Trauma (Deeb)

Question 1

What is life threatening with facial trauma injuries: the fractures themselves or occult injuries?

Answer 1

occult injuries

Question 2

What is the sequence for examining pt with facial and systemic injuries?

Answer 2

ATLS = Advance Trauma Life Support

Question 3

What is the ATLS sequence?

Answer 3

ABCDE
A-Airway
B-Breathing
C-Circulation/bleeding D-Disability/neural
E-Exposure to look for other injuries

Question 4

What is assessed on the Airway?

Answer 4

Patency, can pt maintain airway themself

Question 5

What is assessed on Breathing?

Answer 5

Respiratory effort, can they ventilate and exchange air

Question 6

What is assessed in Circulatory status?

Answer 6

Whether there is bleeding or difficulty maintaining blood pressure

Question 7

What is the most common cause for not being able to maintain blood pressure?

Answer 7

Blood loss

Question 8

What is assessed in Disability?

Answer 8

Neurologic status including cervical spine
Eye response: open spontaneously, or non-responsive
Verbal: do they talk or slur
Motor: do they respond to painful stimuli or give a thumbs up

Question 9

What can the surgeon give after assessing pts Neuorologic status?

Answer 9

GCS score (Glasgow Comma Score)

Question 10

What is done during Exposure?

Answer 10

Roll patient around to look at entire body to assess any hidden injuries

Question 11

Why are the events surrounding traumatic accident important to know?

Answer 11

Determine extent of injuries to pt
Aide in determining method of general anesthesia if req
Help police determine cause of accident

Question 12

How do you classify facial fractures?

Answer 12

1. Location (upperface, midface, mandible)
2. Severity
3. Displacment or displaceability

Question 13

Nose, orbit, zygoma, maxillary complex are contained in what zone of the face?

Answer 13

Midface

Question 14

What is the term for horizontal fracture of maxilla, below the nose?

Answer 14

Leforte I

Question 15

What is the term for a triangular shaped fracture of skull from maxilla up between eyes, and back down to contralateral maxilla(?

Answer 15

Leforte II

Question 16

What is a horizontal fracture separating the mid face from the forehead?

Answer 16

Leforte III

Question 17

A mandibular body fracture occurs near what teeth?

Answer 17

2nd premolar to 1st molar region

Question 18

What are 5 fracture types?

Answer 18

1. Simple
2. Greenstick
3. Comminuted
4. Compound
5. Comminuted compound

Question 19

What is a fracture that communicates with the environment either intraorally or extra orally?

Answer 19

Compound fracture

Question 20

What are 2 other ways to classify a facial fracture?

Answer 20

1. Displaced

2. Nondisplaced

Question 21

What are 2 causes of displacement of fractures?

Answer 21

1. Angulation of fracture

2. Muscle pull at fracture site

Question 22

In a fracture of the body of the mandible what muscles pull in the vertical plane to cause displacement of the fracture vertically?

Answer 22

Masseter and Maedial pterygoid muscles

Question 23

In a fracture of the body of the mandible, what muscles pull in the horizontal plane to displace the fracture laterally?

Answer 23

Mylohyoid

Question 24

Which radiographic view is good for seeing Zygomatic arch fractures?

Answer 24

Submental vertex view (“Waters View”)

Question 25

What is an imaging modality ideal for fractures, especially of the mid face?

Answer 25

CT scan

Question 26

What are common signs and symptoms of facial fractures?

Answer 26

1. Pain (all fractures) 2. Swelling (some fractures) 3. Limited range of motion

Question 27

Eccymosis involving the orbit is commonly seen in what fracture types?

Answer 27

1. Zygoma 2. Leforte II (triangular) 3. Leforte III (Face from forehead)

Question 28

Will malocclusion be seen if the nose or orbit is fractured?

Answer 28

No. Only if the mandible, maxilla, or sometimes the zygoma are fractured

Question 29

If the patient has an anterior open bite, what fractures are considered?

Answer 29

1. Billateral condyle fracture | 2. Leforte fracture

Question 30

If the patient has a unilateral open bite, what fracture is considered?

Answer 30

Unliateral mandibular fracture

Question 31

To which side will a mandible deviate when a condyle is fractured?

Answer 31

Towards the fractured side

Question 32

What nerve can be injured in a maxillae fracture, an orbit fracture or a trimaler fracture?

Answer 32

V2

Question 33

What nerve can be injured in mandibular body fracture?

Answer 33

V3

Question 34

Is there a concern for nerve injury with a condyle or rams fracture?

Answer 34

No

Question 35

What are the top ten signs and symptom of facial fractures?

Answer 35

``` 1. Pain 2 Swelling 3. Limited range of motion 4. Laceration 5. Bleeding 6. Ecchymosis 7. Malocclusion 8. Nerve dysfunction (numbness) 9. Step deformity 10. Tenderness ```

Question 36

What is the treatment of fracture that restores anatomical integrity and alignment, including occlusion?

Answer 36

Reduction

Question 37

What is the treatment of a fracture that holds and immobilizes fracture segments in place so that bone can heal (usual in 4-6 weeks)

Answer 37

Fixation / Stabilization

Question 38

What are 2 types of reduction and fixation?

Answer 38

1. Open | 2. Closed

Question 39

Midface fractures are treated how?

Answer 39

Internal rigid fixation

Question 40

If a mandible fracture is comminuted (bag of bones) what treatment is indicated?

Answer 40

External pin fixation to avoid opening up the site with multiple bone pieces

Question 41

What cranial nerve runs through the temporal bone?

Answer 41

VII. You will see paralysis of the face on that side.

Question 42

What indicates an orbital fracture?

Answer 42

Unable to move the eye up indicates a problem with the orbit