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Flashcards in face, head, neck, eye trauma Deck (15):
1

SACLP DAP anatomy of the skull

Skin (epidermis/dermis
connective tissue (dense)
Aponeurosis
Loose connective tissue
Periostium (skull)
Dura mater (nondistensible)
Arachnoid villa
Pia Mater (contiguous with brain surface)

2

Le fort fractures I, II, II
-exam
-management

Le Fort I- across the maxillae
Le Fort II- across the zygomatic, nasal ethmoid bone, orbit
Le Fort III- across the frontal bone, nasal ethmoid facial detachment

exam: grab upper teeth and shake
manage: airway, nothing in nose, delayed operating room

3

Glasgow Coma Scale

Eye opening
4 spontaneous
3 to verbal command
2 to pain
1 no response

verbal response
5 oriented and converse
4 disoriented and converse
3 inappropriate words
2 incomprehensible sounds
1 no response

motor response
6 obeys verbal commands
5 localizes pain
4 withdraws from pain (flexion)
3 abnormal flexion in response to pain (decorticate)
2 extension in response to pain (decerebrate)
1 no response

4

S&S of traumatic brain injury
-GCS indication of mild, mod, severe

-N/V
-irregular breathing patterns
-clear CSF or blood leaking from ears or nose
-unequal pupil size
-Altered mental status
GCS 15-13 mild, 12-9 mod, 8-3 svere
-paralysis or disability on one side of body
-seizures
-high blood pressure with slow pulse

5

monro-kellie hypothesis and effects of cranial insult injury on the body

hypothesis: blood, brain, CSF
effects:
-cranial insult
-tissue edema
-compression of arteries
-decrease O2 with death of brain cells
-increase ICP with compression of brain stem and resp center
-increase ICP due to increase blood volume
-increase ICP
-decrease cerebral blood flow
-edema around necrotic tissue
-CO2 accumulates, vasodilation

6

Focal, diffuse, primary vs. secondary in TBI

types of TBI

focal
-cerebral contusion
-epidural hematoma
-subdural hematoma
-intracerebral hemorrhage

diffuse
-concusion
-diffuse axonal injury

primary vs. secondary
-hypoxic-ischemic

7

cerebral contusion

-capillary bleeding
-blunt head trauma
-coup vs. contrecoup
SS:
-confusion
-neuro changes personality, vision, speech

8

epidural hematoma

-middle meningeal artery (blood btw dura and skull, btw sutures)
-loss of consciousness (LOC) followed by lucid interval
-hemiparesis (weakness) on opposite side of injury

9

subdural hematoma

-shearing of bridgin veins btw brain and dura not btw sutures
-elderly pts
-slower progression to LOC
-hemiparesis on opposite side of injury

10

intracerebral hematoma

-blood collects in brain
-may also enter ventricles
-signs/symptoms highly dependent on size and location

11

concussion

-brief change in mental status
-CT scan normal
-may/not have LOC
-loss of concentration, disorientation
-retrograde & antegrade amnesia
-visual and sensory disturbances
-mood or personality changes

12

diffuse axonal injury

-CT scan normal
-may see loss of grey-white junction
-rotational forces cause microscopic injury
-AMS

13

management of decreased ICP

-head elevated
-control anxiety/pain
-hyperventilate

14

three zones of neck trauma

I- shoulder to cricoid
II- from cricoid to under the chin
III- back of the neck from chin up

15

possible damage of neck trauma

-primary concern is the airway
-consider C-spine (GSW)
-esophageal injury
-carotid artery/jugular vein
-brachial plexus