TRANS 28 Trauma to ENT Flashcards
Initial assessment for ent trauma
Airway, breathing, circulation (ABC)
Rapid trauma assessment for ENT trauma include? (3)
o Head, face, neck
o Glasgow coma scale score
o Vital sign
is a wound caused by superficial damage to the
skin, no deeper than the epidermis
Abrasions
First versus second vs third degree abrasions?
- A first-degree abrasion involves only epidermal injury
- A second-degree abrasion involves the epidermis as well as the dermis and may bleed slightly
- A third-degree abrasion involves damage to the subcutaneous layer and the skin and is often called avulsion.
A wound produced by the tearing of body tissue, as distinguished from a cut or incision.
Laceration
• Injury to tissues with skin discoloration and without breakage of skin; called also bruise.
Eto yung tinatawag nating pasa o bugbog.
Contusion
• The tearing away of a structure or part either accidentally or surgically
avulsion
frequently injured due to trauma
Poor blood supply
poor healing
what structure in the ear?
Pinna
is well protected due to the mastoid and temporal bone however this can be injured due to rapid pressure changes
internal/inner ear
inner ear may be injured due to what?
May be injured due to rapid pressure changes
▪ Diving, blast or explosions
▪ Temporary or permanent hearing loss
▪ Tinnitus may occur
• Shear force trauma
• Perichondrium lifted & bleeds
Very common among wrestler and boxer. Mga MMA fighter, madalas tamaan sa tenga
Subperichondrial hematoma
Mx for subperichondrial hematoma?
- Drain before cartilaginous necrosis
- Leave drain, antibiotics bolster dressing, monitoring/24 hrs
- “
“Cauliflower” ear asymmetric cartilage formation
where do you find this?
Subperichondrial hematoma
- Inability to ventilate middle ear – abnormal dysfunction of ET
- Occurs in rising ambient pressure (Descent in flight/scuba diving)
- Can produce hemotympanum
OTITIC BAROTRAUMA
MX for otitic barotrauma?
- Repeated Valsalva maneuver
- Topical nasal decongestants
- Myringotomy and PE tube insertion may be needed
is an injury to the inner ear as a result of exposure to loud sound. It can be caused by an isolated exposure to a high decibel noise (like a gunshot, jet airplane, or an explosion near the ear) or due to an exposure to a lower decibel sound (like loud music or heavy machinery over a long period of time). It can be a result of a head injury if the eardrum is ruptured or there are other injuries to the inner ear.
Acoustic trauma
The most common symptom of acoustic trauma which may begin with jut having difficulty hearing high-frequency sounds and then later go on to have difficulty hearing lower frequency
Hearing loss
Permanent hearing loss after a single noise exposure.
Most commonly due to impulse noise (i.e. firearms)
Acoustic trauma
Gradual hearing loss due to noise exposure over an
extended period of time (months to years)
Gradually developing NIHL
NIHL - Noise Induced Hearing Loss
Middle ear trauma causes?
Direct and indirect
Direct force causes of middle ear tranmnas
• Careless while removal wax by himself or herself • Skull fracture may tear TM
• Hot slag fly into the ear
Pinaka-common actually ay cotton buds.
Indirect force causes ofmiddle ear trauma
Increase in violence and firearms • Barotrauma
Mx for middle ear trauma.
What you can do? First you give antibiotic and you can repair the eardrums
RUPTURED EARDRUM
o Sign and symptoms include:
Loss of hearing
▪ Blood drainage from the ear
o Typically heals spontaneously
Management nasal trauma?
Control the bleeding, give antibiotics, repair
the fracture
Structures in the ANTERIOR REGION OF THE NECK
Structures:
o Thyroidandcricoidcartilage
o Trachea
o
Major blood vessels: o Carotid arteries o Jugular veins
What zone of the neck
Carotid arteries
• Jugular and vertebral veins, pharynx and larynx
• Proximal trachea
• Recurrent laryngeal and vagal nerves *Straightforward surgical access
Zone 2
• Proximal common carotid arteries • Vertebral and subclavian arteries • Subclavian and jugular vein, trachea • Recurrent laryngeal and vagus nerves • Esophagus, thoracic duct. *Vascular injury mgt challenging, mortality high *Surgical access difficult-sternotomy or thoracotomy what zone in thnecke
Zone 1
• Extracranial carotid and vertebral arteries.
• Jugular veins
• Cranial nerves IX-XII
• Sympathetic trunk
*Surgical access difficult
*Craniotomy, mandibulotomy maneuvers *Associated high mortality.
what zone in the neck
zone 3
more frequent zone of the neck where injury happens
zone 2
what zone of the neck has more stab wounds
zone 1
Most reliable in the history of laryngeal trauma
Change in voice
