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OMFS > Trauma > Flashcards

Trauma Flashcards

1
Q

Force, in psi, generated by a canine bite

A

200-450psi

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2
Q

Typical bacteria seen in dog and cat bites

A

1 - Aerobic and anaerobic

2- Pasturella most common

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3
Q

Appropriate antibiotics for Dog and Cat bites

A

Augmentin

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4
Q

If a pediatric patient is bitten by a dog or cat and has a penicillin allergy, what is the next in line for antibiotics?

A

Clindamycin plus trimethoprim/sulfamethoxazole (Bactrim)

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5
Q

If an adult is bitten by a dog or cat and has a penicillin allergy, what is the next in line for antibiotics?

A

Doxycycline or Clindamycin/cipro

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6
Q

What size of lip defect can be present in order to obtain primary closure

A

If <1/3 of the lip is gone, the lip can be closed primarily

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7
Q

If 1/3 to 2/3 of the lip is gone, what are options for closure?

A

Reverse Abbe flap
Schuchardt procedure
Johannson step procedure

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8
Q

If the commissure of the lower lip is involved in reconstruction, what is the name of the flap procedure that can be used for reconstruction?

A

Estlander Flap

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9
Q

If >2/3 of the lower lip is defected, what are flap options for reconstruction?

A
  • Gilles Flap
  • Karapandzic flap
  • Modified Webster Bernard flap
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10
Q

Anatomic layers encountered during a tracheostomy

A 
1 - Skin
2 - Sub q
3 - Linea Albea ( confluence of anterior and middle layer of deep cervical fascia)
4 - Thyroid
5 - Pretracheal fascia
6 - Trachea
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11
Q

Posterior nose bleeds usually come from what venous plexus?

A

Posterior nose bleeds usually come from Woodruff’s plexus

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12
Q

Anterior nasal bleeds usually come from what plexus?

A

Anterior basal bleeds usually come from Kiesselbachs plexus

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13
Q

Reversal agent for brown recluse bite on face

A

Dapsone

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14
Q

What are the indications for removing a tooth that is in the fracture line?

A
  1. Tooth luxated from its socket and/or interfering with reduction of the fracture.
  2. Tooth that is fractured
  3. Tooth with advanced dental caries carrying a significant risk of abscess during treatment.
  4. Tooth with advanced periodontal disease with mobility which would not contribute to establishment of stable occlusion.
  5. Tooth with existing pathology such as cyst formation or pericoronitis.
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15
Q

What are the indications for leaving a tooth that is in the fracture line?

A

Indications to leave teeth in the line of fracture

  1. Tooth that does not interfere with reduction and fixation of fracture.
  2. If tooth removal requires removal of excessive amount of bone so as to compromise the fracture site and possible plate/screw fixation.
  3. Tooth that is in good condition and assists in establishing occlusion and reducing the fracture.
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16
Q

How many vertical buttresses does the midface have?

A

6 total vertical buttresses
2 Nasofrontal
2 Lateral zygomatic
2 Pterygomaxillary

17
Q

What is the typical plate width recommended for fixation of the zygomatico-frontal suture?

A

1.3mm plate for the ZF suture

18
Q

What is the typical plate width recommended for fixation fo the zygomatic arch?

A

1.5mm for fixation of the zygomatic arch

19
Q

What is the typical plate width recommended for plating the infra-orbital rim and the naso-frontal suture?

A

1.3mm plates

20
Q

What is the typical width and shape of plate used to stabilize the lefort I fracture

A

1.5mm L plate

21
Q

What is the name of the disimpaction forcep used to mobilize and align the maxilla following a lefort fracture?

A

Rowe disimpaction forcep will assist with disimpaction and repositioning of the maxilla and the midface

22
Q

If a CT scan is not available, what imaging could be obtained for sufficient evaluation of a mandibular fracture?

A

A pan and a reverse Townes view

23
Q

What are the two primary goals of treating mandibular fractures

A
  1. Form and function

2. Osseous union

24
Q

What is the benefit of using IMF screws over traditional wiring methods?

A

Pigadas et al showed a significant reduction in glove perforations and a decrease in operative time

25
Q

What specific mandibular fracture has been show to have the highest rate of postoperative complications of all mandíbulas fractures?

A

The mandibular angle with the presence of a third molar

26
Q

What is the theoretical advantage of primary bone grafting a severely atrophic fractures mandible?

A

Corticocancellous bone graft would augment the osteogenic potential if the atrophic mandible and enhance healing

27
Q

What are the most common bacteria found in cultures of mandibular fractures?

A

Aerobic and anaerobic

Staphylococcus, alpha-hemolytic streptococcus, bacteroides, and gram negative organisms

28
Q

When discussing ballistic injuries, what has a greater affect on the wounding power? Mass of the projectile or velocity of the projectile?

A

Velocity of the projectile

29
Q

In ft/sec, what is the rate at which a low velocity weapon becomes a high velocity weapon?

A

1200 ft/sec

This can also be defined as
Low velocity - 350 m/sex
Medium velocity - 350-600m/sec
High velocity - >600m/sec

30
Q

What velocity of projectile is required to fracture bone?

A

65 m/sec will fracture bone

50 m/sec will penetrate skin

31
Q

How many zones of the neck are there when discussing penetrating neck trauma?
Name the anatomical boundaries for each zone

A

3
Zone I - clavicles to cricoid
Zone II - cricoid to angle of mandible
Zone III - angle of mandible to skull base

32
Q

Which penetrating neck injury zone is associated with the highest mortality rate and why?

A

Zone I - because the risk of injury to great vessels is most common in this area

33
Q

Which penetrating neck zone is the largest of the zones, and thus most commonly involved in penetrating neck trauma?

A

Zone II

34
Q

A downside of using meglumine diatrizoate as a contrast media in penetrating neck injuries…
What is the better option if gag and cough reflexes are impaired?

A

Meglumine diatrizoate causes a severe chemical pneumonitis if aspirated, barium should be used to the gag and cough reflexes are impaired

35
Q

What are signs of tracheal injury?

A 
Subcutaneous emphysema 
Stridor
Hoarseness 
Dysphonia
Hemoptysis

OMFS (14 decks)

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