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Flashcards in Conditions Of The Face Deck (52)

Temporalmanibular Joint Etiology

TMJ is a sliding hinge joint
Injury occurs when a blow to the mandible transmits force to condylar
Injuries may involve intracapsular bleeding, inflammation of ligament, meniscal displacement, subluxation/dislocation/#


Temporomanibular Joint S&Sx

Inability to open mouth (normal=40 mm)
Deviation of jaw to side of injury on opening & biting
Malocclusion, joint noise or inability to close mouth


Temporomanibular Joint Management

Ice to control swelling
Immobilize jaw w/ bandage
Refrain from opening mouth for 7-10 days
Refer to dentist


Zygomatic # S&Sx

Flat or depressed appearance of the cheek
Swelling & periorbital ecchymosis about the eye may occlude vision & hide damage of orbit
Double vision, parathesia/anathesia
Usually epitaxis (nose bleed)


Zygomatic # Management

Crushed ice pack over area to control swelling
No compression or pressure
Refer to MD
R/O concussion


Epitaxis Etiology

Common but 40% of adults require medical attention
Due to:
-picking nose
-facial trauma 2nd blunt facial impact of MVA
-mucosal hyperaemia 2nd to allergic or vitals rhinitis
-presence of foreign body


Epitaxis S&Sx

Originates from superficial blood vessels


Epitaxis Management

Apply pressure to nasal bone for 10-15 mins
Pt. mouth breathing & leaning forward
Ice can be applied to dorsum of nose & back of neck


Deviated Septum Etiology

Partition btwn R&L sides of the nose
May be congenital & asymptomatic
Often caused by nasal trauma
Leads to difficult breathing


Deviated Septum S&Sx

Consistent difference in airflow btwn 2 sides of the nose when one nostril is blocked
Pen light will help


Deviated Septum Management

Refer to MD for further evaluation


Nasal # Etiology

Most common # bone in adult face
Persistent or profuse bleeding may indicate a complex nasal #


Zygomatic # S&Sx

Epitaxis is always present
Nose may look flattened & lose symmetry
Nasal airway may become obstructed w/bony fragments
# can extend to cranial region, loss of CSF
Crepitus over nasal bridge & ecchymosis under eye


Mouth Lacerations Etiology

Trauma can lead to lacerations of face, lips, tongue or internal buccal cavities


Mouth Lacerations S&Sx

Bleeding is often profuse
Lacerated tissue may appear swollen w/jagged edges


Mouth Lacerations Management

Apply direct pressure to stop bleeding
Clean w/saline or clean water
May require suturing if lip is punctured/involves the tongue
Not allowed to RTP until wound is healed


Loose Teeth Etiology

Direct trauma


Loose teeth S&Sx

Loosened tooth may be partially displaced, intruded (pushed into socket), extruded (partially out), luxated (pushed sideways)
Blood is usually involved


Loose teeth management

When tooth extruded or luxated the examiner should try to place the tooth back to normal position w/o force
Teeth which are intruded should be left alone or permanent damage may result
Emerg dentist ASAP


Fractured Tooth Etiology

Direct trauma
Mouth guards reduce fractures
R/O concussions & spinal injuries


Fractured Tooth S&Sx

# may occur through enamel, dentin, pulp or root of tooth
# to enamel causes no symptoms, can be smoothed by dentist to prevent injury to lips & oral cavity
# to dentin cause pain & increase sensitivity to cold & heat
# to pulp or root lead to severe pain & sensitivity


Fractured Tooth Management

Refer to dentist


What are some RED FLAGS when it comes to Ear conditions?

Bleeding/CSF from ear
Feeling of fullness in ear;vertigo
Bleeding/swelling behind ear (battle sign)
Foreign body in the ear which cannot be removed easily
Hematoma or swelling that removes the creases of outer ear
Popping or itching the ear
Tinnitus or hearing impairment
Pain when earlobe is pulled


External Ear Conditions Etiology

Auricular hematoma (cauliflower ear) caused by repeated blunt trauma that pulls cartilage away from perichondrium
Hematoma forms btwn perichondrium & cartilage of ear & compromises blood supply to cartilage
Common in wrestlers who do not wear head gear


External Ear Conditions S&Sx

Outer ear is red, puffy & swollen
If left untreated, hematoma forms fibrosis in overlying skin leading to necrosis of Auricular cartilage


