Injuries to Eyes, Nose, Ears, Face & Throat - CH.26

Question 1

at what depth/length of a laceration should you refer to a physician?

Answer 1

anything more than these values:

1. 25cm long
2. 3 cm deep

Question 2

you come the corner of a side street and you see a person laying on the ground unconscious. Upon inspection, you see that there is apparent ecchymosis around the eyes and ears. There’s clear fluid coming out of their eyes and nose. As you palpate the skull is there’s an apparent divit. What should you expect? how should you mng?

Answer 2

skull fracture

check for ABCs - act accordingly if not present

if they are breathing/pulse/ airway is clear - stabilize Csp & call for EMS - tx for shock

Question 3

an athlete with a concussion has no clue as to what happened prior to the injury, what is this term called?

Answer 3

retrograde

Question 4

an athlete with a concussion has no clue as what happened after the injury, what is this term called?

Answer 4

anterograde

Question 5

an athlete has been hit in the face by one their opponents, you ask them if they’re okay, but they “claim” to be fine. They then get nudged in the back and within a couple mins they start to deteriorate. What could be happening?

Answer 5

secondary-impact syndrome

Question 6

an athlete has sustained a blunt force to their head. As you approach them on the field, you can tell they’re likely unconscious. They come to as you approach them. After talking for a couple of minutes, they seem to be doing fine. A couple mins later they start to deteriorate again. What do you suspect is happening? how to mng?

Answer 6

epidural hematoma - due to to the ludic intervals of being fine for a couple mins to deteriorating

Call EMS immediately - tx for shock & stabilize csp - depending on where you are (provincially), you may be able to collar and board athlete

Question 7

what are the 3 types of subdural hematoma?

Answer 7

acute subdural hematoma (same as epidural hem. - common cause of death in boxers)

subdural hem. associated with other trauma to skull

chronic - occurs due to venous bleeding

Question 8

what must you always suspect if there is an injury to the face?

Answer 8

a head injury

Question 9

you’re at a rugby pitch and you are currently taping an athlete on the sideline. Another athlete runs up to you trying to tell you that it’s hard for them to speak and that they can’t feel their lower jaw. As you look at them - you see an obvs deformity at their jaw and feel slight crepitus. What do you suspect? how to mng?

Answer 9

mandibular fracture

use a triangle bandage to stabilize the jaw - call EMS - tx for shock if applicable

Question 10

in a “tripod fx” what would you see?

Answer 10

all 3 sutures: frontal, temporal and maxilla are fractured

decreased prominence of cheek bone

Question 11

what happens with a maxillary fracture (lefort fracture)?

Answer 11

when maxilla and maxillary teeth are completely separated from the skull

Question 12

what are the 3 types of tooth fractures?

can an athlete continue to play if they continue to play?

Answer 12

1. uncomplicated crown - part of tooth is chipped off (NO bleeding)
2. complicated crown (bleeding occurs)
3. root fx - below gum line

yes as long as there’s no excessive bleeding and there are no reasons to pull them out of play

Question 13

how to store a person’s loose tooth?

Answer 13

in a plastic bag with saliva covering it.

refer to dentist immediately

Question 14

after an athlete has had a nose bleed, what should they avoid post-game/event/ practice?

Answer 14

avoid blowing the nose for at least 2 hrs

Question 15

how to mng cauliflower ear?

Answer 15

decrease the friction/shearing force on ears

wear ear guards

immediate application of ice pack (may need drainage from a physician)

Question 16

one of your athletes tries to dunk, but then gets rejected from the other team. In the process of getting rejected the ball gets slapped back towards their ear. The athlete comes off holding their ear. When you try to talk to them they have to tilt their head the other way because they have a hard time hearing you with that ear. What might you suspect? how should you mng?

Answer 16

potential tempanic membrane rupture from the blow of the ball

rule out concussion - no RTP

Question 17

s/s of otitis externa aka what?

Answer 17

swimmer’s ear - excessive fluid build up leading to infection

P/ discharge at ears
hearing loss

Question 18

when assessing eye movements and tracking, what CN are you testing

Answer 18

CN III, IV, VI

Question 19

perform the 9 cardinal planes of gaze

Answer 19

up L
up 
up R
left 
convergence 
right
down R 
down 
down L

Question 20

What test is used for visual acuity?

Answer 20

Snellen’s chart

Question 21

2 methods to remove foreign bodies at the eye

Answer 21

pull upper eye lid over lower as they look down (promotes prod. of tears)

washed with saline solution

Question 22

an athlete comes to you with blood accumulated in front of their eye - what is this condition called?

Answer 22

hyphema

refer to physician

Question 23

a football player to comes to you on the sideline and is worried that he can’t see properly. They describe it as a “curtain” blocking their vision. What might you suspect?

Answer 23

retinal detachment - refer to MD

Question 24

how to mng a stye?

Answer 24

hot compress to drain the oil gland

resolves within 4 weeks-ish