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Flashcards in Trauma Deck (36)
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1

What is the most common broken bone in the body?

Nose

2

Nose - common mechanism of injury

Fight
Sport
Falls

3

Nose - key history points

Any nosebleeds?
Any difficulties breathing?

4

Nose - clinical examination

Look at person from behind and tilt their head back
- to view any deviation
bruising
swelling
facial tenderness
palpate around the orbit
- check for bony orbital fracture
look at extra ocular movements

5

Nose - Septal haematoma

Boggy swelling in one of the nasal apertures which may lead to destruction of the septum as the septal cartilage is avascular

6

How do you know if the nose is deviated?

The nose will be firm and not move

7

Nose - septal haematoma - management

Drain haematoma so that blood supply to the nose is not lost

8

Nasal fracture - fixed and one sided

Think of septal injury

9

Nasal fracture - which side do most noses deviate to?

Right side (left side is broken)
- bcos most people are right handed during a fight

10

Nasal fracture - investigations?

Clinical diagnosis

11

Nasal fracture - management

Push nose back into place asap

12

Nasal fracture - complications

Epitaxis
CSF leak
Asomnia

13

Epitaxis - definition

Nose bleed

14

Epitaxis - common sites

Little's area of anastomosis in the nasal septum
Venous plexus anastamosis
Internal and external carotid arteries

15

Epitaxis - how to stop the bleed

Squeeze lower part o the nose and the nosebleed should stop in around 10 mins
Sit patient forward

16

Epitaxis - management after bleeding has stopped

Clean out nose to find bleeding source
Remove blood clot (by suction or nose blowing)
Cauterise vessel - silver nitrate
DO NOT sedate patient

17

Ear - pinna haematoma

Bleeding under the perichondrium which has lifted the perichondrium up

18

Ear - what can pinna haematoma result in?

Cauliflower ear
- blood deposition
- calcium
- this can become an abcess if not drained

19

Ear - pinna haematoma cause

Rugby injury

20

Ear - pinna haematoma management

Aspirate or
Incision and drainage or
Pressure dressing

21

Ear - management of laceration

Local anaesthetic
Debridement
Put ear back in anatomical position of suturing
Wrap detached ear in gauze in box of ice
Give antibiotics for 5 days

22

Temporal bone fracture - points from history

Hearing loss
Facial palsy
Vertigo
CSF leak

23

Temporal bone fracture - clinical examination

Bruising behind the ear
Bruising around the eyes
Check tympanic membrane and ear canal function
Test CNVII
Hearing test

24

Temporal bone fracture - otic capsule involvement is more or less common?

Less common

25

Temporal bone fracture - otic capsule involvement

Transverse fracture
Due to frontal blow which causes the compression of the skull
Can cross the IAM causing damage to auditory and facial nerves
Vertigo

26

Temporal bone fracture - otic capsule not involved

Longitudinal fracture
Due to lateral blow
Can get bleeding from the external ear canal

27

Neck - zone 1

Lower part of neck
- trachea, oesophagus, thoracic duct, thyroid, spinal cord, brachiocephalic vein, subclavian vein, common carotid

28

Neck - zone 2

Most accessible area
- larynx, hydropharynx, spinal cord, CN X, CN XI, CNXII, carotids, internal jugular vein

29

Neck - zone 3

Upper part of the neck
- pharynx, carotids, IJV, spinal cord

30

Neck - penetrating injuries usually affect which neck zone?

Zone 2 (most accessible area of the neck)