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BDS4 Oral Surgery > TUT - OMFS trauma > Flashcards

TUT - OMFS trauma Flashcards

1
Q

What is stridor?

A

Inspiratory noise and sign of airway obstruction

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2
Q

What is wheeze?

A

Expiratory noise and sign of airway obstruction

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3
Q

What is stertor?

A

Inspiratory noise and sign of airway obstruction at the top of airway (sounds like snoring)

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4
Q

What is a visual sign of airway obstruction?

A
  • cyanosis
  • choking
  • red face
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5
Q

What are difficult airways according to ATLS?

A
  • uncleared neck (hard collar)
  • poor mouth opening
  • intoxicated or reduced GCS
  • beards
  • overweight
  • arthritic necks (silver trauma)
  • maxillofacial trauma
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6
Q

What injuries are associated with a risk to the airway?

A
  • bilateral mandible fracture (muscles pull mandible backwards and tongue occludes airway)
  • midface or pancake fractures
  • neck injuries
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7
Q

What airway manoeuvres are available?

A
  • chin lift
  • jaw thrust
  • oropharyngeal airway
  • nasopharyngeal airway
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8
Q

What contraindicates a chin lift?

A
  • fractured mandible
  • fractured neck
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9
Q

What contraindicates a jaw thrust?

A

If fingers are resting on mobile bones

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10
Q

What contraindicates an oropharyngeal airway?

A
  • reduced mouth opening
  • plastic collar
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11
Q

What contraindicates a nasopharyngeal airway?

A

Fractured midface without scan to guide airway

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12
Q

What are common sites are bleeding emergencies?

A
  • major vessels
  • maxilla
  • mandible
  • nose
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13
Q

What adjuncts can be used to stop bleeding in midface fractures?

A
  • tranexamic acid
  • interventional radiology (balloons via veins)
  • medication impregnated gauze
  • epistat
  • reduce fractures to apply pressure (sedation and intubated)
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14
Q

What is orbital compartment syndrome?

A
  • retrobulbar bleeding
  • fifteen minutes to blindness
  • surgical emergency but not more important than primary ATLS
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15
Q

What is involved in secondary sight assessment?

A
  • pupils (check disability)
  • eye movement or paralysis
  • pain
  • chemises (conjunctiva looks like snot)
  • proptosis (sticking out, rock hard)
  • visual activity (red colour sight is lost first)
  • numbness in surrounding tissue
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16
Q

How do you manage orbital compartment syndrome?

A
  • steroids (although does not replace surgical intervention)
  • 999
17
Q

What are signs of broken bones?

A
  • numbness
  • mobility
  • visual changes
  • pupils acuity and movement
  • symmetry
  • CSF
18
Q

What imaging is required for broken bones?

A
  • 2 plain films
  • or CT
  • contact OMFS ASAP
19
Q

What is the core advice for OMFS trauma?

A
  • tetanus
  • open fractures require antibiotic cover or fracture through dentate part of mandible
  • refer all fractures
  • fast until contact with OMFS
  • no nose blowing
  • teeth can be placed back
  • check eyes
20
Q

What history is important regarding fractures?

A
  • blunt or sharp injury
  • when
  • any other issues
  • drugs/alcohol/smoking (smoking increases complications)
  • PMH (relevant anti-coag, diabetes)
  • allergies
  • social implications
21
Q

Define a laceration.

A

Blunt force to soft tissue (burst or contusion around site of injury)

22
Q

Define an incised wound.

A

Cut by a sharp object

23
Q

What are hard signs of mandible fracture?

A
  • 2 point vertical mobility
  • sublingual haematoma
  • contralateral numbness to side of impact
  • ipsilateral numbness is impact was distant to extraosseous mental nerve
24
Q

What are hard signs of orbital fracture?

A
  • no distinctive signs, presents with multiple signs
  • infraorbital paraesthesia
  • diplopia
  • subconjunctival bleed
25
Q

What are hard signs of zygoma fracture?

A
  • unilateral epistaxis when nose not injured
  • eyebrow sign (gas escapes from sinus to above eye)
  • paraesthesia when trauma is distant to extraosseous infraorbital nerve
  • buttress/arch/infraorbital/frontal zygomatic suture tenderness when not punched in all areas
26
Q

What are hard signs of midface fracture?

A
  • mobility of maxilla when skull base stabilised
  • often numb
  • epistaxis
27
Q

What is le fort 1?

A

Palate only

28
Q

What is le fort 2?

A

Palate and nose

29
Q

What is le fort 3?

A

Palate, nose and orbit

30
Q

What bone must break in order for it to be considered a le fort fracture?

A

Pterygoid plate

31
Q

What are the hard signs of naso-orbito-ethmoidal fracture?

A
  • retropositioned nose
  • buttress not tender
  • epistaxis
  • often numb
  • steps at IOR, pyriform, glabella
  • hyperteloric (eyes drift apart)
32
Q

What are the hard signs of nasomaxillary fracture?

A
  • tender IOR and pyriform
  • buttress intact
  • numb
  • unilateral epistaxis without blow to nose
33
Q

What imaging is required for mandible fracture?

A

OPT and PA

34
Q

What imaging is required for zygoma fracture?

A

2 PA

35
Q

What imaging is required for orbit fracture?

A

2 PA

36
Q

How do you describe a fracture in the premolar region?

A

Parasymphaseal

37
Q

How do you describe a fracture in the 7/8 region?

A

Angle

BDS4 Oral Surgery (23 decks)

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