module 3 nasal trauma, small and taste disturbances

Question 1

nasal trauma

Answer 1

result of a severe blow to the face
can involve
- skin
- mucous membrane
- muscle
- nerve
- bone
- cartilage
- vascular structures

Question 2

Nasal injury can be assoc. with other conditions

Answer 2

concussion
facial or orbital injury
cervical spine injury

Question 3

Questions to ask with nasal trauma

Answer 3

• LOC
• headache
• N/V
• diplopia/visual changes
• facial numbness
• breath through both nostrils?
• any bleeding form nostrils?
• how long did bleeding last?
• pvs broken nose or nasal surgery?
• change in sense of smell?

Question 4

physical exam with nasal trauma

Answer 4

periorbital ecchymosis
edema
abrasions or lacerations
epistaxis
CSF leakage
trauma to teeth, neck , or chest
obvious deformity
patency of airflow

Question 5

Potential nasal obstruction causes

Answer 5

• deviation or fractured septum
• soft tissue edema
• septal hematoma

Question 6

Palpation with nasal trauma

Answer 6

Dorsum (bridge)
- deformity
- instability
- crepitus
- point tenderness
Orbital rim
- palpable step off: indicates zygomatic complex fracture

Question 7

intranasal examination with nasal trauma

Answer 7

visualize
- mucosa
septum
turbinates
- rule out septal hematoma and CSF leak

Question 8

septal hematoma

Answer 8

rounded bluish or purplish mass against the nasal septum
- separates the septal cartilage from the adherent mucoperichondrium, which supplies nutrition
-> septal cartilage necrosis
- requires urgent drainage

Question 9

tx for nasal trauma

Answer 9

• cool, local pressure to dec. edema and bleeding
• no deformity or hematoma: ice, head elevation, analgesia
• follow up with orolaryngology 3-5 days
• reduction within hours to 3-5 days post-injury

Question 10

children and nasal reductions

Answer 10

closed nasal fracture: reduction in first several days
Open reduction: not recommended, if required is delayed until nasal growth is complete

Question 11

need for referral with nasal trauma

Answer 11

CSF leak
complex skull or facial fractures

Question 12

complications of nasal trauma

Answer 12

septal hematoma
- saddle nose
- septal perforation
- septal abscess
nasal obstruction
- > sinusitis, epistaxis
septal ulcers
perforations

Question 13

anosmia

Answer 13

loss of the sense of smell
- olfactory dysfunction

Question 14

parosmia

Answer 14

smell distortion
- olfactory dysfunction

Question 15

hyposmia

Answer 15

diminished sense of smell
- olfactory dysfunction

Question 16

olfactory dysfunction can result from

Answer 16

aging
tobacco
toxins
meds
malignant neoplasms
nasal inflammation
infection
malnutrition
head or facial trauma
Parkinson’s
Alzheimer’s
MS
DM
inflammatory autoimmune conditions

Question 17

hypogeusia

Answer 17

diminished taste

Question 18

aligeusia

Answer 18

unpleasant taste

Question 19

dysgeusia

Answer 19

persistent taste

Question 20

ageusia

Answer 20

absent taste

Question 21

taste disorders result from

Answer 21

aging
tobacco
toxins
meds
malignancies
inflammation
infection
malnutrition
head or facial trauma
Parkinson
Alzheimer
MS
DM
endocrine dysfunction
anesthesia
head and neck irradiation
procedures
iatrogenic causes
kidney or gastric dysfunction
metabolic or hepatic disorders
environmental exposure
substance use disorder
psych disorders

Question 22

loss of taste or smell clinical presentation

Answer 22

usually after an URI
young adults: head trauma

Question 23

loss of taste or smell physical exam

Answer 23

CN I: olfactory
- identify odors
CN IX and VII: glossopharyngeal, facial
- test with sweet, salty, sour, and bitter
Nasopharynx:
- abnormalities
- crusting
- mucus
- URI s/s

Question 24

complications from loss of taste and smell

Answer 24

permanent loss
brain tumor or degenerative nerve disease
quality of life
depression
loss of appetite and wt
compromise safety