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32 Cards in this Set
- Front
- Back
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Epidemiology of maxillofacial injuries
men vs. women assualt vs. MVAs vs. accidents |
men>women
Assault>MVAs>accidents |
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what are these 2 fractures and 1 fact about them
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greenstick
-can occur at condyles -can prevent more serious injuries simple -bone transectted but NO DISPLACEMENT |
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compound-soft tissue envelop is torn, creating a fracture which communicate with the external environemnt
communitive-shattered fracture, multiple peices, and compounded to external environment |
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coronoid
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1-left unfavo-muscle unopposed
2-right fav-muscle opposed 1-left favorable 2-right unfavorable |
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Displacement of muscle groups
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-masseter-pterygoid swing
-lateral ptrygoid disc and neck of condyle: upwards, downwards and forwards |
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weak points in the mandible
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condyle, ramus, mental foramen
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bones of the midface
what is special about the ethmoid? |
maxillae
nasal ethmoid-include cribiform plate through which olfactory nerves travel to the anterior cranial fossa(weakness?) vomer zygomatic lacrimal cribiform plate |
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Le Fort 1
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-horizontal
-from FRONT OF FACE to PTERYGOID PLATE -move jaw forward or backward in surgery |
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Le Fort 2
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-pyramid type of fracture
-crosses front and nasal bones -moves along inside of orbit then down and back |
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Le Fort 3
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-frontal nasal
-through zygomatic arch and orbit -severe |
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Le Fort 1,2,3
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Mid-face fractures: Dentoalveolar fracture
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includes dentition and alveolar bone
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patterns in zygomatic complex and orbit
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nasoethmoidal fracture patterns
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how to control bleeding
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-direct pressure
-intraoral swabs |
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how to stabilize fracture
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barton bandage(+ on head)
Bridle Wire-like a loop |
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Hospital Care Management
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Management
History medical mechanism of injury Clinical Exam Imaging surgical care |
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History-essential screening questions
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-are your teeth meeting normally
-can you open and close as before -is any part of your face numb -how is your vision -mechanism of injury-did you lose conscious! -can help determine type of fracture ex. punch = body/condyle, fall = condyle |
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Physical exam
inpsect where? |
head/face: front top below
-mid face: blood clots, widening of alar nasal blades, swollen perorbital area eyes: raccoon eyes(anterior cranial fossa fracture-le Fort 2 or 3), battle's signs(manifest hrs after fracture of occiptial/temporal bone), periorbital ecchymosis, subconjunctival ecchymosis(bleeding from orbital region below conjunctiva reaching cornea) Nose: CSF rhinnorhea-nasoethmoidal fracture tears dura (has glucose/beta transferin) mouth-parasymphyseal fractures? palpation -test sensation: infraorbital nerve, IAN |
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Nasoethmoidal fractures present with?
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-widened nasal bridge
-epistasis -telecanthus -severe periorobital edema |
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Orbital fractures present with?
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-diplopia
-enopthalmus -subjunctival and periorbital ecchymosis -eye movements can be affected |
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Areas to palpate?
look for? |
-mandible
-mid face * look for steps |
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Imaging-areas and types?
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Mandible
-pano -mandible series -ct Midface -CT waters, submental-vertex, occlusal |
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Common mandible fracture combinations
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mental foramen + contralateral angle
mental foramen bilateral angle and condyle both angles |
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Mandibular imaging:
-where should you look for discontinuities? -ring bone rule? |
cortical margin of whole mandible
mandible is like a pretzel that usually breaks in 2 or more places |
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Fracture care
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-reduce
-immobilize |
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how to immobilize
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-closed reduction(MMF)
-Open reduction, internal fixation(ORIF) |
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latrogenic?
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caused by surgical procedure
-jaw fractures can come from improper extractions of teeth |
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do fractures tend to run along suture lines
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-only in kids, once ossified fracture occurs less common there
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Prehospital care
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-stabilize spine
-secure airway-finger sweep -maintain airway-pull tongue out -many patients die from airway obstruction control bleeding -direct pressure -intraoral swab |
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Mid-face imaging use?
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CT scan!
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