Trauma 3
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Questions and Answers

What is the most common cause of facial nerve injury at the geniculate ganglion?

  • Fracture of temporal bone (correct)
  • Mandibular injury
  • Scalp lacerations
  • Orbital blowout fractures

    • What is the recommended initial treatment for anterior nosebleeds?

  • Angioembolization
  • Packing (correct)
  • Epidural catheter
  • Balloon tamponade

    • What is the primary indicator of injury in mandibular injuries?

  • Facial nerve injury
  • Temporal bone fracture
  • Malocclusion (correct)
  • Orbital blowout fracture

    • What is the conservative therapy duration for nasoethmoidal orbital fractures with a CSF leak?

    <p>Up to 2 weeks (B)</p> Signup and view all the answers

    What is indicated for prevertebral soft tissue swelling without bony injury?

    <p>MRI (C)</p> Signup and view all the answers

    What is the most common spine injury?

    <p>C-1 burst (Jefferson fracture) (B)</p> Signup and view all the answers

    What is the recommended treatment for a C-2 hangman’s fracture?

    <p>Traction and halo (A)</p> Signup and view all the answers

    What is the primary indication for steroids in spine injury?

    <p>Worsening deficit (A)</p> Signup and view all the answers

    When is the spine considered unstable and in need of operative fixation?

    <p>If more than 1 column is disrupted (D)</p> Signup and view all the answers

    What type of odontoid fracture extends into the vertebral body?

    <p>Type III (A)</p> Signup and view all the answers

    What causes a C-2 hangman's fracture?

    <p>Distraction and extension (A)</p> Signup and view all the answers

    What type of fractures usually involve only the anterior column and are considered stable?

    <p>Compression (wedge) fractures (B)</p> Signup and view all the answers

    What are the components of the middle column of the thoracolumbar spine?

    <p>Posterior ½ of the vertebral body and posterior longitudinal ligament (B)</p> Signup and view all the answers

    What is required for clinical clearance of C-spine?

    <p>No other injuries, GCS 15, not intoxicated, no neck tenderness, and no neuro deficits (D)</p> Signup and view all the answers

    What can cause cord injury and is usually associated with hyperextension and rotation with ligamentous disruption?

    <p>Facet fractures or dislocations (C)</p> Signup and view all the answers

    Which imaging technique is needed for neurologic deficits without bony injury to check for ligamentous injury?

    <p>MRI (D)</p> Signup and view all the answers

    What is the most common cause of facial nerve injury?

    <p>Fracture of temporal bone (B)</p> Signup and view all the answers

    What is used to diagnose mandibular and tripod fractures?

    <p>Fine-cut facial CT scans with reconstruction (A)</p> Signup and view all the answers

    What is indicated for emergent surgical spine decompression?

    <p>Fracture or dislocation not reducible with distraction (A)</p> Signup and view all the answers

    What is required for asymptomatic blunt or penetrating neck trauma?

    <p>Neck CTA (B)</p> Signup and view all the answers

    What are patients with maxillofacial fractures at high risk for?

    <p>Cervical spine injuries (B)</p> Signup and view all the answers

    What may be required for completely occluded carotid to prevent clot propagation?

    <p>Plavix or heparin (C)</p> Signup and view all the answers

    What are nasoethmoidal orbital fractures often associated with?

    <p>CSF leak (B)</p> Signup and view all the answers

    What is indicated for blunt cerebrovascular injury after significant blunt head/neck injury?

    <p>Neck CTA (A)</p> Signup and view all the answers

    What may be required for diagnosis of esophageal injuries?

    <p>Esophagoscopy and esophagogram (D)</p> Signup and view all the answers

    What increases the risk for calcaneus, lumbar, and wrist/forearm fractures?

    <p>Upright fall (B)</p> Signup and view all the answers

    What is the primary indicator of injury in mandibular injuries?

    <p>Prevertebral soft tissue swelling without bony injury (D)</p> Signup and view all the answers

    What type of odontoid fracture extends into the vertebral body?

    <p>Type III – extends into vertebral body (will need fusion or halo) (E)</p> Signup and view all the answers

    What causes a C-2 hangman's fracture?

    <p>Distraction and extension (C)</p> Signup and view all the answers

    What is required for clinical clearance of C-spine?

    <p>No other injuries, GCS 15, not intoxicated, no neck tenderness, and no neuro deficits (A)</p> Signup and view all the answers

    What is the recommended imaging technique for diagnosing mandibular and tripod fractures?

    <p>Cone beam CT scan (C)</p> Signup and view all the answers

    What is the primary treatment for completely occluded carotid to prevent clot propagation?

    <p>Clopidogrel (Plavix) (B)</p> Signup and view all the answers

    What is the most common cause of facial nerve injury at the geniculate ganglion?

