1 Evaluation of Patients with Facial Trauma Exam 4 Terms & Definitions | OMFS Study Guide

ATLS (Advanced Trauma Life Support)

_______ is the gold standard for triaging and caring for patients with traumatic injuries

•Prepare, Transport, Triage

•Primary Survey

•Secondary Survey

•Continued monitoring and re-evaluation

•Tertiary Survey

•Definitive Care

What are the 6 steps for ATLS (Advanced Trauma Life Support):

Airway and C-spine stabilization

What does the A stand for in the Primary survey ABC's:

Breathing (respiratory)

What does the B stand for in the Primary survey ABC's

Circulation

What does the C stand for in the Primary survey ABC's

Disability

What does the D stand for in the Primary survey ABC's

Exposure

What does the E stand for in the Primary survey ABC's

Airway

Placing an endotracheal tube or performing a circothyoidotomy falls under which Primary Survey Step:

- Airway

- Breathing

- Circulation

- Disability

- Exposure

Breathing

Auscultating, placing a pulse ox, and obtaining a chest x-ray all fall under which Primary Survey Step:

- Airway

- Breathing

- Circulation

- Disability

- Exposure

Circulation

Monitoring heart rate, BP, and surveying for hemorrhage all fall under which Primary Survey Step:

- Airway

- Breathing

- Circulation

- Disability

- Exposure

Disability

Asking a patient what year it is and evaluating eye movement all fall under which Primary Survey Step:

- Airway

- Breathing

- Circulation

- Disability

- Exposure

brain function:

- eye response

- motor response

- verbal response

What aspects are you surveying as a part of Disability survey?

Glasgow Coma Score

What tool is used to survey a patient's level of disability?

15

What's the highest score you can get on a Glasgow Coma Score?

3

What's the lowest score you can get on a Glasgow Coma Score?

8

A Glasgow Coma Score of less than ____ indicative of substantial intracranial injury and the patient may not be able to reliably maintain their own airway, thus requiring intubation

Exposure

Cutting off a patient's clothes for a physical survey falls under which Primary Survey Step:

- Airway

- Breathing

- Circulation

- Disability

- Exposure

Allergies

What the the A in AMPLE history stand for:

Medications

What the the M in AMPLE history stand for:

Past history/Pregnancy

What the the P in AMPLE history stand for:

Last oral intake (both food and liquids)

What the the L in AMPLE history stand for:

Events leading up to injury

What the the E in AMPLE history stand for:

1. Scalp/Calvarium

2. Globe/Periorbital Region

3. Ears

4. Nose

5. Mid and Lower face

In what order should you evaluate a patient for a physical exam:

Inspect the forehead/frontal region for

- lacerations, contusions, edema

- Assess sensation and movement

Inspect the entirety of the scalp

- Close scalp wounds

Palpate for any step deformities

- Note any crepitus

- Note areas of tenderness

What things are evaluated in the Scalp/Calvarium:

•Pupils (shape, reactivity), Iris, and Conjunctiva/Sclera

•Globe position (enophthalmos, exophthalmos)

•Eyelids (lacerations, ptosis, entropion/ectropion)

•Racoon eyes (bilateral "black eyes" from a skull base fracture)

• Evaluate intraocular pressure

•Check for step deformities of the orbital rims

•Check for telecanthus

•Eye movements

•Vision

What things are evaluated in the Globe/Periorbital Region:

skull base fracture

bilateral "black eyes" can indicate a ______

globe injury

non-round pupils (outside of being congenital) are indicative of a _______ and require immediate ophthalmologic treatment

•Lacerations

•Malformations

•Tympanic membranes

•Otorrhea

•Hearing

What things are evaluated in the Ear Region:

•Clean the skin to look for lacerations

•Check for asymmetry, deformity, deviation, mobility or crepitus

•Check the septum for deviation or hematoma

•Address epistaxis/nose bleeding

•Rhinorrhea

What things are evaluated in the Nose Region:

Le Fort III

ID the fracture indicated by the green line:

Le Fort II

ID the fracture indicated by the red line:

Le Fort I

ID the fracture indicated by the blue line:

CT? CBCT

What is the Gold Standard imaging modality when evaluating trauma?

- CT/CBCT

- Pano

- Bitewing

- PA

Pano

This imaging modality is good evaluation of mandibular angle, body, and symphysis/parasymphysis fractures:

Lateral Ceph

This imaging modality is less valuable in trauma, better for orthodontics and orthognathic planning:

SMV (submentovertex)

This imaging modality is taken with the neck extended

•Good for viewing the zygomatic arches, sometimes helpful for looking at mandible fractures:

PA Ceph

This imaging modality, Prior to CT, was very commonly used to evaluate facial fractures:

Plain Film Imaging

This imaging modality is markedly less helpful than a PAN in many cases

•When taken intraoperatively, may have significant angulation concerns

3D imaging

_______ is increasingly popular and the standard of care in the setting of upper and mid face trauma as well as significant odontogenic infections