The Head and Face

1
The Head and Face

• Chapter 22 part 2

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

3
Recognition and Management of Specific Head
Injuries

• Temporomandibular Joint (TMJ) dislocation
• Mandible Fracture
• Zygomatic Complex

4
Mandible Fracture

• Etiology
• Direct blow to lower jaw
• Area of fracture often frontal angle.
• Symptoms and Signs
• Deformity
• Loss of occlusion
• Pain on biting
• Bleeding around teeth
• Lower lip anesthesia
• Management
• Immobilization and refer to physician
• Reduction
• Four to six weeks immobilization
• May return to mild activity
• Full activity in 3 to 4 months

5
Zygomatic Complex Fracture

• Etiology
• Third most common facial fracture.
• Direct blow to the cheekbone.
• Symptoms and Signs
• 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

6
Recognition and Management of Dental Injuries

• Tooth Fracture
• Tooth Subluxation
• Luxation
• Avulsion

7
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

8
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

9
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

10
Recognition and Management of Nasal Injuries

• Nasal Anatomy
• Cavity
• Fibrocartilage
• Septum
• Right and Left Chamber

11
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

12
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

13
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

14
Recognition and Management ofEar Injuries

• Anatomy
• External
• auricle (pinna)
• external auditory cannal (meatus)
• Middle (tympanic)
• Internal (eustachian)

• Ruptured Tympanic Membrane
• Swimmers Ear
• Middle Ear infection
• Impacted Cerumen

15
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

16
Swimmers Ear

• Etiology
• Infection of the ear canal
• Water becomes trapped due to obstructions
• Symptoms and Signs
• Itching
• Discharge
• Partial hearing loss
• Pain
• dizziness
• Management
• Prevention by drying ears thoroughly
• Ear drops (3 boric acid and alcohol solution)
• Avoid wind exposure

17
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

18
Recognition and Management of Eye Injuries

• Orbital Hematoma (black eye)
• Rupture Globe
• Hyphema
• Orbital Fracture

• Foreign Body in Eye
• Retinal Detachment
• Acute Conjunctivitis
• Hordeolum (sty)
• Corneal Abrasion

19
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

20
Throat Contusion

• Etiology
• Direct blow
• clotheslining
• Symptoms and Signs
• Severe pain
• Spasmodic coughing, hoarse voice
• Difficulty swallowing
• Breathing difficulties
• Expectoration of frothy blood
• cyanosis
• Management
• Manage airway
• EMS
• Cold application