid arteries
Thoracic vessels
Superior mediastinum
Lungs
Esophagus
Trachea
Thoracic duct
Spinal cord

..important structures in what zone?

Answer 10

Zone 1

Question 11

Mid-carotid and vertebral arteries
Jugular veins
Esophagus
Trachea
Larynx
Spinal cord

important structures in what zone?

Answer 11

Zone 2

Question 12

Distal carotid and vertebral arteries
Pharynx
Spinal cord

important structures in what zone?

Answer 12

Zone 3

Question 13

MC zone injured

Answer 13

zone 1

Question 14

True or False…

If wound penetrates the platysma, pt should go right to OR for removal

Answer 14

True

Question 15

Trendelenberg position helps avoid the formation of…

Answer 15

air embolus

Question 16

Facial edema
mobility of teeth and palate

which LeFort classification?

Answer 16

LeFort I

Question 17

telecanthus
mobility of maxilla
epistaxis
CSF rhinorrhea

What LeFort classification?

Answer 17

LeFort II

Question 18

facial elongation/flattening,
movement of all facial bones with respect to cranial base,
CSF rhinorrhea

which LeFort classification?

Answer 18

LeFort III

Question 19

What easy test should you always do to rule out/confirm mandible fracture

Answer 19

tongue blade test

Question 20

Hallmark=

CN I deficits with or without CN VII or VIII

Raccoon eyes
Battle’s sign

Answer 20

Basilar skull fracture

Question 21

In severe mandible fractures, loss of bony support may result in _____ displacement of the tongue

Answer 21

posterior

Question 22

MC orbital fracture

occur when a blunt object strikes the globe, fracturing the medial or inferior orbital wall

exam reveals:
Enophthalmos
Infraorbital anesthesia
Diplopia on upward gaze
Step off deformity on palpation of infraorbital rim

Answer 22

Blowout fracture

Question 23

True or False..

There is a high incidence of blindness in Le Fort III fractures

Answer 23

True

Question 24

A barton bandage (elastic bandage wrapped around the jaw and head) can be worn for comfort with what fractures?

Answer 24

Mandible