Term
| Which of the following bones is part of the cranial vault AND the face? |
|
Definition
|
|
Term
| What two major nerves provide sensory and motor control to the face? |
|
Definition
|
|
Term
| Blood supply to the face is provided primarily through the: |
|
Definition
|
|
Term
| The __________ is a cone-shaped fossa that encloses and protects the eye |
|
Definition
|
|
Term
| Which of the following statements regarding the nasal septum is correct? |
|
Definition
| The nasal septum may be slightly deviated to one side or the other. |
|
|
Term
|
Definition
| floats in the superior aspect of the neck just below the mandible. |
|
|
Term
| Which of the following cranial nerves innervates the muscles that cause motion of the eyeballs and upper eyelids? |
|
Definition
|
|
Term
| What portion of the eye may become icteric in patients with hepatitis? |
|
Definition
|
|
Term
| The ________ conducts signals to the brain via the optic nerve and interprets them as vision |
|
Definition
|
|
Term
| The anterior chamber is the portion of the globe between the _____ and the _____, and is filled with _____ humor. |
|
Definition
|
|
Term
| Which of the following statements regarding vitreous humor is correct? |
|
Definition
| Vitreous humor fills the posterior chamber and maintains the shape of the globe. |
|
|
Term
| The middle ear consists of the: |
|
Definition
| inner portion of the tympanic membrane and the ossicles. |
|
|
Term
| In addition to massive bleeding, injury to a carotid or vertebral artery would MOST likely cause: |
|
Definition
|
|
Term
| Loss of function of the lower arms and hands following trauma to the anterior neck is indicative of damage to the: |
|
Definition
|
|
Term
| Open soft-tissue facial trauma following a significant mechanism of injury: |
|
Definition
| suggests that the patient may have a closed head injury or spinal injury. |
|
|
Term
| When assessing a patient with maxillofacial trauma, it is MOST important to: |
|
Definition
| protect the cervical spine and monitor the patient's neurologic status |
|
|
Term
| Which of the following is the MOST significant complication associated with a fractured nasal bone? |
|
Definition
|
|
Term
| Because significant force is required to fracture the mandible: |
|
Definition
| it is often fractured in more than one place and is unstable to palpation. |
|
|
Term
| A fracture of all midfacial bones, separating the entire midface from the cranium: |
|
Definition
| is commonly associated with facial elongation and dental malocclusion |
|
|
Term
| If a patient is unable to follow your finger above the midline following blunt trauma to the face, you should be MOST suspicious for a(n): |
|
Definition
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|
Term
| A flattened appearance to the face and loss of sensation over the cheek following blunt facial trauma is MOST indicative of a(n): |
|
Definition
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|
Term
| If you are unable to orotracheally intubate a patient due to massive maxillofacial trauma and severe oropharyngeal and nasopharyngeal bleeding, you would MOST likely have to perform: |
|
Definition
| a needle or surgical cricothyrotomy |
|
|
Term
| Appropriate management for a patient with severe epistaxis, tachycardia, and diaphoresis following an injury to the face includes: |
|
Definition
| administering enough IV crystalloid fluids to maintain adequate perfusion |
|
|
Term
| General care for an eye injury involves: |
|
Definition
| covering both eyes to minimize further injury. |
|
|
Term
| Which of the following statements regarding anisocoria is correct? |
|
Definition
| Anisocoria is a condition in which the pupils are unequal |
|
|
Term
| A patient with a dysconjugate gaze following an ocular injury: |
|
Definition
| has discoordination between the movements of both eyes |
|
|
Term
| When treating a patient with an ocular injury, what should you do to avoid an increase in intraocular pressure? |
|
Definition
| Discourage the patient from coughing |
|
|
Term
| When caring for a patient with a seemingly isolated ear injury, you should: |
|
Definition
| perform a careful assessment to detect or rule out more serious injuries |
|
|
Term
| The primary risk associated with oral and dental injuries is: |
|
Definition
|
|
Term
| When caring for a patient with fractured or avulsed teeth following an assault, you should: |
|
Definition
| assess the knuckles of the person who assaulted the patient. |
|
|
Term
| Proper treatment for an open wound to the neck includes: |
|
Definition
| sealing the wound with an occlusive dressing. |
|
|
Term
| If a knife is impaled in the neck: |
|
Definition
| a cricothyrotomy may be required to establish a patent airway |
|
|
Term
