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Flashcards in The Head Deck (53)
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1

Mandibular Fractures

Caused by a direct blow.
Sx's:
Deformity
Loss of occlusion (loss of bite)
Pain with biting
Bleeding around the teeth
Lower lip anesthesia

2

Mandible Fracture Management

Temporary immobilization with elastic wrap followed by reduction and fixation.

3

Mandible Dislocation

Caused by a blow to an open moth from the side.

Sx's:
Locked-open jaw position
Decreased ROM with poor occlusion
Pain

4

Mandible Dislocation Management

Ice, immobilization and reduction
Follow-up with a soft diet, NSAIDs and analgesics as needed.
Gradual return to activity, 7-10 days, post acute
Can be recurrent, result in malocclusion, or TMJ dysfunction.

5

Temporomandibular Joint Dysfunction

Disk condyle derangement (disk is positioned anteriorly).

Sx's:
Headaches, earaches
vertigo
Inflammation, neck pain, muscle guarding and development of trigger points.
Hyper-or hypomobility, muscle dysfunction
Limited ROM
Clicking, popping

6

Management of TMJ Dysfunction

Custom fit, removable mouth piece.
Strengthening and/or ROM exercises.
Referral if symptoms do not resolve.

7

Zygomatic Complex Fracture

Caused by a direct blow.

Sx's:
Deformity, nosebleed
Pain
Diplopia (double vision)
Numbness

Always monitor airway, get to the hospital right away.

8

Zygomatic Complex Fracture Management

Ice
Referral
Protective gear upon return to play.

9

Maxillary Fracture

Caused by a blow to the upper jaw.

Sx's:
Pain
Malocclusion
Epitaxis
Dilopia
Numbness; lip and cheek

10

Maxillary Fracture Management

Maintain airway
Monitor for brain injury
Transport to the hospital immediately, upright and leaning forward, if conscious (This allows for external drainage of saliva and blood).
Fracture reduction, fixation and immobilization.

11

Facial Lacerations

Caused by a direct impact and indirect compressive force.
Contact with a sharp object.

Sx's:
Pain and substantial bleeding.

12

Facial Laceration Management

Control Bleeding
Cover
Referral (if needed)
Monitor for head injury

13

For Any Face or Head Injury

Check for neck or head injury.

14

Prevention of Dental Injuries

Mouth guards should be routinely worn when engaged in contact or collision sports.
Make them required.
Concussion prevention (maybe)
Practice food dental hygiene and disease prevention (Gingivitis. Periodontitis)
Yearly dental screenings
Cavity prevention.

15

Tooth Fractures

Caused by impact to the jaw and direct trauma.

Sx's:
Uncomplicated fractures produce fragments without bleeding.
Complicated fractures produce bleeding and exposure of the tooth chamber which produces pain.

16

Tooth Fracture Management

Save the fractured pieces
If pt is not in pain or sensitive to air or cold, the follow up can wait up to 24-48 hours.
Control bleeding with gauze
Cosmetic reconstruction of the tooth.

With a root fracture, the athlete can continue to play but must follow-up immediately after the competition ends.

Rule out fracture
Monitor for concussion.

17

Tooth Subluxation, Luxaion and Avulsion

Luxation-tooth is out but still attached
Avulsion-tooth is completely out

Caused by a direct blow.

Sx's
Tooth may be loosned or dislodged
Subluxed tooth may be loose within socket with little or no pain.
Luxations, no fracture has occured, but there is displacement of the tooth.

18

Tooth Subluxation, Luxation and Avulsion Management

Subluxed tooth; referral should occur within the first 48 hours.
Luxated tooth, re-positioning should be attempted along with immediate follow-up (fuck that, refer).
Avusled teeth should not be re-implanted except by a dentist. Save the tooth. (Recent studies suggest that this should be attempted if the athlete is willing, this creates the best environment for the tooth).

19

Nasal Fracture and Chondral Separation

Caused by a direct blow.

Sx's:
Separation of frontal processes of maxilla, separation of lateral cartilage or combination of both.
Profuse bleeding
Immediate Swelling
Deformity
Pain

20

Nasal Fracture and Chondral Separation Management

Control bleeding
MONITOR AIRWAY
Refer for x-ray exam and reduction
Uncomplicated simple fractures may pose few problems and allow the athlete a quick return to activity (or even to finish competition)
Splinting (not really)
Nose guard
Monitor for concussion.

21

Deviated Septum

Caused by compression or lateral trauma.

Sx's
Bleeding
Septal hematoma may form
Nasal Pain

22

Deviated Septum Management

Hematoma requires compression and drainage.
Following drainage, a wick is inserted to allow for further drainage.
Packing to prevent a return of the hematoma.
An untreated hematoma can result in formation of an abcess resulting in bone and cartilage loss and deformity.

23

Epitaxis

(Nosebleed)
Caused by direct blow
sinus infection
Humidity
Allergies
Foreign Body

Sx's:
Bleeding from he anterior aspect of the septum
Generally presents with minimal bleeding and resolves spontaneously.
Severe bledding may require medial attention.

24

Epitaxis Management

Sit upright
Cold with Compression
Put pressure on the affected nostril (gauze between the upper lip and gum - limits blood supply.
If bleeding does not cease in 5 minutes then an astringent or styptic may be applied. Guaze or cootn nose plug to encourage clotting . Afrin
After the bleeding has ceased the athlete can return to play if there are no other injuries.
Should be reminded not to blow the nose for at least 2 hours.

25

Auricular Hematoma

(Cauliflower ear)
Caused by compression and or shear force. Single or repeated trauma, Subcutaneous bleeding.

Sx's:
Separation and tearing of overlying tissue and cartilage of the ear.
Hemorrhaging and fluid accumulation
If untreated, coagulation, organization and fibrosis occurs.

26

Auricular Hematoma Management

Proper ear protection
Icing to minimize hemorrhage
Prevent fluid solidification (physician aspiration, packing, pressure, collodion pack).
The key is compression.

27

Tympanic Membrane Rupture

Caused by a fall or slap to the unprotected ear, or sudden underwater pressure change.

Sx's:
Loud pop, followed by pain, nausea, vomiting and dizziness.
Hearing loss
Visible rupture using an otoscope.

28

Tympanic membrane Rupture Management

Small to moderate perforations usually heal spontaneously in 1-2 weeks.
Infection can occur and must be continually monitored.

29

Otitis Externa

(Swimmers Ear)
Caused by an infection of the ear canal caused by a bacillus.
Water becomes trapped by a cyst, bone growth, earwax or swelling of the canal caused by allergies.

Sx's:
Pain and dizziness, itching, discharge and possible loss of hearing.

30

Otitis Externa Management

Prevent by keeping the canal dry.
Ear drops with boric acid and alcohol before and after swimming.
Physician referral for antibiotics, acidification of the ear canal to kill bacteria and to rule out tympanic membrane rupture.