46 - facial and neck trauma Flashcards Preview

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Flashcards in 46 - facial and neck trauma Deck (17)
1

approach to nose #

- rarely need xrays
- allow 2-3weeks for swelling to reduce then plastics
- inspect septum for hematoma
- if pushed back into infraorbital rim, then may need urgent surg

2

approach to midface #

- usually a direct frontal blow
- 3 lefort fractures
- all leforts need plastics

3

3 types of lefort #

1. upper alveolar rigde and upper teeth will be mobile
2. though or just inf. to orbital rim and teeth will move as a unit
3. across the orbits and the entire face will be mobile

4

approach to mandibular #

- usually 2 site for injury
- suspect when: irregular bite, feels misaligned, point tenderness, loose teeth, strong pain when biting
- panorex plain films

5

approach to temporomandibular dislocation

- malocclusion but no bony tenderness
- sedate and replace

6

zygomatic #

- if depressed, should be elevated surgically
- can be done outpatient

7

4 methods to minimize scarring on face

1. remove at day 5
2. use smallest possible - 5-0 or 6-0
3. place at regualar, close intervals
4. adive to avoid sunlight and use sunscreen

8

5 unique facial lacerations issues

1. search for fat protrusion in the eyelid
2. repair of skin over cart. should be done by exp. provider
3. should ensure all edges line up perfectly
4. lip should start along the vermillion border to ensure they line up well
5. ensure people are aware of potential for bleeds along the labial art. in lips

9

4 types of dental injury

1. avulsion
2. fracture
3. subluxation (loose)
4. impaction

10

mgmt of avulsion

- rinse socket with NS
- sterilize tooth and put in socket
- if not in milk
- xray and refer

11

mgmt of fracture

- check if residual tooth loose
- iff ellis 3-4 (pulp) cover with bone wax for pain releif

12

mgmt of subluxation

- palpate all front teeth
- refer to dent

13

mgmt of impaction

- refer

14

signs of obst. in neck penetration

- stridor
- ab. breathing
- incr. muscle use
- swelling or masses
- bleeding from mouth

15

what to do if obst.

intubation by EXPERienced provider

16

3 zones of neck and imaging

1 and 3 - difficult so use imaging
2 - can explore surgically

17

neck zone border

1. above mandibles
2. mandible to clavicle
3. below clavicle