| Significant blunt injuries to the larynx or trachea pose an IMMEDIATE risk of: |
|
Definition
|
|
Term
| When managing the airway of an unresponsive patient with serious anterior neck trauma and shallow breathing, you should: |
|
Definition
| assist ventilations with a bag-mask device and prepare to intubate |
|
|
Term
| Bradycardia that occurs shortly after you have dressed and bandaged an open neck wound is MOST likely the result of: |
|
Definition
| parasympathetic nervous system stimulation due to excessive pressure on the carotid artery. |
|
|
Term
| Vascular injury following trauma to the anterior neck would MOST likely present with: |
|
Definition
|
|
Term
| A young man was assaulted and has extensive maxillofacial injuries. Your primary assessment reveals that he is semiconscious, has shallow breathing, and has blood draining from the corner of his mouth. Initial management for this patient involves: |
|
Definition
| manually stabilizing his head in a neutral position, suctioning his oropharynx, and assisting ventilations with a bag-mask device and 100% oxygen. |
|
|
Term
| A conscious but combative patient with severe facial trauma is fully immobilized on a backboard. During your assessment, the patient begins coughing up large amounts of blood. You suction his oropharynx, but his mouth quickly refills with blood. You should: |
|
Definition
| roll the backboard on its side, suction his oropharynx, and prepare to perform pharmacologically assisted intubation |
|
|
Term
| Following blunt trauma to the face, a 30-year-old man presents with epistaxis, double vision, and an inability to look upward. You should be MOST suspicious of: |
|
Definition
| an orbital blowout fracture |
|
|
Term
| You are dispatched to a high school where a 16-year-old male was stabbed in the eye with a pencil. The patient is conscious and in severe pain. A classmate removed the pencil prior to your arrival. The MOST appropriate care for this patient's injury includes: |
|
Definition
| covering the affected eye with a sterile dressing and protective eye shield, covering the unaffected eye, and transporting promptly. |
|
|
Term
| You are caring for a man with a chemical burn to both eyes. The patient, who has contact lenses in place, is in severe pain and tells you that he can't see. Proper care for this patient includes: |
|
Definition
| carefully removing his contact lenses, flushing both eyes for at least 20 minutes, and transporting with continuous eye irrigation. |
|
|
Term
| A 51-year-old woman sustained a large laceration to her cheek when she was cut by a knife during a robbery attempt. The patient is conscious and alert and has severe oral bleeding. She denies any other trauma. Your FIRST action should be to: |
|
Definition
| ensure that she is sitting up and leaning forward. |
|
|
Term
| During an explosion, a 42-year-old construction worker sustained a large laceration to the lateral aspect of his neck when he was struck by a piece of flying debris. The patient is conscious, but complains of difficulty hearing. In addition to protecting his spine, you should be MOST concerned with: |
|
Definition
| covering the laceration with an occlusive dressing and controlling the bleeding |
|
|
Term
| You are transporting a conscious middle-aged man with anterior neck trauma. He is on high-flow oxygen, has spinal precautions in place, and has a large-bore IV line of normal saline in place. When you reassess his vital signs, you note that his blood pressure is 90/64 mm Hg, his pulse rate is 120 beats/min, and his respirations are 22 breaths/min with adequate depth. You should: |
|
Definition
| keep the patient warm and infuse enough isotonic crystalloid solution to maintain adequate perfusion. |
|
|
Term
| When the globe of the eye is displaced from the socket |
|
Definition
| Cover the protruding eye with a moist, sterile dressing and stabilize it along with the uninjured eye to prevent further injury due to sympathetic eye movement, which is the movement of both eyes in unison. |
|
|
Term
| Elevate the head of the backboard |
|
Definition
| 40 degrees to decrease intraocular pressure. |
|
|
Term
| Hyphema or rupture of the globe indicate |
|
Definition
| A significant amount of force was applied to the face and may include spinal injury. |
|
|
Term
| 3 Important rules for treating penetrating eye injuries |
|
Definition
1. Never exert pressure on or manipulate the injured globe in any way.
2. If part of the globe is exposed, gently apply a moist, sterile, dressing to prevent drying.
3. Cover the injured eye with a protective metal eye shied, cup, or sterile dressing. Apply soft dressings to both eyes, and provide transport. |
|
|
Term
| Aluminum eye shields, not |
|
Definition
| gauze patches, applied over both eyes are generally all that are needed in the field. |
