EMT Chapter 27 - Face and Neck Injuries
The head is divided into two parts: - ANS-1)The cranium
2)The face
The cranium is contains: - ANS--The brain, which connects the spinal cord through the
foramen magnum
The face is composed of: - ANS--Eyes, ears, nose, mouth, cheeks, & jowls
-Six bones (nasal, 2 maxillae, 2 zygomas, & the mandible)
What portion of the nose is formed by bone? - ANS-Only the proximal third, or the
bridge.
What is the pinna? - ANS-The external,visible part of the ear.
What is the tragus? - ANS-The small, rounded, fleshy bulge that lies immediately
anterior to the ear canal.
What is the mastoid process? - ANS-The prominent bony mass at the base of the skull
about 1" posterior to the external opening of the ear.
What is the temperomandibular joint? - ANS-The joint formed where the mandible and
cranium meet, just in front of the ear.
The neck contains many important structures and is supported by: - ANS-The cervical
spine, or the first seven vertebrae in the spinal column (C1-C7)
The Adam's apple is: - ANS-Specifically, the upper part of the larynx, formed by thyroid
cartilage (more prominent in men).
Between the thyroid cartilage and the cricoid cartilage in the midline of the neck lies: -
ANS-A soft depression, the cricothyroid membrane (fascia; connective tissue) which
joins thyroid & cricoid.
The trachea connects: - ANS-The oropharynx and the larynx with the main air passages
of the lungs (bronchi).
,What are the sternocleidomastoid muscles? - ANS-The muscles on either side of the
neck that allow movement of the head.
Bony prominences in the neck: - ANS--The lower c-spine are more prominent than the
upper ones
-Most easily palpable when the neck is in flexion
-Most prominent is at the base of the neck (7th C-vertebra)
In adults, how much of the eyeball is protected? - ANS-More than 80% of the eyeball is
protected within the orbit (eye is 1" in diameter)
What is the globe? - ANS-It is the eyeball.
What is the conjunctiva? - ANS-The delicate membrane that lines the eyelids and
covers the exposed surface of the eye.
What are the lacrimal glands? - ANS-The glands that produce fluids to keep the eye
moist; also called tear glands.
How does crying work? - ANS--Blinking sweeps fluid from the lacrimal ducts over the
surface
-Tears drain on the inner side through lacrimal ducts into the nasal cavity
What is the sclera? - ANS-The tough, fibrous, white portion of the eye that protects the
more delicate inner structures.
What is the cornea? - ANS-The transparent tissue layer in front of the pupil and iris of
the eye.
What is the iris? - ANS-The muscle surrounding tissue behind the cornea that dilate and
constrict the pupil, regulating the amount of the light that enters the eye; pigment in this
tissue gives the eye its color.
What is the pupil? - ANS-The circular opening in the middle of the iris that admits light to
the back of the eye.
What is anisocoria? - ANS-Naturally occurring uneven pupil size.
What is the lens? - ANS-The transparent part of the eye through which images are
focused on the retina.
,What is the retina? - ANS-The light-sensitive area of the eye where images are
projected; a layer of cells at teh back of the eye that changes the light image into
electrical impulses, which are carried by the optic nerve to the brain.
What is the optic nerve? - ANS-A cranial nerve that transmits visual information to the
brain.
What is retinal detachment? - ANS-Separation of the retina from its attachments at the
back of the eye.
What are signs of mandibular fractures? - ANS--Misalignment of teeth
-Numbness of the chin
-Inability to open mouth
Maxillary fractures are predominantly found? - ANS-After blunt force high-energy
impacts such as:
-Unrestrained driver striking the steering wheel
-A fall
-Direct blow from an object such as a pipe
Signs of maxillary fractures include: - ANS--Massive facial swelling
-Instability of facial bones
-Misalignment of the teeth
When an injury exposes the brain, eye, or other structures: - ANS-Cover the exposed
parts with a moist, sterile dressing to protect them from further damage.
What is conjuctivitis? - ANS-Inflammation of the conjunctiva.
When you see or suspect an impailed object in the eye: - ANS-Banage both eyes with
soft dressings to prevent further injury to the affected eye.
-This prevents sympathetic motion
If the burn to the eye was caused by an alkali or a strong acid: - ANS-You should irrigate
continuously for 20 minutes
For penetrating injuries of the eye: - ANS-1)Never exert pressure or manipulate the
globe
2)If part of the eyeball is exposed, apply a moist sterile dressing
, 3)Cover the injured eye with shield/cup. Cover both eyes with soft dressings, and
transport
What is a hyphema? - ANS-Bleeding into the anterior chamber of the eye, that obscures
part of all of the iris (common following blunt trauma to the eye)
What is a blowout fracture? - ANS-A fracture of the orbit or of the bones that support the
floor of the orbit.
-Pt cannot move eyes together because of muscle entrapment
What is retinal detachment and what does it produce? - ANS-Is often seen in sports
(boxing). It is painless but produces flashing lights, specks, or floaters. Retina is
separated from the nourishing choroid, prompt medical attention is needed to preserve
vision.
Eye findings that indicate the possibility of a head injury: - ANS-1)One pupil larger than
the other
2)Eyes not moving together or pointing in different directions
3)Failure of the eyes to follow movement as instructed
4)Bleeding under the conjunctiva, which obscures teh sclera (white portion)
5)Protrusion or bulging of the eye
Contact lenses should: - ANS--In general, you should never remove either kind of lens
from a patient
When is the only time you should remove a contact lens? - ANS-Immediately in the field
in the case of a chemical burn
-Hard - remove with suction cup
-Soft - 1-2 drops of saline and gently pinch
What is epitaxis? - ANS-Nosebleed
What are classified into two categories: - ANS-1)Anterior - originate from the septum,
bleed fairly slowly, and are usually self-limiting
2)Posterior - more severe & often cause blood to drain into the patient's throat; posterior
wall of the nasal cavity becomes unstable
What are turbinates? - ANS-Layers of bone within the nasal cavity (Superior, midline,
and inferior)
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