External Ear Conditions Management

If swelling, refer to MD for draining
Wear protective head gear


Internal Ear Conditions Etiology

Blow to ear
Pressure changes (diving/scuba diving)
Infection (may damage the external auditory eardrum)


Internal Ear Conditions S&Sx

Intense pain in ear, feeling of fullness, nausea, tinnitus, dizziness or loss of hearing


Internal Ear Conditions Management

Elevated by MD
Most minor ruptures of eardrum heal spontaneously
Larger ruptures may require surgical repair


Otitis Externa Etiology

Bacterial infection that involves lining of external auditory canal
Higher prevalence among water sport athletes
Occurs in individual who fails to dry ear canals


Otitis Externa S&Sx

Pain in acute cases
Itching in chronic cases w/discomfort & pain 2nd
May/may not be a discharge of pus
Gentle pressure around auditory opening & pulling on the pinna causes increase pain
Left untreated, infection can spread to middle ear causing balance disturbances/hearing loss


Otitis Externa Management

Custom ear plugs
Ear drops that contain an acidifying agent, either aluminum acetate or vinegar
Homemade remedy


RED FLAGS for Eye Conditions

Visual disturbances or loss of vision
Blood in anterior chamber
Unequal pupils/bilateral dilated pupils
Irregular eye movement/failure to adjust to light
Severe ecchymosis & swelling (raccoon eyes)


Periorbital Ecchymosis Etiology

Direct trauma to external eye region
Area high vascularity & when impacted can produce capillary bleeding in tissue space


Periorbital Ecchymosis S&Sx

Significant swelling & hemorrhage in surrounding eyelids
Impact can lead to faulty vision


Periorbital Ecchymosis Management

Inspection for obvious abnormalities
Palpation of orbit for #
Pupillary response to light
Ice application
Referral to eye specialist to R/O # or injury to globe


Foreign Bodies Etiology

Dust/dirt is frequent occurrence


Foreign Bodies S&Sx

Intense pain & tearing
Individual may attempt to remove substance by rubbing eyes


Foreign Bodies Management

If body not embedded, should be removed
Inspect cornea for scratches, abrasions or lacerations


Sty Etiology

Infection of sebaceous gland & caused by bacteria
Improper/incomplete removal of eye make-up, use of out dated or infected, poor eyelid hygiene


Sty S&Sx

Red nodule that will progress into painful pustule
Painful to touch & may elicit a scratchy sensation on eyeball
Crusting of eyelid margins, burning in eye, blurred vision & mucous discharge


Sty Management

Warm, moist compass to the eye
Pustule doesn't improve within 2 days refer to MD


Subconjunctival Hemorrhage Etiology

Direct trauma
More common in individual w/ high BP


Subconjunctival Hemorrhage S&Sx

Several small capillaries rupture, making the white sclera of eye appear red, blotchy, inflamed


Subconjunctival Hemorrhage Management

Harmless condition requires no Rx & resolves spontaneously in 1-3 weeks
If blurred vision, pain, limited eye movement or blood in anterior chambers is present refer to ophthalmologist


Hemorrhage in Anterior Chamber Etiology

Hyphema usually results from blunt trauma caused by small ball, hockey puck/stick


Hemorrhage in Anterior Chamber S&Sx

Red tinge in anterior chamber within few hours blood begins to settle into anterior chamber giving eye presence of a meniscus


Hemorrhage in Anterior Chamber Management

Patch both eyes
Immediate referral
Activate EAP
Conditions require hospitalization, bed rest, bilateral patching of eye & sedation


Detached Retina Etiology

Damage to posterior segment of eye can occur w/ or w/o trauma
Detached retina occurs when fluid seeps into retinal break & separates the nerosensory retina from the retinal epithelium
Can take days or weeks following initial trauma


Detached Retina S&Sx

Results in (+) scotoma (blind spot) at edge of visual field
As detachment progress, individual frequently describes conductor ad a 'curtain over their eyes'


Detached Retina Management

Patch both eyes & immediate referral to an ophthalmologist b/c surgery is often necessary


Orbital Blowout # Etiology

Caused by blunt force to eye or impact force that drives the orbital contents posteriorly against orbital wall
Increase pressure is released to area of least resistance, typically inferior orbital floor