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Otorhinolaryngology > Otorhinolaryngology Emergency > Flashcards

Otorhinolaryngology Emergency Flashcards

1
Q

Fracture of the facial bones are composed of

A

Upper: Frontal, Orbital
Middle: Maxillary, Nasal bone, Zygomatic
Lower: Mandible

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2
Q

Facial paired bones

A

• Maxilla
• Lacrimal bone
• Nasal bone
• Inferior nasal conchae
• Palatine bone

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3
Q

Thick areas that provide support and strength in the facial bones

A

Buttresses of facial bones

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4
Q

Use of oropharyngeal airway, supraglottic airway devices, tracheal intubation/surgical airway

A

cricothyrotomyotracheostomy

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5
Q

Visible sign of shock

A
  1. Pallor
  2. Prolonged capillary refill time
  3. Clammy and cool skin
  4. Tachycardia
  5. Diminished/absent pulse pressure
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6
Q

GCS (Eye Opening Response)

A

Spontaneously 4
To speech 3
To pain 2
No response 1

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7
Q

GCS (Best verbal response)

A

Oriented to time, place and person 5
Confused 4
Inappropriate words 3
Incomprehensible sounds 2
No response 1

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8
Q

GCS (Best motor response)

A

Obeys commands 6
Move to localized pain 5
Flexion withdrawal from pain 4
Abnormal flexion (decorticate) 3
Abnormal extension (decerebrate) 2
No response 1

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9
Q

Serious complication; collection of blood under the mucoperichondrium or mucoperiostium of nasal septal cartilage or bone; may be unilateral or bilateral (more common in severe trauma)

A

Nasal septal hematoma

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10
Q

Nasal septal abscess to the cavernous sinus thrombosis causes

A

Meningitis

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11
Q

Etiologies of Maxillofacial fractures

A

• 60% of patients with severe facial trauma have multisystem trauma and the potential for airway compromise
• 20-50% concurrent brain injury
• 1-4% cervical spine injuries
• Blindness occurs in 0.5-3%
• 25% of women with facial trauma are victims of domestic violence ( increase to 30% if with orbital wall fracture
• 25% of patients with severe facial trauma will develop PTSD

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12
Q

Emergency management airway control

A

o Chin lift
o Jaw thrust
o Oropharyngeal suctioning
o Manually move the tongue forward
o Maintain cervical immobilization

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13
Q

Intraoral examination

A

o Manipulation of each tooth
o Check for lacerations
o Stress the mandible
o Tongue blade test

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14
Q

Frontal sinus/Bone fracture associated with

A
  1. Intracranial injuries
  2. Injuries to the orbital roof
  3. Dural tears
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15
Q

Frontal sinus/Bone fractures clinical findings

A

o Disruption or crepitance of the orbital rim
o Subcutaneous emphysema
o Associated with a laceration

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16
Q

Frontal sinus/Bone fractures radiographic views

A

Facial views
- Waters
- Caldwell
- Lateral projections

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17
Q

Frontal sinus/Bone fractures complications

A

Associated with intracranial injuries:
1. Orbital roof fractures
2. Dural tears
3. Mucopyocele
4. Epidural empyema
5. CSF leaks
6. Meningitis

18
Q

Naso-ethmoidal orbital fractures clinical findings

A

Patient complain of pain on eye movement

Clinical findings
- Flattened nasal bridge or saddle-shaped deformity of the nose
- Widening of the nasal bridge (telecanthus)
- CSF rhinorrhea or epistaxis
- Tenderness, crepitus, and mobility of the nasal complex

19
Q

3 types of nasal fractures

A
  1. Depressed
  2. Lateral displaced
  3. Nondisplaced
20
Q

Type I Nasal fracture

A

Laterally displaced fracture

21
Q

Type II Nasal fracture

A

Disarticulation of upper lateral cartilage

22
Q

Type III Nasal fracture

A

Posteriorly depressed fractures

23
Q

Type IV Nasal fracture

A

Anterior nasal spine fracture

24
Q

Type V Nasal fracture

A

Involvement of nasal septum

25
Q

Type V Nasal fracture

A

Involvement of nasal septum

26
Q

Orbital blowout fractures clinical findings

A
  1. Periorbital tenderness, swelling, ecchymosis
  2. Enopthalmos or sunken eyes
  3. Impaired ocular motility
  4. Infraorbital anesthesia 5. Step off deformity
27
Q

Radiograph findings on Orbital blowout fractures

A
  1. Hanging teardrop sign
  2. Open bomb day door
  3. Air fluid levels
  4. Orbital emphysema
28
Q

Most common types of fracure on zygoma

A

Blunt trauma
Arch fracture- most common
Tripod fracute- most serious

29
Q

Most common types of fracture in zygoma

A

Blaunt trauma
Arch fracture- most common
Tripod fracture- most severe

30
Q

Most common types of fracture in zygoma

A

Blaunt trauma
Arch fracture- most common
Tripod fracture- most severe

31
Q

Zygomatic arch fractures clinical findings

A
  1. Palpable bony defect over the arch
  2. Depressed cheek with tenderness
  3. Pain in cheek and jaw movement
  4. Limited mandibular movement
32
Q

Tripod fracture consist of fractures through

A

-Zygomatic arch
-Zygomaticofrontal suture
-Inferior orbital rim and floor

33
Q

Clinical features of Zygoma tripod fractures

A

o Periorbital edema and ecchymosis\
o Hypesthesia of the infraorbital nerve
o Palpation may reveal step off
o Concomitant globe injuries are common

34
Q

Horizontal fracture of the maxilla at the level of the nasal fossa

A

LeFort I/Guerin Fracture

35
Q

Pyramidal fracture of the maxilla, nasal bones and medial aspect of the orbits

A

LeFort II/Pyramidal fracture

36
Q

Fractures through maxilla, zygoma, nasal bones, ethmoid bones and base of the skull

A

LeFort III/Craniofacial disjunction

37
Q

LeFort I/Guerin Fracture clinical findings

A
  1. Facial edema
  2. Malocclusion of the teeth
  3. Motion of the maxilla while the nasal bridge remains stable
  4. (+) Drawer sign
38
Q

LeFort I/Guerin Fracture clinical findings

A
  1. Facial edema
  2. Malocclusion of the teeth
  3. Motion of the maxilla while the nasal bridge remains stable
  4. (+) Drawer sign
39
Q

Lefort III/Craniofacial disjunction clinical findings

A
  1. Dish faced deformity
  2. Epistaxis and CSF Rhinorrhea
  3. Motion of the maxilla, nasal bones, and zygoma
  4. Severe airway obstruction
40
Q

Most common fracture site of the mandible

A

Condylar process followed by the body

41
Q

Clinical findings of Mandibular fractures

A
  1. Mandibular pain
  2. Malocclusion of the teeth
  3. Separation of teeth with intraoral bleeding
  4. Inability to fully open mouth
  5. Preauricular pain with bitting
  6. (+) Tongue blade test
  7. Check if there is hematoma on the floor of the mouth (may lead to airway obstruction)
42
Q

For immboilization of mandible

A

Barton’s bandage

Otorhinolaryngology (6 decks)

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