|
|
Term
| Bleeding from lacerations on the eyelids may be |
|
Definition
| heavy but it is usually controlled by gentle, manual pressure |
|
|
Term
| Symptoms that indicate serious ocular injury are |
|
Definition
1. Visual loss that does not improve when a patient blinks is the most important symptom of an eye injury.
2. Double vision
3. Severe eye pain
4. A foreign body sensation |
|
|
Term
| Treatment of a specific eye injury begins with |
|
Definition
| a thorough examination to determine the extent and nature of any damage. |
|
|
Term
| Superficial burns to the eye |
|
Definition
| may not be painful initially but may become so 3 to 5 hours later, as the damaged cornea responds to injury |
|
|
Term
| The first step when assessing a patient with an eye injury is |
|
Definition
|
|
Term
| In thermal burns to the eye caused by pain |
|
Definition
| the eyes natural reflex is to close rapidly and protect the eyes from further injury. However, the eyelids may be severely burned. |
|
|
Term
|
Definition
A painless condition that produces flashing lights, specks, or floaters in the field of vision and a cloud or shade over the patients vision.
*It can cause devastating damage to vision and is an ocular emergency that requires urgent medical attention. |
|
|
Term
|
Definition
| pain, double vision, or decreased vision following a blunt injury about the eye should be assumed to have a blowout fracture and should be promptly transported to a trauma center |
|
|
Term
|
Definition
bleeding into the anterior chamber of the eye that obscures vision.
*25% of these are caused by globe injuries. |
|
|
Term
| The protective orbit prevents |
|
Definition
| large objects from penetrating the eye. |
|
|
Term
| If there is a laceration to the globe itself |
|
Definition
| apply no pressure to the eye. Compression can interfere with blood supply to the back of the eye and result in loss of vision from damage to the retina. |
|
|
Term
| elderly patients are at a high risk for |
|
Definition
epistaxis following even minor facial injuries, especially in those patients with a history of hypertension or anticoagulation medication use.
*This bleeding often originates in the posterior nasopharynx and may not be grossly evident unless you look int the patients mouth. |
|
|
Term
| Do not apply a compress to the eyeball if you suspect |
|
Definition
| that it has been injured following an orbital fracture. Doing so may increase the intraocular pressure and further damage the eye. |
|
|
Term
| Proper positioning of the patient with epistaxis is |
|
Definition
| important to prevent blood from draining down the throat and compromising the airway either by occlusion or by vomiting and then aspirating the gastric contents |
|
|
Term
| For severe oropharyngeal bleeding in patients with inadequate ventilation |
|
Definition
| suction the airway for 15 secs and provide ventilatory assistance for 2 mins. Continue this alternating pattern until the airway is cleared of blood or secured with an ET tube. |
|
|
Term
| Leave all impaled objects to the face |
|
Definition
| in place and stabilize them, unless they pose a threat to the airway such as an object impaled through the cheek. |
|
|
Term
| Perform ET intubation in patients who are |
|
Definition
| unresponsive with massive facial trauma, to protect their airway from aspiration and to ensure adequate oxygenation and ventilation. |
|
|
Term
| Oropharyngeal bleeding poses an immediate threat to |
|
Definition
| the patients airway, and unstable facial bones can hinder your ability to maintain an effective mask-to-face seal for BVM ventilation. |
|
|
Term
| Only use a nasopharyngeal airway in patients with facial trauma |
|
Definition
| using extreme caution and with medical directions approval only. |
|
|
Term
| If a patient reports severe pain upon movement |
|
Definition
| the head and neck should be immobilized in the position found |
|
|
Term
| Management of the patient with a facial trauma begins by |
|
Definition
|
|
Term
| A posterior epistaxis can be nearly |
|
Definition
| impossible to control in the prehospital setting, therefore, alert the ED to this situation so that advanced airway management can be in place on your arrival. |
|
|
Term
| Evaluate cranial nerve function because |
|
Definition
| subtle signs can help you determine the extent of the injury |
|
|
Term
| Any patient with significant head injury |
|
Definition
| also had a c-spine injury until proven otherwise |
|
|
Term
| When the zygomatic bone is fractured |
|
Definition
| that side of the patients face appears flattened, and there is loss of sensation over the cheek, nose, and upper lip. |
|
|
Term
| Check eye movements in all planes in the patient with |
|
Definition
| possible facial fractures |
|
|
Term
| Fractures of the inferior orbit |
|
Definition
| are the most common type of orbital fracture and may cause paralysis of the upward gaze |
|
|
Term
| Enophthalmos traumaticus is |
|
Definition
| when the eyeball may retract posteriorly into the space created when the cavity is enlarged. |
|
|
Term
| Infraorbital hypoesthesia is |
|
Definition
| reduced sensation that extends from the tip of the nose, including the nares, and follows the margin of the maxilla, curving up to meet the temple. |
|
|
Term
| Orbital fractures are typically caused by |
|
Definition
| an object that strikes the region during sporting events, such as s baseball or a hockey puck |
|
|
Term
|
Definition
| Also called a craniofacial disjunction, is a fracture of all midfacial bones, separating the entire midface from the cranium |
|
|
Term
|
Definition
| Is a fracture with a pyramidal shape, involving the nasal bone and inferior maxilla. |
|
|
Term
|
Definition
| is a horizontal fracture of the maxilla that involves the hard palate and the inferior maxilla, separating them from the rest of the skull. |
|
|
Term
| Maxillary fractures produce |
|
Definition
| massive facial swelling, instability of the midfacial bones, malocclusion, and an elongated appearance of the patients face. |
|
|
Term
| Maxillary fractures result from |
|
Definition
| massive blunt facial trauma, such MVCs, falls, and assaults. |
|
|
Term
| A Temporomandibular joint dislocation may result from |
|
Definition
exaggerated yawning or widely opening the mouth.
