CHP 34: FACE/NECK TRAUMA

Question 1

what three cranial nerves control ocular movement

Answer 1

3, 4, and 6 - oculomotor, trochlear, abducens

Question 2

what cranial nerve is responsible for sense of vision

Answer 2

2 - optic nerve

Question 3

how many teeth does adult have

Answer 3

32

Question 4

what is the adam’s apple

Answer 4

thyroid cartilage

Question 5

what is periorbital ecchymosis

Answer 5

raccoon eyes

Question 6

what is retro auricular ecchymosis

Answer 6

battle sign

Question 7

what is diplopia

Answer 7

double vision

Question 8

what is hemianopsia

Answer 8

loss of one half of vertical visual field

Question 9

what is the focus with face and neck injuries

Answer 9

protecting the airway

Question 10

what injuries can also be present with maxilla fractures

Answer 10

traumatic brain injuries and cervical spine injuries

Question 11

what is the first clue to presence of maxillofacial fracture

Answer 11

ecchymosis

Question 12

what type of injury should you suspect with mandibular fractures

Answer 12

malocclusion - misalignment of teeth

Question 13

what happens with temporomandibular joint dislocation

Answer 13

patient opens mouth widely, feels pop, and then can’t close their mouth - locked in wide-open position

Question 14

what is Le Fort 1 fracture

Answer 14

horizontal fracture of maxilla and hard palate, separating them from skull

Question 15

what is Le Fort 2 fracture

Answer 15

pyramid fracture involving nasal bone and maxilla

Question 16

what is Le Fort 3 fracture

Answer 16

fracture of all midfacial pones separating entire midface from cranium

Question 17

what is Le Fort 4 fracture

Answer 17

Le Fort 3 fracture with frontal bone fracture

Question 18

S/S of Le Fort fractures

Answer 18

severe facial pain, paresthesia of upper lip, visual disturbances, swelling, hemorrhage, deformity of face

Question 19

symptoms of orbital fracture

Answer 19

diplopia and loss of sensation above eyebrow or cheek

Question 20

what is enophthalmos traumaticus

Answer 20

eyeball retracts into space created when cavity is enlarged after orbital fracture

Question 21

what does stimulation of the oculocardiac reflex do

Answer 21

causes decreased heart rate by 20%

Question 22

what medication can stop nose bleeds

Answer 22

aerosoled alpha adrenergic agents

Question 23

what material can’t be flushed out of eyes

Answer 23

rust and metal

Question 24

what is hyphema

Answer 24

bleeding into anterior chamber of the eye that obscures vision

Question 25

what is an eight-ball hyphema

Answer 25

dark-colored clot that covers entire anterior chamber of eye (non-acute injury)

Question 26

when is retinal detachment most often seen

Answer 26

sports injuries, especially boxing

Question 27

what painless eye injury causes flashing lights, specks, or "floaters" in vision field

Answer 27

retinal detachment

Question 28

symptoms with central retinal artery occlusion

Answer 28

sudden, painless loss of vision in affected eye

Question 29

how will the eye appear after acid burn

Answer 29

white and opaque

Question 30

what is the most important symptom of an eye injury

Answer 30

visual loss that does not improve when the patient blinks

Question 31

what does double vision usually involve

Answer 31

trauma to extraocular muscles

Question 32

how many cardinal positions of gaze are there

Answer 32

six

Question 33

what is dysconjugate gaze

Answer 33

discoordination between movements of two eyes

Question 34

what is sympathetic eye movement

Answer 34

movement of both eyes in unison

Question 35

how to decrease intraocular pressure

Answer 35

elevate backboard 40 degrees and discourage coughing

Question 36

what is hemorrhagic otorrhea

Answer 36

blood drainage from ear

Question 37

what are the boundaries of zone 1 of the neck

Answer 37

area between cricoid cartilage and clavicles/sternum

Question 38

what are the boundaries of zone 2 of the neck

Answer 38

area between angle of mandible and cricoid cartilage

Question 39

what are the boundaries of zone 3 of the neck

Answer 39

area above angle of the mandible

Question 40

which neck zone has the association with highest mortality rate

Answer 40

1

Question 41

which neck zone is the most difficult to recognize and which zone has the most obvious injuries

Answer 41

not obvious: 1 obvious: 2

Question 42

what happens if the jugular veins are exposed to the environment

Answer 42

may create air embolism

Question 43

signs of neurogenic shock

Answer 43

hypotension, slow HR, lack of diaphoresis

Question 44

what is tracheal transection and its S/S

Answer 44

trachea separation from larynx labored breathing, stridor, hoarseness, hemoptysis, structural irregularity

Question 45

what can esophageal perforation result in

Answer 45

mediastinitis - inflammation of the mediastinum from leakage of gastric contents into thoracic cavity

Question 46

S/S of esophageal perforation

Answer 46

dysphagia, hematemesis, hemoptysis (aspiration of blood)