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Head and Face Injuries

Anatomy and Select Facial Injuries. Head and Face Injuries. 1. Diving Example http://www.youtube.com/watch?v=i5RqhiGdP0c Ice Hockey Example http://www.youtube.com/watch?v=cIVAUo1CL2g&feature=PlayList&p=29D8DEB14BDCC1D6&playnext=1&playnext_from=PL&index=25.

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Head and Face Injuries

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  1. Anatomy and Select Facial Injuries Head and Face Injuries 1

  2. Diving Example http://www.youtube.com/watch?v=i5RqhiGdP0c Ice Hockey Example http://www.youtube.com/watch?v=cIVAUo1CL2g&feature=PlayList&p=29D8DEB14BDCC1D6&playnext=1&playnext_from=PL&index=25 Many times the blood masks what the “problem” is…..have gloves handy! 2

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  5. Cerebrospinal fluid • Blood brain barrier • Meninges Protection of the CNS

  6. Location of the CSF 6

  7. Carotid arteries Vertebral arteries Jugular veins Vascular Supply 7

  8. Causes? Rule out head injury Use of steri-strips Sutures Why wouldn’t you shave the eyebrow? Soft Tissue Injuries - Lacerations 8

  9. Forceful blow to head Rule out C-spine injury Signs HA Nausea Deformity Raccoon eyes Battle’s sign Blood or CSF drainage from ears (ottorhea) or nose (rhinorhea) Skull Fractures 9

  10. Blood from ear (Ottorhea) 10

  11. Immediate referral!! Skull fracture itself is not the most serious problem…. Complications Intracranial injury Subdural or epidural hemorrhage Infections (meningitis) Skull Fractures con’t 11

  12. 2nd most common fracture (nose is 1st) Direct blow to mandible Signs Deformity (step defect) Malocclusion Pain biting down Bleeding around teeth Lower lip anesthesia Ecchymosis on floor of mouth Treatment Mandible Fracture 12

  13. MOI:Side blow to the jaw • subluxate or complete dislocation • S&S: Locked open jaw • movement of jaw? • how to reduce dislocation? • Recovery time? • Complications • Recurrent dislocations • TMJ dysfunction Mandibular Dislocation 13

  14. Direct blow to side of jaw Signs Lock jaw Malocculsion Temporomandubular joint (TMJ) dislocation 14

  15. Direct blow Signs Malocclusion Pain Epistaxis (nose bleed) Diplopia (dbl. vision) Numbness in lip and cheek LeFort Fracture types I - III (red indicates fracture location; III worse!) Admission 3 days post surgery Le Fort Type II Maxillary Fracture 15

  16. Direct blow Signs Deformity (flatness of cheek, step defect) Numbness in cheek, nose, and upper ip Limited TMJ movement Restricted eye movement Diplopia Epistaxis Edema/ecchymosis Zygoma Fracture 16

  17. Direct blow Signs Edema Ecchymosis Subconjunctival hemorrhage Don’t allow pt. to sneeze or blow nose Blow Out Fracture – Orbital Floor 17

  18. Dental, Nasal, Ear and Eye Injuries on Wednesday! 18

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