"BJ" dislocation
*The patient will feel a pop and then not be able to close their mouth, the jaw will then spasm and cause severe pain. |
|
|
Term
| Point tenderness and pain on motion can identify |
|
Definition
injuries that patients might not have otherwise noticed because they may have been distracted with other injuries.
|
|
|
Term
| Mandibular fractures should be suspected in |
|
Definition
| patients who present with malocclusion, numbness to the chin, and inability to open the mouth |
|
|
Term
| A force of 150 g is required to |
|
Definition
| fracture the maxilla, and a force of that magnitude is also likely to produce traumatic brain injuries and C-spine injuries |
|
|
Term
| When assessing a patient with a suspected maxillofacial fracture |
|
Definition
| you should protect the C-spine and monitor the patients neurological signs, specifically the patients level of consciousness. |
|
|
Term
| ecchymosis is the first sign of |
|
Definition
|
|
Term
| The most common facial fracture is a |
|
Definition
| nasal fracture, which is characterized by swelling, tenderness, and crepitus when the nasal bone is palpated. |
|
|
Term
| Fractures of the mandible typically result from |
|
Definition
| massive blunt force trauma to the lower third of the face, common following an assault injury. |
|
|
Term
| The mandible may be fractured |
|
Definition
| in more then 1 place making it unstable for palpation |
|
|
Term
|
Definition
| irritant and swallowing as little as a few tablespoons of blood can make a patient vomit, increasing the likelihood of vomiting. |
|
|
Term
| When an impaled object penetrates the cheek |
|
Definition
| massive oropharyngeal bleeding can result in an airway obstruction, aspiration, and ventilatory inadequacy. |
|
|
Term
| Open soft tissue injuries to the face |
|
Definition
| following a significant MOI, suggests the potential for more severe injuries. |
|
|
Term
|
Definition
| painful, swollen, or deformed should be splinted. |
|
|
Term
| All patients with major closes soft tissue injury should |
|
Definition
|
|
Term
|
Definition
| wounds, control bleeding, and be prepared to treat for shock |
|
|
Term
| By appropriately treating open soft tissue injuries |
|
Definition
| you can minimize the common complications such as bleeding, shock, pain, and infection. |
|
|
Term
| Airway issues are the most |
|
Definition
| dangerous of the results on injuries to both the face and the neck |
|
|
Term
| In patients who have open injuries with |
|
Definition
| severe external bleeding, it is important to recognize, estimate, and report the amount of blood loss that has occurred and how rapidly it occurred. |
|
|
Term
|
Definition
| Poor skin tone and a loss of body fat can produce significant soft tissue injury in the presence of even a simple MOI, so normally trivial findings such as bruises and minor lacerations can belie severe underlying trauma such as traumatic brain injury. |
|
|
Term
| The reassessment of your patients V/S will give you |
|
Definition
| a good understanding of how well or how poorly your patient is tolerating the injury. |
|
|
Term
| Soft tissue injuries, even without |
|
Definition
| significant MOI, can cause shock |
|
|
Term
| Log rolling and securing the patient to backboard |
|
Definition
| should take into consideration injuries found during the primary assessment. |
|
|
Term
| Signs of increased respiratory efforts are |
|
Definition
| retractions, nasal flaring, pursed lip breathing, or use of accessory muscles. |
|
|
Term
| Physical examinations will be performed |
|
Definition
| en route to the hospital and they should result in reconsidering or reconfirming your initial transport decision. |
|
|
Term
| Any information you receive will be |
|
Definition
| valuable if the patient loses consciousness |
|
|
Term
| Ask the patient or family members and bystanders about the injury things such as |
