Head/Face Lecture Flashcards
Which zone…
base of the neck
contains: subclavian, aortic arch, trachea, c-spine roots
Zone 1
Which zone…
Midportion of neck (cricoid to mandible)
Contains: carotid/vertebral arteries, jugular vein, larynx, c-spine
Zone 2
Which zone…
superior aspect of neck
95% of penetrating traumas to the neck are from…
guns/knives
(5% are MVAs, sports, etc )
Which zone…
clavicles to cricoid cartilage
zone 1
which zone…
cricoid cartilage to angle of mandible
zone 2
which zone…
angle of mandible to base of skull
Zone 3
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?
HARD!
(hard signs more often associated with significant injury)
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?
Soft
Proximal vertebral and carotid arteries
Thoracic vessels
Superior mediastinum
Lungs
Esophagus
Trachea
Thoracic duct
Spinal cord
..important structures in what zone?
Zone 1
Mid-carotid and vertebral arteries
Jugular veins
Esophagus
Trachea
Larynx
Spinal cord
important structures in what zone?
Zone 2
Distal carotid and vertebral arteries
Pharynx
Spinal cord
important structures in what zone?
Zone 3
MC zone injured
zone 1
True or False…
If wound penetrates the platysma, pt should go right to OR for removal
True
Trendelenberg position helps avoid the formation of…
air embolus
Facial edema
mobility of teeth and palate
which LeFort classification?
LeFort I
telecanthus
mobility of maxilla
epistaxis
CSF rhinorrhea
What LeFort classification?
LeFort II
facial elongation/flattening,
movement of all facial bones with respect to cranial base,
CSF rhinorrhea
which LeFort classification?
LeFort III
What easy test should you always do to rule out/confirm mandible fracture
tongue blade test
Hallmark=
CN I deficits with or without CN VII or VIII
Raccoon eyes
Battle’s sign
Basilar skull fracture
In severe mandible fractures, loss of bony support may result in _____ displacement of the tongue
posterior
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
Blowout fracture
True or False..
There is a high incidence of blindness in Le Fort III fractures
True
A barton bandage (elastic bandage wrapped around the jaw and head) can be worn for comfort with what fractures?
Mandible
