1|Page
KIN 2236 Final Exam ||Just Out!!!
Bottom line regarding head injuries - ANSWER-1. Following any
head trauma, the athlete should be monitored for at least 4-6
hours!
2. Don't send them home alone
3. IF IN DOUBT, GET IT CHECKED OUT
Recognition and Management of Specific Facial Injuries -
ANSWER-Following significant facial trauma
1. Assess
- mental status
- airway and breathing
2. Manage significant bleeding
- can better assess all structures
3. Check nose and ears for CSF (use halo sign)
4. Take a top-down approach to assess
- get an idea of facial asymmetry ASAP, these injuries will swell
quickly
-- forehead and orbits
-- maxilla and nose
-- cheekbones (zygoma)
,2|Page
-- oral cavity and mandible
5. Evaluation Criteria
- symptoms
-- asymmetry, bony steps, bruising and mobility
Cause of injury for forehead fractures - ANSWER-- most
common cause is blunt trauma
- usually fairly restraint to fractures
- most superior portions of the weaker orbital structures reside
within the bounds of the forehead
-- watch and palpate both sides for symmetry
-- don't see a lot unless its right over top of the eye
Signs of injury for forehead fractures - ANSWER-- Severe
headache and nausea
- palpation may reveal defect in skull
- May be blood in the middle ear, ear canal, nose, ecchymosis
around the eyes (racoon eyes) or behind the ear (battle's sign)
- cerebrospinal fluid also appear in ear and nose (halo sign seen
on gauze)
,3|Page
Orbital Fracture cause of injury and signs of injury - ANSWER-
COI:
- Direct trauma to the eyeball
- force blows our bottom of orbit and sinuses below it will let
out (unilateral nose bleed)
SOI:
- possible posterior displacement of the eye (enophthalmos)
- Diplopia
- Restricted upward gaze
- Downward displacement of the eye
- Soft tissue swelling and hemorrhaging
- subconjunctival hemorrhaging -- red/bloody eye
- Periorbital ecchymosis (raccoon eyes)
- Unilateral epistaxis
- numbness
-- due to injury infra orbital nerve - cheek, side of nose, upper
lip, and ipsilateral teeth
Care of an Orbital Fracture - ANSWER-- Ice, bo blwing nose and
valsalva maneuver
-- risk of infection (due to proximity of maxillary sinus and
bacteria)
, 4|Page
- x-ray/CT will be necessary to confirm fracture
- Treated surgically or allow to resolve spontaneously
-- surgical or non-surgical
--- check for ability to move eye upwards
Signs of Midface Maxillary Fracture - ANSWER-- assess airway,
make sure they are breathing and not swallowing blood
-- you should clear eyes first!! (top-down)
- visible lengthening and flattening of face
- mobile maxilla (see below)
- nasal bleeding
- ecchymosis of cheek
- malocclusion (alteration of bite)
-- bite down and see if the teeth meet
Palpation of facial bones for Maxillary Fracture - ANSWER--
palpation along maxilla for major deformities
- identify by forehead stabilization with one hand, while gently
pulling maxillary incisors
-- put hand on forehead and pull on 2 front teeth with other
hand ot see if whole face moves (even a bit)
KIN 2236 Final Exam ||Just Out!!!
Bottom line regarding head injuries - ANSWER-1. Following any
head trauma, the athlete should be monitored for at least 4-6
hours!
2. Don't send them home alone
3. IF IN DOUBT, GET IT CHECKED OUT
Recognition and Management of Specific Facial Injuries -
ANSWER-Following significant facial trauma
1. Assess
- mental status
- airway and breathing
2. Manage significant bleeding
- can better assess all structures
3. Check nose and ears for CSF (use halo sign)
4. Take a top-down approach to assess
- get an idea of facial asymmetry ASAP, these injuries will swell
quickly
-- forehead and orbits
-- maxilla and nose
-- cheekbones (zygoma)
,2|Page
-- oral cavity and mandible
5. Evaluation Criteria
- symptoms
-- asymmetry, bony steps, bruising and mobility
Cause of injury for forehead fractures - ANSWER-- most
common cause is blunt trauma
- usually fairly restraint to fractures
- most superior portions of the weaker orbital structures reside
within the bounds of the forehead
-- watch and palpate both sides for symmetry
-- don't see a lot unless its right over top of the eye
Signs of injury for forehead fractures - ANSWER-- Severe
headache and nausea
- palpation may reveal defect in skull
- May be blood in the middle ear, ear canal, nose, ecchymosis
around the eyes (racoon eyes) or behind the ear (battle's sign)
- cerebrospinal fluid also appear in ear and nose (halo sign seen
on gauze)
,3|Page
Orbital Fracture cause of injury and signs of injury - ANSWER-
COI:
- Direct trauma to the eyeball
- force blows our bottom of orbit and sinuses below it will let
out (unilateral nose bleed)
SOI:
- possible posterior displacement of the eye (enophthalmos)
- Diplopia
- Restricted upward gaze
- Downward displacement of the eye
- Soft tissue swelling and hemorrhaging
- subconjunctival hemorrhaging -- red/bloody eye
- Periorbital ecchymosis (raccoon eyes)
- Unilateral epistaxis
- numbness
-- due to injury infra orbital nerve - cheek, side of nose, upper
lip, and ipsilateral teeth
Care of an Orbital Fracture - ANSWER-- Ice, bo blwing nose and
valsalva maneuver
-- risk of infection (due to proximity of maxillary sinus and
bacteria)
, 4|Page
- x-ray/CT will be necessary to confirm fracture
- Treated surgically or allow to resolve spontaneously
-- surgical or non-surgical
--- check for ability to move eye upwards
Signs of Midface Maxillary Fracture - ANSWER-- assess airway,
make sure they are breathing and not swallowing blood
-- you should clear eyes first!! (top-down)
- visible lengthening and flattening of face
- mobile maxilla (see below)
- nasal bleeding
- ecchymosis of cheek
- malocclusion (alteration of bite)
-- bite down and see if the teeth meet
Palpation of facial bones for Maxillary Fracture - ANSWER--
palpation along maxilla for major deformities
- identify by forehead stabilization with one hand, while gently
pulling maxillary incisors
-- put hand on forehead and pull on 2 front teeth with other
hand ot see if whole face moves (even a bit)