|
Definition
1. Was the patient wearing a seat belt?
2. How fast was the vehicle traveling?
3. How high is the location from which the patient fell?
4. Was there a LOC?
5. What type of weapon was used? |
|
|
Term
| Signs that imply the need for rapid transport are |
|
Definition
| Tachycardia, tachypnea, weak pulse, cool, moist, and pale skin. |
|
|
Term
| Patients with significant bleeding, there treatment must be |
|
Definition
| directed at quickly addressing life threats and providing rapid transport. |
|
|
Term
| Patients who need immediate transport are |
|
Definition
1. Poor initial general impression
2. ALOC
3. Dyspnea
4. Abnormal V/S
5. Shock
6. Severe pain |
|
|
Term
|
Definition
| you have to work within the platinum 10, and any intervention that can be done en route should be delayed until you are in the ambulance. |
|
|
Term
| If you indentifty conditions that have the potential to become unstable |
|
Definition
| such as a distended abdomen or femur fracture, the patient requires rapid and immediate transport. |
|
|
Term
| A 60-90 seconds exam may identify |
|
Definition
| factors that assist you in determining whether a patient requires rapid transport. |
|
|
Term
| Significant bleeding is an |
|
Definition
| immediate life threat and must be controlled quickly using appropriate methods. |
|
|
Term
| Pale or ashen skin points to |
|
Definition
| inadequate perfusion. Cool, or moist skin is an early indicator of shock. |
|
|
Term
| An inadequate rate or depth that results in |
|
Definition
| compromised breathing should prompt you to take immediate action. |
|
|
Term
| Immediately correct anything that |
|
Definition
| interferes with airway patency; failure to provide patent airway can quickly lead to the patients death |
|
|
Term
| Nasopharyngeal airways are contraindicated if there is suspicion of |
|
Definition
| basilar skull or cribriform plate fracture. |
|
|
Term
| Patients whose level of consciousness is altered need |
|
Definition
| High flow O2 and immediate transport. |
|
|
Term
| When serious trauma is present |
|
Definition
soft tissue injuries take a lower priority than airway control, breathing inadequacy, and bleeding.
*Do not let soft-tissue injuries distract you from life threatening injuries that may not be readily apparent. |
|
|
Term
| If you are responding to a vehicle crash |
|
Definition
| ensure that traffic is controlled and personnel are operating with protective measures in place, including federal safety vest requirements. |
|
|
Term
| The carotid and vertebral arteries supply |
|
Definition
| oxygenated blood directly to the brain. Injury to these vessels can cause massive bleeding, shock, cerebral hypoxia, infarct, air embolism, and permanent neurological impairment. |
|
|
Term
| The major blood vessels in the anterior portion of the neck are |
|
Definition
| the internal and external carotid arteries, and the internal and external jugular veins. |
|
|
Term
|
Definition
| supplies motor activity to all the muscles of facial expression |
|
|
Term
|
Definition
| provides motor innervation to the muscles of mastication |
|
|
Term
| The glossopharyngeal nerve |
|
Definition
| provides taste sensation to the posterior portions of the tongue and carries parasympathetic fibers to the salivary glands on each side of the face. |
|
|
Term
|
Definition
| provides motor function to the muscles of the tongue. |
|
|
Term
|
Definition
| is also important in the formation of speech and in the chewing and swallowing of food. |
|
|
Term
|
Definition
| food is mixed with secretions from the salivary glands |
|
|
Term
| Teeth are attached to the |
|
Definition
| alveolar bone by a periodontal membrane. |
|
|
Term
| Dentin and enamel surround the |
|
Definition
| pulp cavity and protect the tooth from damage. |
|
|
Term
|
Definition
| the center of the tooth and contains blood vessels, nerves, and specialized connective tissue called pulp. |
|
|
Term
| The external ear consists of the |
|
Definition
|
|
Term
|
Definition
| carries parasympathetic nerve fibers that cause constriction of the pupil |
|
|
Term
| A blow to the eye may result in fracture of the |
|
Definition
| orbital floor because the bone is very thin and breaks easily |
|
|
Term
| Blood supply to the face is provided through |
|
Definition
| the external carotid artery. |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| sensory and motor nerve that supplies the muscles of chewing. |
|
|
Term
| Which two major nerves provide sensory and motor control to the face? |
|
Definition
| Trigeminal nerve which is the 5th cranial nerve and the facial nerve which is the 7th cranial nerve |
|
|
Term
| Injuries to the spine and spinal cord often occur in conjunction with |
|
Definition
|
|
