Transcript The Head and Face - University of Ottawa

The Head and Face
Chapter 22 part 2
Preventing Injuries to the Head
 Wearing proper protective equipment
 Instruct proper techniques of wearing the
head and face equipment
 Instruct proper techniques of usage of head
and face equipment
Recognition and Management of
Specific Head Injuries
 Temporomandibular Joint (TMJ) dislocation
 Mandible Fracture
 Zygomatic Complex
Mandible Fracture
 Etiology
– Direct blow to lower jaw
– Area of fracture often frontal angle.
 Symptoms and Signs
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Deformity
Loss of occlusion
Pain on biting
Bleeding around teeth
Lower lip anesthesia
 Management
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Immobilization and refer to physician
Reduction
Four to six weeks immobilization
May return to mild activity
Full activity in 3 to 4 months
Zygomatic Complex Fracture
 Etiology
– Third most common facial fracture.
– Direct blow to the cheekbone.
 Symptoms and Signs
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Obvious deformity can be felt on palpation
Nosebleed (epistaxis)
Double vision (diplopia)
Numbness of cheek
 Management
– Cold application and referral to physician
– Six to eight weeks for healing
– Proper protective gear on return to play
Recognition and Management of
Dental Injuries
 Tooth Fracture
 Tooth Subluxation
 Luxation
 Avulsion
Tooth Fracture
 Etiology
– Direct trauma
 Symptoms and Signs
– Uncomplicated crown fracture
• Small portion of tooth is broken no bleeding, pulp not
exposed
– Complicated crown fracture
• Tooth is broken and there is bleeding, pulp is exposed,
painful
– Root fracture
• Occurs below gum line, requires x-ray
Tooth Fracture
 Management
– Do not require immediate visit to dentist – play
can continue if tolerated
– Place fractured piece in plastic bag.
– If bleeding place gauze over fracture site
– Root fracture must see dentist after game –
dentist will reposition tooth
Tooth Subluxation, Luxation,
Avulsion
 Etiology
– Direct trauma
 Symptoms and Signs
– May be slightly loosened or totally dislodged.
– May have pain
 Management
– No immediate treatment required.
– Tooth may be put back in place.
– May place tooth in saline or milk if can not reimplant
Recognition and Management of
Nasal Injuries
 Nasal Anatomy
– Cavity
– Fibrocartilage
– Septum
– Right and Left Chamber
Nasal Fracture
 Etiology
– Lateral or straight on blow to the nose
– Most common fracture of the face
 Symptoms and Signs
– Profuse bleeding
– Immediate swelling
– Deformity
– Crepitus on palpation
 Management
– Control bleeding
– Splint
– Refer to physician for reduction
Deviated Septum
 Etiology
– Compression or lateral trauma
 Symptoms and Signs
– Nasal pain
– Septal hematoma
 Management
– Compression
– Surgical drainage of hematoma
– Packed to reduce reformation of hematoma
Nosebleed (epistaxis)
 Etiology
– Direct blow
– Sinus infection
– High humidity
– Allergies
– Foreign body lodged in nose
– Head injury
 Symptoms and Signs
– bleeding
 Management
– Compression
– Cold
– Head forward
Recognition and Management of
Ear Injuries
 Anatomy:
– External
• auricle (pinna)
• external auditory
cannal (meatus)
– Middle (tympanic)
– Internal (eustachian)
 Ruptured Tympanic
Membrane
 Swimmer’s Ear
 Middle Ear infection
 Impacted Cerumen
Auricular Hematoma
(cauliflower ear)
 Etiology
– Seen in boxing, rugby, wrestling
– Compression or shearing
– Subcutaneous bleeding into the auricular cartilage
 Symptoms and Signs
– Overlying tissue torn away from cartilage
– Bleeding and fluid accumulation (hematoma formation)
– Elevated, rounded, white nodular and firm
 Management
– Prevention – reduce friction, jelly, ear guards
– Cold for immediate treatment
– aspiration
Swimmer’s Ear
 Etiology
– Infection of the ear canal
– Water becomes trapped due to obstructions
 Symptoms and Signs
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Itching
Discharge
Partial hearing loss
Pain
dizziness
 Management
– Prevention by drying ears thoroughly
– Ear drops (3% boric acid and alcohol solution)
– Avoid wind exposure
Recognition and Management of
Eye Injuries
 Anatomy:
– Orbit
– Eye lid
– Anterior Chamber
 Preventing Eye Injuries
– Shatterproof Eyeglasses
• Goggles
• Rec Specs
 Assessment of the Eye
– History
– Observation
– Palpation
– Special Tests
• Visual Acuity
• Opthalmoscope
Recognition and Management of
Eye Injuries
 Orbital Hematoma
(black eye)
 Foreign Body in
Eye
 Rupture Globe
 Retinal Detachment
 Hyphema
 Acute Conjunctivitis
 Orbital Fracture
 Hordeolum (sty)
 Corneal Abrasion
Hyphema
 Etiology
– Collection of blood within anterior chamber of the eye
– Caused by blunt blow
– Common in racquetball or squash with no eye protection
 Symptoms and Signs
– Visible reddish tinge in anterior chamber within few hours
– Blood settles inferiorly and may fill entire chamber
– Vision is impaired or blocked
 Management
– Prevention by wearing protective eye ware
– Immediate referral
– Bed rest with elevated head
Throat Contusion
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Etiology
– Direct blow
– clotheslining
 Symptoms and Signs
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Severe pain
Spasmodic coughing, hoarse voice
Difficulty swallowing
Breathing difficulties
Expectoration of frothy blood
cyanosis
 Management
– Manage airway
– EMS
– Cold application