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Questions and Answers
What can penetrating trauma to the neck cause?
How many major bones make up the facial skeleton?
What is the function of the mandible?
What is a common mechanism that can cause mandibular fractures?
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What is the location of the hyoid bone?
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What is the function of the oculomotor nerve?
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What is a common complication of orbital fractures?
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What can contribute to partial or complete obstruction of the upper airway?
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What is a characteristic sign of zygomatic or cheekbone fractures?
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What are signs of facial fractures?
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What is a potential airway obstruction in dental injuries?
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What should be considered when inserting an appropriately sized airway adjunct in an unresponsive patient?
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What is the most common type of facial fracture?
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What behavior may indicate a closed head injury in a patient?
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Study Notes
Face and Neck Injuries
- Face and neck injuries are common and can be life-threatening due to traumatic forces, soft tissue injuries, and fractures to bones.
- Penetrating trauma to the neck can cause severe bleeding, allow air to enter the circulatory system, and stop or slow down blood flow to the brain.
Structural Anatomy
- The head is divided into the cranium and the face.
- The facial skeleton consists of six major bones: nasal bone, two maxillae, two zygomas, and the mandible.
- The mandible forms the jaw and chin, and motion in the jaw occurs at the temporomandibular joint.
Principal Structures of the Anterior Region of the Neck
- The thyroid cartilage, cricoid cartilage, and trachea are located in the anterior region of the neck.
- The hyoid bone floats in the superior aspect of the neck, just below the mandible.
The Eye
- The eye is a globe-shaped, approximately 1-inch diameter, located within the bony socket of the skull (orbit).
- The eye is held in place by loose connective tissue and several muscles.
- The oculomotor nerve innervates the muscles and carries parasympathetic nerve fibers, while the optic nerve provides the sense of vision.
Injuries to the Head and Face
- Injuries can lead to partial or complete obstruction of the upper airway.
- Contributing factors include direct injuries to the nose and mouth, larynx, and trachea, as well as swelling and bleeding from injuries to the soft tissue, brain, and cervical spine.
Facial Fractures
- Facial fractures occur when facial bones absorb the energy of a strong impact.
- Signs of facial fractures include deep facial lacerations, pain over a bone, swelling, pain on palpation or crepitus, misalignment of teeth, and any obvious facial deformities or asymmetry.
Types of Facial Fractures
- Nasal fractures are the most common type of facial fracture, characterized by swelling, tenderness, and crepitus, and often complicated by the presence of an anterior or posterior nosebleed.
- Mandibular fractures result from massive blunt force trauma to the lower third of the face, often located at the angle of the jaw.
- Maxillary fractures occur with mechanisms that produce massive blunt facial trauma, classified into three types: LeFort 1, 2, and 3.
Orbital Fractures
- Orbital fractures can create double vision and a loss of sensation above the eyebrow and over the cheek.
- Patients may have reduced sensation to areas innervated by the infraorbital nerve, impaired vision, and paralysis of upward gaze.
Zygomatic or Cheekbone Fractures
- Zygomatic or cheekbone fractures are common and result from blunt trauma, often associated with mechanisms that cause severe maxillofacial trauma.
- Signs and symptoms include a flattened appearance of the patient's face, loss of sensation over the cheek, nose, and upper lip, and paralysis of upward gaze.
Dental Injuries
- Fractured and avulsed teeth are common and may be associated with mechanisms that cause severe maxillofacial trauma or occur in isolation.
- Teeth fragments can become an airway obstruction, and patients with well-fitting dentures should keep them in place.
Primary Survey and Assessment
- Identify and manage life threats in the primary survey, being aware of combative or aggressive behavior as a sign of a closed head injury.
- Check for responsiveness, ensure a clear and patent airway, and suction any blood, vomit, or fluid from the patient's mouth.
- Consider inserting an appropriately sized airway adjunct if the patient is unresponsive, and be cautious of nasal fractures when using an NPA.
Face and Neck Injuries
- Face and neck injuries can be life-threatening due to traumatic forces, soft tissue injuries, and fractures to bones.
- Penetrating trauma to the neck can cause severe bleeding, air embolism, and decreased blood flow to the brain.
Structural Anatomy
- The head consists of the cranium and face.
- The facial skeleton consists of six major bones: nasal bone, two maxillae, two zygomas, and the mandible.
- The mandible forms the jaw and chin, and motion in the jaw occurs at the temporomandibular joint.
Principal Structures of the Anterior Region of the Neck
- The thyroid cartilage, cricoid cartilage, and trachea are located in the anterior region of the neck.
- The hyoid bone floats in the superior aspect of the neck, just below the mandible.
The Eye
- The eye is a globe-shaped, approximately 1-inch diameter, located within the bony socket of the skull (orbit).
- The eye is held in place by loose connective tissue and several muscles.
- The oculomotor nerve innervates the muscles and carries parasympathetic nerve fibers, while the optic nerve provides the sense of vision.
Injuries to the Head and Face
- Injuries can lead to partial or complete obstruction of the upper airway.
- Contributing factors include direct injuries to the nose and mouth, larynx, and trachea, as well as swelling and bleeding from injuries to the soft tissue, brain, and cervical spine.
Facial Fractures
- Facial fractures occur when facial bones absorb the energy of a strong impact.
- Signs of facial fractures include deep facial lacerations, pain over a bone, swelling, pain on palpation or crepitus, misalignment of teeth, and any obvious facial deformities or asymmetry.
Types of Facial Fractures
- Nasal fractures are characterized by swelling, tenderness, and crepitus, often complicated by anterior or posterior nosebleed.
- Mandibular fractures result from massive blunt force trauma to the lower third of the face, often located at the angle of the jaw.
- Maxillary fractures occur with mechanisms that produce massive blunt facial trauma, classified into three types: LeFort 1, 2, and 3.
Orbital Fractures
- Orbital fractures can create double vision and loss of sensation above the eyebrow and over the cheek.
- Patients may have reduced sensation to areas innervated by the infraorbital nerve, impaired vision, and paralysis of upward gaze.
Zygomatic or Cheekbone Fractures
- Zygomatic or cheekbone fractures are common and result from blunt trauma, often associated with mechanisms that cause severe maxillofacial trauma.
- Signs and symptoms include a flattened appearance of the patient's face, loss of sensation over the cheek, nose, and upper lip, and paralysis of upward gaze.
Dental Injuries
- Fractured and avulsed teeth are common and may be associated with mechanisms that cause severe maxillofacial trauma or occur in isolation.
- Teeth fragments can become an airway obstruction, and patients with well-fitting dentures should keep them in place.
Primary Survey and Assessment
- Identify and manage life threats in the primary survey, being aware of combative or aggressive behavior as a sign of a closed head injury.
- Check for responsiveness, ensure a clear and patent airway, and suction any blood, vomit, or fluid from the patient's mouth.
- Consider inserting an appropriately sized airway adjunct if the patient is unresponsive, and be cautious of nasal fractures when using an NPA.
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Description
This quiz covers the anatomy of the face and neck, as well as the traumatic injuries that can occur in this region, including penetrating trauma and fractures. Learn about the structural anatomy of the head and face, and the life-threatening consequences of trauma to this area.
