head and neck trauma

Question 1

why are geriatric pts more vulnerable to trauma?

Answer 1

• fragile bones
• less soft tissue, muscle,and fat
• decreased collogen production for flexibility

Question 2

what comorbitites contribute to a decreased ability for greiatric patients to compensate for trauma?

Answer 2

• reenal impairment
• loss of elasticity in blood vessels
• a decrease in effectiveness in hormones/neurotransmitters

Question 3

geriatric patients show signs of shock much earlier than younger patients. why might the heart rate not increase appropriatly to compensate to trauma?

Answer 3

the patient might be on anti arrythmic drugs such as beta blockers or calcium channel blockers which lower the heart rate

Question 4

how does beta blockers impact trauma compensation?

Answer 4

slows heartrate and prevents compensatory tachycardia

Question 5

how does calcium channel blockers impact trauma compensation?

Answer 5

inhibit vasoconstriction

Question 6

how does antiplatelets and anticoagulants impact trauma compensation?

Answer 6

hinders coagulation and increases risk of uncrontrolled bleeding

Question 7

what is cerebral atrophy?

Answer 7

the brain tissue shrinks with age

Question 8

what are implications of cerebral atrophy?

Answer 8

more room for blood and fluid to accumulate during a head trauma

Question 9

complications with penetrating traumas?

Answer 9

exsanguination
aspyxiation
neurological deficits

Question 10

complications with blunt trauma?

Answer 10

the risk of vascular damage like carotid artery injury which could lead to emboli or thrombi

Question 11

why are antihypertensive medications problematic with compensation for trauma?

Answer 11

they could prevent the nessasary vasocontriction the heart needs to increase

Question 12

blunt traumas can cause gowing hematomas. this poses the risk of what to develop?

Answer 12

they can compress ajacent structures causing airway obstruction or vascular compromise

Question 13

crushing the hyoid bone can dirsupt what?

Answer 13

swalowing

Question 14

crushing the thyroid cartilage can interefere with what?

Answer 14

the vocal cords

Question 15

injuries to the pharynx or esophagus can lead to what?

Answer 15

mediastinitis

Question 16

what conditions in geriatric patients put them at a higher risk for fluid overload with fluid administration?

Answer 16

heart failure or fibrotic changes in the heart, or renal inssuficiency

Question 17

what are key concerns with neck injuries

Answer 17

• massive bleeding
• airway obstruction
• delayed cerebral infarction

Question 18

what is the location of zone 1

Answer 18

between the clavical and cricoid cartilage

Question 19

zone 1 contains vital structures such as?

Answer 19

• major vessels
• nerves
• trachea, esophagus, apex of lungs, thyroid gland

Question 20

what major vessels are located in zone 1?

Answer 20

• arch of aorta
• braciocephalic artery
• carotid artery
• vertebral arteries

Question 21

the nerve in zone one, if damaged can cause neuro deficits in the arm. this nerve is called?

Answer 21

brachial plexus

Question 22

zone 1 is quite close to this cavitiy which is a major risk to hemorhage

Answer 22

the thoracic cavity

Question 23

where is zone 2 of the neck located

Answer 23

from the cricoid to the mandibular angle of the jaw

Question 24

which cranial nerves are at risk for damage in zone 2?

Answer 24

cranial nerves 10, 11, and 12

Question 25

where is zone 3 located on the neck?

Answer 25

from the mandibular angle to the base of the skull

Question 26

which cranial nerves are likly to get damaged in zone 3 of the neck?

Answer 26

7, 9, 10, 11, and 12

Question 27

out of all the zones, c spine fractures are more common uin this area?

Answer 27

zone 3

Question 28

what are potential consequences of mandibular fractures?

Answer 28

malocclusion and trismus

Question 29

what is malocclusion

Answer 29

misalignment of teeth

Question 30

mid face fractures (le forte fractures) invlove sites such as the maxilla and zygomatic floor. the MOI is often a high imact force. this could potentially effect what parts of the body?

Answer 30

the brain stem and spinal cord

Question 31

what symptoms can zygomatic fractures produce?

Answer 31

- numbness - altered vision - epistaxsis ( anterior or posterior

Question 32

orbital fracturs can result in subconjunctival hemmorrhage. what is this sign?

Answer 32

this is red eyes

Question 33

telecanthus is a sign often associated with which type of le fort fracture

Answer 33

le forte 3

Question 34

what is globe rupture

Answer 34

the loss of intraocular fluid and pressure

Question 35

what are signs of globe rupture?

Answer 35

- irregular pupil shape - conjuctival hemmorrhage - possible loss of vision

Question 36

what conditions can cause globe rupture?

Answer 36

- basal skull fracture - orbital bone fracture - retinal detachment

Question 37

what is anophthalmos

Answer 37

posterior displacement of the eyeball within the orbit (sunken eyes)

Question 38

why does anophthalmos happen?

Answer 38

results because of changes in globe volume and pressure

Question 39

hyphema

Answer 39

blood in the anterior chamber of the eye

Question 40

diplopia

Answer 40

blurry vision that occurs with severe eye injury

Question 41

tympanic membrane perforation of the ear can cause what symptoms?

Answer 41

- severe pain - hearing loss/deafness - ringing in the ear (tinnitus)

Question 42

what are complications for flail chest?

Answer 42

- impaired respiration and ventilations causing VQ mismatch - atelectasis

Question 43

what is the patho behind a pneumo thorax?

Answer 43

pleural pressure is normally negative to keep the lungs inflated. if the pleural pressure becomes equal to atmospheric pressure, the lung can collapse

Question 44

becks triad is a sign of pericardial tamonade and pneumothorax. what is this triad?

Answer 44

- hypotension - JVD - muffled heart sounds

Question 45

what is pericardial tamponade?

Answer 45

when lood fills up in the pericardial sac