Trauma symposium extra reading 1-8

Question 1

How do you examine pts presenting with facial trauma?

Answer 1

Using inspection and palpation, both intra orally and extra orally

Question 2

What comes under extra oral inspection?

Answer 2

standing in front of pt, checking for:
-bruising, soft tissue abrasions, alcerations

If the pt has any injury affecting eye, nasal complex or zygoma, you NEED to check pts ability to see- using a visual acuity test using a snellen chart. In practice, you can also hold up your fingers and ask pt to count how many

check for asymmetry
flattening of cheeck prominence

asymmetry of the eyes-hypoglobus (pupil is lower), or hyperglobus (pupil is higher than the affected side)

Check pts eye movements: Test forCN III, IV, VI and also extraocular muscles:
Test by moving fingers in H motion- checking for double vision

Question 3

What comes under extra oral palpation?

Answer 3

Palpating the margins of the orbit, nasal bones, zygomatic arches, mandicular condyle and lower border of mandible

Check for:
tenderness, deformities, movement of fracture fragments, crepitus or surgical emphysema-(feeling of popping bubbles, caused by air within tissues)

Question 4

How to examine intra orally?

Answer 4

Check for :
-obvious malocclusion
-mobility of fragments
-steps in occlusion
-intraoral bruising
-tears in gingivae

Question 5

What should you do after clinical examination?

Answer 5

Take radiographs

Question 6

which radiographs should you take?

Answer 6

OPG and PA are mandatory
If OPG is not available/possible can use lateral oblique views

Can also consider CT