Transcript Head and Facial Conditions - College of the Siskiyous | Home

Head and Facial
Conditions
Chapter 8
Anatomy
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Bones
Scalp
Brain
Eyes
Nerves
Blood Supply
Bones
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Frontal
Occipital
Temporal
Maxilla
Zygomatic
Palatine
Nasal
• Lacrimal
• Vomer
• Nasal Concha
Scalp
• Skin
• Subcutaneous connective tissue
• Pericardium
Brain
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Cerebral hemispheres
Diencephalons
Brain stem
Cerebellum
Meninges
– Dura mater
– Arachnoid mater
– Pia mater
Eyes
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Lacrimal glands
Sclera
Cornea
Choroid
Retina
Nerves
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I Olfactory
II Optic
III Oculomotor
IV Trochlear
V Trigeminal
VI Abducens
• VII Facial
• VIII Vestibulocochlear
• IX Glossopharyngeal
• X Vagus
• XI Accessory
• XII Hypoglossal
Skull Fractures
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Linear
Comminuted
Depressed
Basilar
Raccoon Eyes
Battle’s Sign
Loss of Smell or Sight
Blood or CSF leaking from ears or
nose
Focal Cerebral Injuries
• Localized collection of blood or
hematoma.
• Increases pressure on the brain.
• Epidural or Subdural
Epidural Hematoma
• Outside the dura mater
• Direct blow to the side of the head
usually causing a fracture.
• LOC
• Lucid interval  Decline in mental
status
• Headache, nausea, vomiting, - level
of consciousness, dilated pupil,
contra lateral weakness, and
decerebrate posture.
Subdural Hematoma
• Hemorrhaging beneath the dura
mater
• S&S may not be evident for days or
even weeks after injury
• Severe headache, nausea or
vomiting, pupil irregularity,
confusion, + BP, - HR, Irregular
breathing and eye movements, +
body temperature, and a change in
emotional control.
Cerebral Contusion
• Concussion
• Posttraumatic Headaches
• Secondary impact syndrome
Concussions
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Grade I
Grade II
Grade III
Cantu
Torg
Colorado
American Academy of Neurology
Grade I
• No loss of consciousness (LOC)
• Brief period of confusion
• Symptoms last less than 15
minutes
• Return to play guidelines
Grade II
• No LOC
• Transient confusion
• Symptoms lasting more than 15
minutes
• Retrograde amnesia
• Anterograde amnesia
• Return to play guidelines
Grade III
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LOC of seconds or minutes
Decortication
Decerebration
Convulsions
Return to play guidelines
Posttraumatic
Headaches
• Easily confused with
concussions
• Localized area of blindness
• Brilliantly colored lights
Postconcussion
Syndrome
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Develops after a concussion
Persistent headaches
Blurred vision
Vertigo
Memory loss
Irritability
Inability to concentrate
Secondary Impact
Syndrome
• Concussed individual gets a
second concussion
• Rapidly dilating pupils
• Loss of eye movement
• Coma
• Respiratory failure
Scalp Injuries
• Control bleeding
• Prevent contamination
• Rule out skull fracture
Cranial Injuries
• Vital Signs
– Pulse
– Respiration
– Blood Pressure
History and Mental
Status Testing
• Distractibility, stream of
thought, goal-directed
movements
• Orientation
• Concentration
• Memory
• Symptoms
• Loss of consciousness
Observation and
Inspection
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Leakage of cerebrospinal fluid
Signs of trauma
Skin color
Loss of emotional control
Palpation
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Scalp and hair
Cervical spinous processes
Base of skull
Frontal bone, eye orbit, bridge of
the nose
• Zygomatic arch
• Upper and lower jaw
Neurologic Examination
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Cranial Nerve assessment
Pupil abnormalities
Babinski’s reflex
Strength
Coordination
Sensation and balance
External provocation
Facial conditions
• Facial soft tissue injuries
– Treat same as rest of body
– Steri-strip if larger than thumb
Temporomandibular
Joint
• Hit in jaw
– Malocclusion
– Joint noise
– Inability to close mouth
Zygomatic Fractures
Mandibular Fractures
Maxillary Fractures
Nasal conditions
• Epistaxis
• Nasal Fractures
Oral and Dental
Conditions
• Mouth lacerations
• Fractured tooth
• Dislocated tooth
Ear Conditions
• External ear injury
• Internal ear injury
• Swimmers ear
Eye conditions
• Periorbital
Ecchymosis
• Foreign bodies
• Sty
• Conjunctivitis
• Corneal
abrasion
• Corneal
Laceration
• Subconjunctival
Hemorrhage
• Hemorrhage of
the anterior
chamber
• Detached retina
• Orbital Blowout
• Displaced
contact lens