Anatomy and Physiology
What structure lies on either side of the lower larynx and upper trachea and plays a role in regulating metabolism?
The thyroid gland
When treating a chemical burn to the eye caused by acid or alkali, what are the proper irrigation technique and required duration?
Flush from the inner to outside corner. If the burn was caused by an alkali or a strong acid, irrigate continuously for at least 20 minutes.
What position should a nontrauma patient be placed in when managing a nosebleed?
Place the patient in a sitting position, leaning forward, and pinch the nostrils together.
How should direct pressure be applied to control bleeding from a cheek injury?
Provide direct pressure both on the inside and outside of the cheek.
Concussion vs Brain Contusion
Concussion: partial/full loss of function without physical damage to brain; Contusion: physical injuries to brain soft tissue, associated bleeding, swelling, and increased ICP
What protects over 80% of the eyeball?
The orbit protects over 80% of the eyeball and is composed of adjacent bones of the face and skull.
What two actions should you take when managing a patient with an impaled object in the eye?
Bandage the object in place to support it. Bandage both eyes with soft, bulky dressings to prevent further injury.
What signs may suggest a ruptured tympanic membrane after a blast?
Signs and symptoms include severe ear pain, difficulty hearing, or ringing in the affected ear.
When bandaging a cheek wound, what complication must you avoid?
The amount of bandaging should not be so overwhelming that it occludes the mouth and makes it difficult to breathe.
What are S/Sx of skull fractures, and what are the four types?
S/Sx: penetration, raccoon eyes (bruising under eyes), Battle sign (bruising behind one ear over mastoid process); Linear (not usually life threatening), Depressed (high-energy direct trauma), Basilar (high-energy diffuse trauma), Open Fractures
What structure is located in the midline of the neck and contains the vocal cords?
The larynx
What is your general guideline for removing contact lenses in the field?
In general, do not attempt to remove contact lenses, except for chemical burns.
What signs may indicate a facial fracture after blunt trauma?
Signs and symptoms include bleeding in the mouth, inability to swallow or talk, absent or loose teeth, and/or movable bone fragments.
What is a severe complication of an open wound in the neck besides bleeding?
Air embolism, where air enters a vein and goes to the heart, which can cause cardiac arrest
What are special considerations when transporting avulsed teeth?
Place the tooth in a special tooth storage solution if available, or sterile saline. Handle the tooth by the crown, not the root.
What is the piece of cartilage immediately anterior to the ear canal, and what artery can be palpated anterior to it?
Tragus; superficial temporal artery
What is the proper response if the eyeball has been displaced from its socket?
Do not attempt to reposition it. Cover the eye and stabilize it with a moist, sterile dressing.
What serious underlying condition may be indicated by cerebrospinal fluid leaking from the nose?
Cerebrospinal fluid (CSF) may escape down through the nose following a fracture at the base of the skull.
What airway and spine precautions should you take when managing a laryngeal injury?
Provide oxygen and ventilation. Apply cervical immobilization but avoid the use of rigid collars.
What three signs may indicate a fractured mandible in a trauma patient?
Misalignment of the teeth, Numbness of the chin, Inability to open the mouth.
What muscle group originates at the skull and inserts into both the collarbone and the sternum?
Sternocleidomastoid muscles originate from the mastoid process of the cranium and insert into the medial border of each collarbone and the sternum at the base of the neck.
What eye condition may lead to permanent vision loss if the layer containing nerve endings is no longer attached to its underlying structures?
Retinal detachment is when the retina detaches from the underlying choroid and sclera and can cause blindness.
What is a key difference between anterior and posterior nosebleeds?
Anterior nosebleeds usually originate from the area of the septum and bleed fairly slowly. Posterior nosebleeds are usually more severe and often cause blood to drain into the patient’s throat.
What clinical signs may indicate laryngeal trauma?
Signs and symptoms of larynx injuries include respiratory distress, hoarseness, pain, difficulty swallowing, cyanosis, pale skin, sputum in the wound, subcutaneous emphysema, bruising on the neck, hematoma, and bleeding.
What the characteristics of epidural, subdural, subarachnoid, and intracerebral bleeds?
Epidural: b/n skull and dura mater, arterial, lucid intervals; Subdural: venous, beneath dura mater but outside brain; Subarachnoid: blood mixing with CSF, causes stiff neck with sudden, severe headache; Intracerebral: bleeding within brain tissue, strokelike symptoms