Trauma To The Face Flashcards
swinging flashlight test is for
Check the swinging flashlight test for evidence of an afferent papillary defect (Marcus Gunn pupil).
With normal function, the swinging light results in brief dilation during movement followed by constriction when the light is directly over the eye.
With injury to the optic nerve or retina, the affected pupil will not constrict until the light is again moved to the unaffected eye.
The test is sensitive but not specific for optic nerve injury, because an afferent papillary defect may result from pathology anywhere along the visual pathway.
Binocular double vision suggests entrapment of the _____________, whereas monocular double vision suggests _______________.
extraocular muscles
lens dislocation
Loss of vision implies injury to the _________ or _________\
optic nerve or globe
The most common fractures are to the
nasal bone
The most common fractures are to the nasal bone, followed by
orbital floor, zygomaticomaxillary, maxillary sinuses, and mandibular ramus
Binocular double vision suggests entrapment of the
extraocular muscles
monocular double vision suggests
lens dislocation
Limitation on upward gaze
occurs with fractures of the inferior and medial orbital wall from
entrapment or injury to the inferior rectus, inferior oblique, or oculomotor
Lateral view inspection for
dish face with Le Fort III fractures
Frontal view inspection
for donkey face with Le Fort II or III fractures.
Worm’s view inspection for
enophthalmos with blow-out fractures or flattening of malar prominence with zygomatic arch fractures.
bilateral orbital ecchymosis
Raccoon eyes
mastoid ecchymosis
Battle’s sign
Raccoon eyes and Battle’s sign typically develop over several hours, suggesting
basilar skull fracture
Crepitus over any facial sinus suggests
sinus fracture
Nasal septal hematoma appears as
blue, boggy swelling on nasal septum.
Tongue blade test is
Patient without fracture can bite down on a tongue blade enough
to break blade twisted by examiner
Teardrop-shaped pupil indicates
globe injury
Normal distance between the medial canthi
normal is the width of the patient’s
globe
widening of this distance with normal interpupil-
lary distance, occurs with naso-orbito-ethmoid injuries
Telecanthus
Widening of the interpupillary distance
hypertelorism
results from a “blow-out” injury to the orbits, often resulting in blindness
hypertelorism
True or false
Cricothyrotomy is contraindicated in patients <8 years old because the cricothyroid membrane is not developed until age 8 and should be avoided in those between 9 and 12 years of age
True
In children with severe midfacial injury in whom oral
endotracheal intubation is not possible,______________ placement or _______________ serves as a temporizing measure pending emergency tracheostomy
laryngeal mask airway
needle cricothyrotomy
True or false
Cervical spine injury in children occurs at
higher levels and more often without bony radiographic injury (spinal cord injury without radiologic abnormality)
True
second most common facial fracture after nasal fractures
Mandible fractures
Most frequently fractured, part of the mandible
angle of mandible
initial imaging study in patients with mandibular fracture with a low clinical suspicion of injury
Panorex
Antibiotics for mandibular fracture
penicillin G 2 to 4 million units IV
(or clindamycin, 600 to 900 milligrams, in penicillin-allergic patients)
Le Fort injury one
alveolar
Le Fort injury II
zygomatic maxillary complex
Le Fort injury III
craniofacial dysjunction
Le Fort injury IV
Le Fort III and also involves the frontal bone
Characteristic location of tripod fracture
Identify
Retrobulbar hematoma
occurs when an object of small diameter strikes the globe without causing an orbital ridge or rim fracture
pure orbital blow-out fracture
involves only the orbital walls