    <p>Fracture of temporal bone (B)</p> Signup and view all the answers

    What is indicated for asymptomatic blunt or penetrating neck trauma?

    <p>Neck CTA (A)</p> Signup and view all the answers

    What is the primary imaging technique needed for neurologic deficits without bony injury to check for ligamentous injury?

    <p>MRI (A)</p> Signup and view all the answers

    What is the recommended initial treatment for anterior nosebleeds?

    <p>Nasal packing (B)</p> Signup and view all the answers

    What increases the risk for calcaneus, lumbar, and wrist/forearm fractures?

    <p>Upright fall (A)</p> Signup and view all the answers

    What is required for clinical clearance of C-spine?

    <p>Both MRI and CT scan (A)</p> Signup and view all the answers

    What causes a C-2 hangman's fracture?

    <p>Hyperextension injury (D)</p> Signup and view all the answers

    What are nasoethmoidal orbital fractures often associated with?

    <p>Penetrating trauma (D)</p> Signup and view all the answers

    What is the best indication for steroid use in spine injury?

    <p>Worsening deficit (D)</p> Signup and view all the answers

    What is the primary treatment for a C-1 burst (Jefferson fracture)?

    <p>Rigid collar (A)</p> Signup and view all the answers

    What type of odontoid fracture is unstable and will need fusion or halo?

    <p>Type II – at base, unstable (C)</p> Signup and view all the answers

    What must be present for clinical clearance of C-spine?

    <p>No other injuries, GCS 15, not intoxicated, no neck tenderness, and no neuro deficits (A)</p> Signup and view all the answers

    What is the primary treatment for a C-2 hangman’s fracture?

    <p>Traction and halo (A)</p> Signup and view all the answers

    What can cause cord injury and is usually associated with hyperextension and rotation with ligamentous disruption?

    <p>Facet fractures or dislocations (C)</p> Signup and view all the answers

    What indicates that the spine is considered unstable and needs operative fixation?

    <p>Disruption of more than 1 column of the thoracolumbar spine (D)</p> Signup and view all the answers

    What kind of fractures usually involve the anterior column only and are considered stable?

    <p>Compression (wedge) fractures (B)</p> Signup and view all the answers

    What are the components of the middle column of the thoracolumbar spine?

    <p>Posterior ½ of the vertebral body and posterior longitudinal ligament (A)</p> Signup and view all the answers

    What is required for asymptomatic blunt or penetrating neck trauma?

    <p>Clinical clearance of C-spine with GCS 15 and no neck tenderness (D)</p> Signup and view all the answers

    Study Notes

    Management of Trauma to the Neck and Maxillofacial Region

    • Burst fractures are considered unstable and require spinal fusion
    • Upright fall increases the risk for calcaneus, lumbar, and wrist/forearm fractures
    • MRI is needed for neurologic deficits without bony injury to check for ligamentous injury
    • Indications for emergent surgical spine decompression include fracture or dislocation not reducible with distraction
    • Fracture of temporal bone is the most common cause of facial nerve injury
    • Nasoethmoidal orbital fractures often have a CSF leak and may require surgical closure
    • Fine-cut facial CT scans with reconstruction are used to diagnose mandibular and tripod fractures
    • Patients with maxillofacial fractures are at high risk for cervical spine injuries
    • Asymptomatic blunt or penetrating neck trauma requires neck CTA
    • Blunt cerebrovascular injury requires neck CTA for any significant blunt head/neck injury
    • Completely occluded carotid may be treated with Plavix or heparin to prevent clot propagation
    • Esophageal injuries are the hardest neck injury to find and may require esophagoscopy and esophagogram for diagnosis

    Management of Trauma to the Neck and Maxillofacial Region

    • Burst fractures are considered unstable and require spinal fusion
    • Upright fall increases the risk for calcaneus, lumbar, and wrist/forearm fractures
    • MRI is needed for neurologic deficits without bony injury to check for ligamentous injury
    • Indications for emergent surgical spine decompression include fracture or dislocation not reducible with distraction
    • Fracture of temporal bone is the most common cause of facial nerve injury
    • Nasoethmoidal orbital fractures often have a CSF leak and may require surgical closure
    • Fine-cut facial CT scans with reconstruction are used to diagnose mandibular and tripod fractures
    • Patients with maxillofacial fractures are at high risk for cervical spine injuries
    • Asymptomatic blunt or penetrating neck trauma requires neck CTA
    • Blunt cerebrovascular injury requires neck CTA for any significant blunt head/neck injury
    • Completely occluded carotid may be treated with Plavix or heparin to prevent clot propagation
    • Esophageal injuries are the hardest neck injury to find and may require esophagoscopy and esophagogram for diagnosis

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    Description

    Test your knowledge on spine trauma with this quiz. Learn about the screening for spine injury, indications for steroids, and treatment options for specific cervical spine fractures.

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