Recognition of Jaw and Facial Injuries

Question 1

Mandible Fractures

Answer 1

• direct blow
• deformity/loss of function/bleeding
• occlusion = loss of bite
• temporary immobilization with elastic wrap

Question 2

Mandibular Dislocation

Answer 2

• involves TMJ joint
• blow to open mouth from side
• locked-open jaw position
• decreased ROM with poor occlusion
• need doc release (immob, soft food diet)

Question 3

Temporomandibular Joint Dysfunction

Answer 3

• disk condyle derangement (anteriorly)
• headaches, earaches, vertigo, neck pain
• custom fit, removable mouth piece, strengthening ROM

Question 4

Zygomatic Complex Fracture

Answer 4

• direct blow
• deformity, pain, diplopia (double vision)
• ice, referral, protective gear upon return to play

Question 5

Maxillary Fracture

Answer 5

• blow to the upper jaw
• nosebleed, diplopia, numbness
• maintain airway, monitor for brain injury, transport to hospital immediately upright and leaning forward, if conscious

Question 6

Facial Lacerations

Answer 6

• contact with a sharp object
• pain and bleeding
• control bleeding, cover/referral

Question 7

Tooth Fractures

Answer 7

• impact to the jaw
• uncomplicated produce fragments without bleeding
• complicated produce fragments with bleeding/exposure of the tooth chamber/pain

Question 8

Management of Tooth Fractures

Answer 8

• save fractured pieces
• refer
• if not in pain or sensitive to air/cold followup can wait 24-48 hours

Question 9

Tooth Subluxation

Answer 9

• direct blow, tooth maybe slightly loosened or dislodged
• avulsion, the tooth is completely dislodged
• referral w/in first 48 hours
• lactated tooth = repositioning should be attempted along with immediate follow-up
• save the tooth

Question 10

Nasal Fracture and Chondral Separation

Answer 10

• direct blow
• separation of frontal processes of maxilla, separation of lateral cartilage or combination of both
• immediate swelling
• deformity
• control bleeding
• monitor airway
• nose guard

Question 11

Deviated Septum

Answer 11

• compression or lateral trauma
• septal hematoma may form
• nasal pain
• hematoma needs drainage

Question 12

Epistaxis (nosebleed)

Answer 12

• direct blow

- bleeding from the anterior aspect of the septum

Question 13

Auricular Hematoma

Answer 13

• cauliflower ear
• separation and tearing of overlying tissue
• proper ear protection
• icing

Question 14

Tympanic Membrane Rupture

Answer 14

• fall or slap to the unprotected ear
• loud pop, followed by pain, nausea, hearing loss
• usually heal spontaneously

Question 15

Otitis Externa

Answer 15

• swimmers ear
• infection of the ear canal caused by a bacillus
• water becomes trapped by a cyst
• pain/dizziness/itching/discharge
• physician referral for antibiotics

Question 16

Otitis Media

Answer 16

• middle ear infection
• accumulation of fluid in the middle ear caused by local and systemic infection and inflammation
• intense pain, fluid drainage
• tympanic membrane may appeared bulging and/or bleeding
• generally resolves in 24 hours while pain may last for 72 hours

Question 17

Impacted Cerumen

Answer 17

• excessive earwax

- physician removal with a curette

Question 18

Assessment of the Eye

Answer 18

• be cautious
• cover both eyes
• transport athletes to hospital lying down
• palpation
• pupillary response
• visual acuity
• ophthalmoscope

Question 19

Orbital Hematoma

Answer 19

• blow to the eye causing capillary bleeding
• swelling and discoloration
• ice/rest/monitor vision/ do not blow nose

Question 20

Orbital Fracture

Answer 20

• blow to the eyeball forcing it posteriorly, compressing the orbital fat until a blowout rupture occurs to the floor
• restricted eye movement, diplopia
• x-ray to confirm fracture

Question 21

Foreign Body in the Eye

Answer 21

• do not attempt to remove by rubbing
• close eye and determine location
• wash out with saline
• if embedded, patch and send to the doc

Question 22

Corneal Abrasions

Answer 22

• severe pain
• eye watering
• patch and send to doc

Question 23

Hyphema

Answer 23

• blunt trauma to the eye
• serious injury that may cause long-term vision problems
• collection of blood in the anterior chamber of the eye
• refer to physician

Question 24

Rupture of the Globe

Answer 24

• blow by an object smaller than the eye
• severe pain, decreased visual acuity
• immediate rest
• eye protection

Question 25

Retinal Detachment

Answer 25

• painless
• floating specks, flashes or light or blurred vision
• “curtain fallin”
• immediate referral

Question 26

Acute Conjunctivitis

Answer 26

• bacteria
• swelling with purulent discharge
• highly infectious

Question 27

Hordeolum

Answer 27

• sty
• infection of the sebaceous gland at the edge or the eyelid
• painful pustule
• application of moist compresses
• patient should avoid squeezing sty to drain

Question 28

Throat Injuries

Answer 28

• direct blow
• severe pain with spasmodic coughing, speaking hoarse voice and complaining of difficulty swallowing
• expectoration of frothy blood

Question 29

Throat Contusion

Answer 29

• airway integrity is the first priority
• try intermittent cold application
• stabilization with a well-padded collar