HEENT Injuries Flashcards
What is raccoon eyes, battle sign, and halo sign indicative of?
Raccoon eyes: TBI
Battle sign: posterior skull fracture
Halo: CSF leakage
How does O2/Co2 affect ICP?
Hypercarbia leads to increased ICP via vasodilation
Hypocarbia leads to decreased ICP via vasoconstriction
What is the CPP formula, normal value, and management
CPP = MAP -ICP
Normal 70-100
Manipulate via mannitol, lasix, limited hyperventilation
Causes, s/s, and treatment of concussions
Closed head injuries, develops w/in 7-10 days lasts 3 months
S/s: N/V, headache, dizziness, LOC, agitation, retrograde anterograde amnesia
Tx: supportive care
What is the management for depressed skull fracture
Surgical elevation
What is a epidural hematoma, what are the causes, and how does it present on CT
Bleed between skull and dura matter
Trauma to the MMA (Middle meningeal artery)
Lenticular shape on CT
Findings and treatment of subdural hematoma
LOC that becomes transient that progresses to decreased
Ipsilateral pupil dilation
Contra lateral hemiparesis/hemiplegia
Posturing
TX: Craniotomy vs hematoma evacuation. Stop arterial bleeding
What is a subdural hematoma, causes, and presentation on CT
Blood in subdural space: venous
Acceleration/ deceleration injuries
Crescent shaped bleed
Risk factors, clinical findings, and treatment for subdural hematoma
Risk: ETOH and age
Clinical findings: steady decline in LOC, ipsilateral fixed dilated pupil, contralateral hemiparesis/hemiplegia
Tx: operation vs non operative (craniotomy w/ evacuation vs burr hole) Surgery only on hematoma >10mm and midline shift >5mm
Where do cerebral contusions occur and what are the causes
Scattered areas of bleeding on the brain surface mostly on temporal and frontal lobes
Brain strikes ridge on skull
Bruises may occur
Clinical findings and treatment of cerebral contusions
LOC decreased, cerebral edema, swelling (48-72 hours after injury)
Craniotomy removal of cerebral contusion
Intra ventricular bleeds clinical findings and treatment
Clinical findings: hydrocephalus, small bleeds (mild to no symptoms), large bleeds (altered LOC and herniation)
Tx: vary per neurosurgeon, IR if suspected hypertensive bleed (coiling vs embolization)
Tx for frontal sinus nondisplaced fracture
ABX
Observation
Frontal sinus displaced fracture treatment
Surgery
Nasal fracture tx
Reduced non-operatively
