Maxillofacial Trauma: Questions and Answers for Medical Professionals, Exams of Biology

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What is the mechanism of injury that can result in nasalorbitalethmoidal or NOE injury? - answer A direct below to the nasal region May be associated with cribiform fracture and orbital roof fracture Commonly associated with a loss of smell due to direct injury of the olfactory nerve What is the mechanism of injury for a blowout fracture - answer Direct blow to the orbital globe Can cause entrapment of the eyeball and most commonly the inferior or medial rectus muscle Often associated with restriction of eye-movement A penetrating trauma to the roof of the mouth can result in injury to which structure? - answer Brain Lacerations to the floor of the mouth can extend to the pharynx, tonsil, submaxillary triangle, or hyoid bone What is a common cause of facial trauma in a front impact motor vehicle collision? - answer Airbag Violence or assault is most commonly associated with injuries to which region of the face? - answer Midface Includes knows, maxillary, zygoma, frontal bones Women are more likely to experience these factors

Which injury is commonly associated with blunt facial trauma and what should it be assessed for? - answer Cervical spine injury Blunt force to the face may cause hyper extension of the neck Cervical stabilization until injury has been rolled out What is the most prominent clinical sign of an optic nerve laceration? - answer Immediate blindness Other injuries that result in blindness include penetrating trauma to the eye and sudden acceleration or do you celebration of the head Other symptoms of I injuries include diplopia or blurred vision and delayed or immediate blindness Immediate or early onset blindness trauma induced - answer Vitreous hemorrhage Prolapse globe contents Intraocular foreign body Optic nerve laceration Occipital lobe hemorrhage Delayed or late onset blindness caused by trauma - answer Retinal detachment Hemorrhage Glaucoma What is an associated injury that is considered life-threatening? - answer Airway obstruction What is a significant complications that can occur with scalp laceration? - answer Bleeding Extensive blood loss may result due to dense vasculature

What type of LeFort fracture at results in isolated movement of the maxilla? - answer LeFort I Isolated maxilla movement or free-floating maxilla Caused by horizontal fracture through the maxillary body causing a detachment of the entire maxilla at the level of the nasal floor Results from horizontal or downward force applied to the anterior face What is the injury that is classified as a LeFort II fracture? - answer Separation of the mid face Usually pyramid shaped Result from a horizontal impact to the upper mid face Extension of a LeFort I through the orbital rim, medial orbital wall, ethmoid sinuses, and knows What is the injury that is classified as a LeFort III fracture? - answer Total cranial facial separation Also known as craniofacial disjuncture Downward oblique impact that separates the facial skeleton from the skull base What is a severe eye injury that can occur following a sudden acceleration or decelebration movement of the head? - answer Optic nerve avulsion Symptoms include sudden onset blindness align often caused by motor vehicle collision when A head impacts a windshield What is the term for an accumulation of blood in the anterior chamber of the eye? - answer Hyphema Amount of visual impairment is related to the amount of occlusion Severe or complete loss of vision is caused by obscuring of the entire chamber of the eye with blood

Symptoms include deep aching Eye pain and increased intraocular pressure Mechanism of injury is a direct below to the globe of the eye What type of eye injury causes a decrease in intraocular pressure following a facial trauma? - answer Perforated globe Normal intraocular pressure is about 15 MMHG Low pressure is less than 10 MMHG and indicated globe rupture High pressure maybe caused by retrobulbar hemorrhage A facial fracture that results in loss of sensation main valve damage to which cranial nerve? - answer Cranial nerve five or trigeminal Responsible for sensation across the four head, cheek, and jaw Injury to the peripheral portion of the cranial nerve can cause loss of sensation Which cranial nerves are the most commonly injured following a facial trauma - answer Cranial nerve two and cranial nerve seven What is the assessment for cranial nerve II injury - answer Visual acuity What is the assessment for cranial nerve 3, 4 and six - answer Extraocular eye-movement What is the assessment for cranial nerve five - answer Sensory Determined by light touch or pinprick Two for head, cheek, and Jaw What is the assessment for cranial nerve seven - answer Symmetry of facial expressions

What is a trauma nurse looking for while palpating the skull and face during an assessment? - answer Bony depression Lacerations of the scalp may be explored with a finger or a blunt instrument to determine depth Displacement of the inner walls of the frontal sinus can result in Dural involvement A trauma patient presenting with epistaxis and nasal discoloration is most likely to have sustained what type of injury - answer Nasal fracture Nasal deformity may not be immediately Noticeable due to a facial edema When looking at the patient's profile, the nose appears to have an abnormal pug appearance. What is the most likely injury? - answer Nasal orbital ethmoidal injury Often time illusion of eyes being further apart called Telecanthus Results from disruption of the medial canthal ligaments Telecanthus is present when the intercanthal distance is greater than ______ to ______ MM - answer 30 to 35; definitive diagnosis when distances greater than 45 MM What is a primary finding of a blowout orbital fracture with entrapment - answer Restricted eye-movement Phony piece is impinge on extraocular muscles Trauma nurse should evaluate vision, I am movement, pupil size and reaction, lid appearance, cornea, and conjunctiva May have the presence of enophthalmos (receding globe) A patient with pain on opening the mouth with limited your movement may have what type of facial injury? - answer Mandibular fracture

Significant pain on opening the mouth or clenching the jaw Malocclusion or deviation of the jaw Nerve injury may be present with numbness Palpate the temporomandibular joint bilaterally as the patient opens and closes their mouth Airway obstruction can occur because the tongue is attached to the mandible and a fracture can cause loss of Tongue control What should the trauma nurse assessed on a patient with lower facial trauma? - answer The inside of the mouth should be assessed for breaks in the skin, Eckie Mosie's, clots, exposed bone, or bone fragments Severe injuries are characterized by fragmentation of bone and teeth and disruption of adjacent soft tissue Caution for upper airway obstruction due to hematoma's, soft tissue injuries, or blood accumulation Large amount of blood can be swallowed it may not be apparent Until the patient vomits Following a Trumatic injury to the face the patient presents with stridor. What would be the trauma nurse is concerned about this patient? - answer Airway obstruction Strider, drooling, and cyanosis are signs of arterial airway obstruction Injury to the Vegas or hypoglossal nerve with facial trauma can cause vocal cord or hemi-tongue paralysis Blood or vomit aspiration after a facial trauma can cause laryngospasm and contribute to upper airway obstruction In the trauma intensive care unit, patient develops a beach ball appearance of the face. What is the most likely LeFort classification of the facial fracture? - answer LeFort III Upper airway obstruction and into Bashan may occur

When the patient's nose and chin are against the x-ray place, what is the radiographic of you called? - answer Water's view Used to identify maxillofacial bones, maxillary sinus, nasal bones, frontal processes of the maxilla, zygoma, and zygomatic arch, coronoid process of the mandible, orbit, ethmoid and frontal sinuses What is caldwells view use for for radiological imaging - answer Involves placing the four head and nose against the x-ray plate Evaluate similar structures to waters view What is used to identify presence of corneal abrasion's? - answer Fluoroscein staining Examination under a wood the lamp or a slit lamp occurs The abrasion will appear as green Signs of a serious eye injury - answer Sudden decrease in vision or blurred vision Photophobia Diplopia Abnormal papillary reaction Proptosis Eye pain Eye redness or ecchymosis Hyphema