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ENT SOH > Trauma > Flashcards

Trauma Flashcards

1
Q

What is the most common broken bone in the body?

A

Nose

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2
Q

Nose - common mechanism of injury

A

Fight
Sport
Falls

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3
Q

Nose - key history points

A

Any nosebleeds?

Any difficulties breathing?

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4
Q

Nose - clinical examination

A 
Look at person from behind and tilt their head back 
- to view any deviation 
bruising
swelling
facial tenderness
palpate around the orbit 
- check for bony orbital fracture
look at extra ocular movements
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5
Q

Nose - Septal haematoma

A

Boggy swelling in one of the nasal apertures which may lead to destruction of the septum as the septal cartilage is avascular

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6
Q

How do you know if the nose is deviated?

A

The nose will be firm and not move

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7
Q

Nose - septal haematoma - management

A

Drain haematoma so that blood supply to the nose is not lost

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8
Q

Nasal fracture - fixed and one sided

A

Think of septal injury

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9
Q

Nasal fracture - which side do most noses deviate to?

A 
Right side (left side is broken) 
- bcos most people are right handed during a fight
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10
Q

Nasal fracture - investigations?

A

Clinical diagnosis

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11
Q

Nasal fracture - management

A

Push nose back into place asap

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12
Q

Nasal fracture - complications

A

Epitaxis
CSF leak
Asomnia

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13
Q

Epitaxis - definition

A

Nose bleed

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14
Q

Epitaxis - common sites

A

Little’s area of anastomosis in the nasal septum
Venous plexus anastamosis
Internal and external carotid arteries

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15
Q

Epitaxis - how to stop the bleed

A

Squeeze lower part o the nose and the nosebleed should stop in around 10 mins
Sit patient forward

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16
Q

Epitaxis - management after bleeding has stopped

A

Clean out nose to find bleeding source
Remove blood clot (by suction or nose blowing)
Cauterise vessel - silver nitrate
DO NOT sedate patient

17
Q

Ear - pinna haematoma

A

Bleeding under the perichondrium which has lifted the perichondrium up

18
Q

Ear - what can pinna haematoma result in?

A

Cauliflower ear

  • blood deposition
  • calcium
  • this can become an abcess if not drained
19
Q

Ear - pinna haematoma cause

A

Rugby injury

20
Q

Ear - pinna haematoma management

A

Aspirate or
Incision and drainage or
Pressure dressing

21
Q

Ear - management of laceration

A

Local anaesthetic
Debridement
Put ear back in anatomical position of suturing
Wrap detached ear in gauze in box of ice
Give antibiotics for 5 days

22
Q

Temporal bone fracture - points from history

A

Hearing loss
Facial palsy
Vertigo
CSF leak

23
Q

Temporal bone fracture - clinical examination

A 
Bruising behind the ear 
Bruising around the eyes 
Check tympanic membrane and ear canal function 
Test CNVII 
Hearing test
24
Q

Temporal bone fracture - otic capsule involvement is more or less common?

A

Less common

25
Q

Temporal bone fracture - otic capsule involvement

A

Transverse fracture
Due to frontal blow which causes the compression of the skull
Can cross the IAM causing damage to auditory and facial nerves
Vertigo

26
Q

Temporal bone fracture - otic capsule not involved

A

Longitudinal fracture
Due to lateral blow
Can get bleeding from the external ear canal

27
Q

Neck - zone 1

A

Lower part of neck

- trachea, oesophagus, thoracic duct, thyroid, spinal cord, brachiocephalic vein, subclavian vein, common carotid

28
Q

Neck - zone 2

A

Most accessible area

- larynx, hydropharynx, spinal cord, CN X, CN XI, CNXII, carotids, internal jugular vein

29
Q

Neck - zone 3

A

Upper part of the neck

- pharynx, carotids, IJV, spinal cord

30
Q

Neck - penetrating injuries usually affect which neck zone?

A

Zone 2 (most accessible area of the neck)

31
Q

Neck - how do you differentiate between proper / superficial penetrating injuries?

A

If penetration goes through the platysma then it is penetrating

32
Q

Neck - penetrating injury management

A

Surgical exploration OR
Laryngoscopy, bronchoscopy OR
Angiography

33
Q

Facial trauma - investigations

A

CT scan

34
Q

Le Fort 1

A

Horizontal

Passes horizontally above teeth

35
Q

Le Fort 2

A

Pyramidal

Can get significant airway obstruction

36
Q

Le Fort 3

A

Craniofacial dysfunction

ENT SOH (9 decks)

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