Orbital Floor Fracture & Auricular Hematoma

Question 1

what are causes of an orbital floor fracture? (3)

Answer 1

1. intracranial injury
2. intraocular injury
3. direct blunt force trauma

Question 2

what are complications associated with an orbital floor fracture? (2)

Answer 2

1. entrapment of muscle in fracture
2. edema/hemorrhage of muscle and fat in maxillary sinus

Question 3

patient presents with history of blow to the face, diplopia with upward gaze, infraorbital numbness, periocular ecchymosis and n/v due to severe pain. what is their most likely diagnosis?

Answer 3

orbital floor fracture

Question 4

what are 2 things I should look for in a physical exam for a patient with an orbital floor fracture?

Answer 4

1. enophthalmos
2. orbital dystopia

Question 5

what is part of my physical exam in a patient with an orbital floor fracture? (5)

Answer 5

1. pupillary reaction
2. extraocular movements
3. visual acuity
4. fundoscopic exam
5. slit-lamp

Question 6

what should I perform on a patient with an orbital floor fracture that has evidence of a fracture on exam, limited extraocular movement, decreased visual acuity, and severe pain?

Answer 6

CT

Question 7

when should a patient with an orbital floor fracture be referred to an ophthalmologist immediately? (2)

Answer 7

1. severe vagal symptoms
2. extraocular muscle entrapment

Question 8

when should a patient with an orbital floor fracture be referred to an ophthalmologist or plastic surgeon within 24 hours? (2)

Answer 8

1. muscle entrapment
2. facial asymmetry

Question 9

what is the management for a patient with an orbital floor fracture? (2)

Answer 9

1. oral antibiotics
2. cold packs for swelling

Question 10

what patient education should be given to a patient with an orbital floor fracture? (2)

Answer 10

1. sleep with elevation
2. avoid nose blowing and sniffing

Question 11

a collection of blood within the cartilaginous auricle that results from blunt trauma during sports

Answer 11

auricular hematoma

Question 12

a patient presents with tender, tense, fluctuant collection of blood, typically on the anterior aspect of the pinna and often within the scaphoid fossa (depression between the helix and antihelix). what is their diagnosis?

Answer 12

auricular hematoma

Question 13

why must an auricular hematoma be drained as soon as possible after injury?

Answer 13

forms granulation tissue after 7 days

Question 14

what is the protocol after drainage of an auricular hematoma?

Answer 14

evaluate every 24 hours for 4 days for hematoma and signs of infection

Question 15

a permanent deformity caused by fibrocartilage overgrowth that occurs when an auricular hematoma is not fully drained, recurs, or is left untreated

Answer 15

cauliflower ear