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Flashcards in 3 - MaxFace Deck (44)
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1
Q

most frequently fx’ed facial bone

A

nasal

2
Q

what is the best dx test for nasal fx?

A

trickster!! This is a clinical dx.

3
Q

What soft tissue issue are you looking for in a nasal fx? How will you treat it and why?

A

septal hematoma, drain it to reduce risk of septal necrosis

4
Q

Crepitus over maxillary sinus and CSF rhinorrhea following a head on MVA is most likely what type of fx?

A

frontal sinus

5
Q

Are frontal sinus fractures known to occur in an isolated area, or in conjunction with another fracture?

A

Look for another fx

6
Q

This fracture often has no obvious visible signs, but patient might c/o hearing loss, facial numbness, vertigo, or CSF otorrhea

A

temporal fx

7
Q

This fracture commonly presents with the Battle sign, which is bruising to the _______ or the Raccoon sign, which is bruising to the _______

A

Basilar skull fx
Battle = behind ear
Raccoon = black eyes

8
Q

This fracture presents with a flattened cheek, low eyelid swelling, pain opening mouth, cheek numbness, and possible vision changes

A

zygomatic complex fx

9
Q

Are zygomatic fractures typically isolated?

A

No, often a “tripod fx”

10
Q

Which bones are part of a tripod fx?

A

1) zygomatic arch
2) zygomaticofrontal suture
3) infraorbital foramen

11
Q

If you have a tripod fracture, which muscle is typically entrapped? Which direction CAN’T you look?

A

lateral rectus, can’t look medial

12
Q

What part of the orbit is most likely to fx?

A

floor

13
Q

When do you need to provide abx for orbital fx’s?

A

Always, risk of cellulitis = blindness

14
Q

orbital floor fractures cause pain and limited ROM when looking in what direction

A

up

15
Q

which sinus is mostly affected by orbital floor fractures?

A

Mostly maxillary….sometimes ethmoid

16
Q

If your patient has epistaxis and limitation of the lateral gaze, they most likely have what fracture? What sinus does this affect?

A

medial orbital, ethmoid

17
Q

this orbital fracture is life threatening and requires immediate neurosx consult

A

orbital roof

18
Q

This low impact orbital floor fracture causes muscle entrapment, but has few other symptoms

A

trapdoor fx, most common in kiddos

19
Q

During TBI, what confounding factor increases mortality by 50%? How can this be prevented?

A

hypoxia, provide O2 via NC, check blood gasses. Maintain adequate perfusion (MAP at 90mmHG)

20
Q

At what level on the GCS do you consider intubation

A

8-9 (depressed gag, not handling secretions)

21
Q

This brain bleed is most common in the elderly or alcoholics (brain atrophy). It is caused by a rupture of a vein or artery? Does it cross suture lines?

A

subdural, vein, yes (crescent)

22
Q

This brain bleed is fast. Patients will have brief periods of lucidity, but you shouldn’t assume they are getting better. It is caused by a rupture of a/an ________. Does it cross suture lines?

A

epidural, artery, no (lens)

23
Q

this type of brain bleed can lead to the blockage of CSF from the 3rd and 4th ventricles.

A

subarachnoid

24
Q

This type of brain bleed is deep within the brain and causes edema

A

contusion: coup/contracoup

25
Q

occurs when an athlete sustains a second concussion before being completely asymptomatic from the first and then experiences a rapid, usually fatal, neurologic decline

A

second impact syndrome

26
Q

This occurs as a result of shearing and edema that affects the nerves in the brain. It is often the cause of traumatic coma.

A

diffuse axonal injury

27
Q

How will you dx diffuse axonal injury (what imaging? and what does it look like on imaging?)

A

CT typically neg. Get MRI, look for

1) punctate hemorrhages
2) blurred gray/white matter border

28
Q

what type of skull fracture is most concerning for airway compromise?

A

Le Fort III (face smashed back and down)

29
Q

Where is the fracture line in a Le Fort III?

A

horizontally at mid eye level

30
Q

Where is the fracture line in Le Fort II?

A

triangle of nose, medial/inferior orbital, maxillary, pterygoid plates (nose smashed into dental space)

31
Q

which le fort fx is highest risk for blindness?

A

III

32
Q

This is the most common type of Le Fort fracture (use fancy name). The fracture line falls where?

A

Guerin’s fx (le fort I), horizontally across the maxilla/pterygoid plates

33
Q

what is the classification system for dental injuries?

A

Ellis:

1) chipped tooth, enamel only
2) enamel + dentin
3) enamel + dentin + pulp

34
Q

Which of the ellis classifications are true emergencies?

A

Ellis III

35
Q

If a tooth is avulsed, what do you do?

A

rinse only with saline, put it back. (unless baby tooth)….if you can’t, put in Hanks, which keeps it viable x 4-6 hours

36
Q

What ligament are you preserving by not rubbing the tooth?

A

periodontal ligament

37
Q

You’re told a patient has a maxillary fracture….what is the first thing you should assess.

A

airway. (maxillary has common a/w airway compromise)

38
Q

General observation….

A

CSF rhinorrhea seems to be bad.

39
Q

What type of history is a common MOI for a mandibular fx?

A

1) MVA

2) assault

40
Q

what are the s/s of mandibular fx?

A

1) malocclusion,
2) dental injury,
3) bruising on floor of mouth,
4) numbness of lower lip

41
Q

In general, open fractures require what medications?

A

1) tetanus

2) abx

42
Q

The _____nerve supplies the motor function of the face, and the _____nerve supplies the sensation.

A

Facial = motor
Trigeminal = sensation
(I know, they both do both….but this is a general rule of thumb….I think the exceptions are in the tongue)

43
Q

what is the best imaging for a mandibular fx?

A

Panorex (also dental fx’s)…all the rest is CT head

44
Q

when I say “craniofacial dysjunction” you say:

A

dish face….(Le Fort III)