THE FACE Chapter 19

I. ANATOMY OF THE FACE The face is made up of 18 bones, eyes, nose, mouth, and ears. 1. Major bones include the: 2. maxillae (upper jaw) 3. Mandible (lower jaw) 4. Zygomatic bones (cheek bones) 5. Nasal bone

A. THE EYE 1. ¾ of the round shaped eye are protected by the orbital foramen which also serves as attachment point for muscles 2. The eye itself consists of two fluid filled chambers (anterior and posterior) which give it the rounded shape

A. THE EYE 3. Components of the anterior chamber: Sclera (white outer covering) Cornea (center clear portion) Iris (contractile colored portion) Pupil (opening of eye) Lens

A. THE EYE 4. Components of the posterior chamber: Retina (contains rods (black and white vision) and cones (color vision)) Optic nerve Sclera

B. THE EAR Has 3 distinct areas: The external ear The middle ear Pinna (skin covered cartilage) Ear canal Tympanic membrane (eardrum) The middle ear The inner ear

C. THE NOSE Consists of 2 nasal bones and cartilage The Septum is a piece of cartilage separating the right and left side of the nose Air inhaled through the nose is warmed, moisturized, and cleansed before reaching the lungs

II. EYE INJURIES A. CORNEAL ABRASION Caused by being poked in the eye or by leaving contacts in for too long Signs and Symptoms: Athlete will complain of severe pain,such as if an object is in the eye Watering Sensitivity to light

III. EYE INJURIES Treatment: 1. Extreme care must be taken with any eye injury, since a mistake can cost the athlete his/her vision 2. For ALL eye injuries, cover both eyes (if one eye moves the other one moves with it) and send athlete to a physician in a recumbant position 3. Do not put any pressure on the eye

III. EYE INJURIES B. DETACHED RETINA A blow to the eye, side of the head, or even a hard sneeze can cause the retina to detach Signs and Symptoms: Painless, but Seeing specks floating in front of the eye, flashes of light, or blurred vision Sees a „curtain falling“ from one side Treatment: - Send to physician

III. EYE INJURIES C. ORBITAL HEMATOMA (BLACK EYE) Signs and Symptoms: - Delayed hemorrhaging after 24 hours Treatment: Ice Send to physician if vision is impaired

III. EYE INJURIES D. FOREIGN BODY - Dust, Grass, Bug, Hair, Etc. Signs and Symptoms: Pain and watering of the eye Treatment: - Eyewash (have athlete tilt head with involved eye down and apply eyewash from nose outwards, flushing out the object).

III. EYE INJURIES - If eyewash is not successful because the object is stuck under the eyelid, use an applicator stick to remove it as shown in the picture.

III. EYE INJURIES E. EMBEDDED OBJECT something is stuck in the eye, e.g. Dirt or a shattered contact Signs and Symptoms: Pain, tearing, anxiety Treatment: - Send to a physician

III. EYE INJURIES F. HYPHEMA visible blood under the cornea Signs and Symptoms: pain and impaired vision Treatment: send to physician May cause permanent damage (blindness,cataracts)

III. EYE INJURIES G. BLOWOUT FRACTURE Caused by a blow to the eye which forces the eye backwards and causes the tiny bones under the eye to fracture Signs and Symptoms: Minimal pain (due to severing of nerve endings) Double vision Possible numbness of upper jaw and lip Inability to control eye movement

III. EYE INJURIES eye may appear to be sunken in the socket Possible nosebleed Discolored conjunctiva Swelling Treatment: CALL 911! Permanent damage may include impaired vision, glaucoma, cataracts Athlete will be out of competition for months

III. EAR INJURIES A. HEMATOMA AURIS (Cauliflower Ear) Contusion, wrenching or extreme friction of the ear causes internal bleeding Signs and Symptoms: pain, redness, swelling Treatment: ice and compression Send to physician to lance or drain the ear

IV. NOSE INJURIES A. EPISTAXIS (Nosebleed) Can be caused by direct blow or wheather conditions (dry air) Treatment: - Lean forward, apply direct pressure to the nose and upper lip, ice

V. NOSE INJURIES B. NASAL FRACTURE Most comon fracture to the face C. DEVIATED SEPTUM (separated cartilage) Signs and Symptoms: Bleeding, pain, deformity Treatment: - Control bleeding and refer to physician

V. INJURIES TO THE MOUTH REGION A. JAW FRACTURES (Mandible) Fracture of the Mandible is second in facial fractures Occurs most often in collision sports Signs and Symptoms: pain, swelling Bleeding around teeth Loss of normal occlusion (teeth) Possible deformity and lower lip anesthesia

VI. INJURIES TO THE MOUTH REGION Treatment: - stabilize in position and send to physician

VI. INJURIES TO THE MOUTH REGION B. TEMPOROMANDIBULAR DISLOCATION Usually initiated by a blow to the side of the open jaw Signs and Symptoms: Jaw is in a „Locked-Open“ position Movement almost impossible Extremely painful

VI. INJURIES TO THE MOUTH REGION Treatment: like any dislocation, DO NOT attempt to relocate Stabilize in position found and refer to physician Jaw will most likely be wired shut for ~ 3 wks

VI. INJURIES TO THE MOUTH REGION C. TOOTH DISLOCATION A tooth that is completely pulled out of its socket or pushed backwards/forward, without breaking off Treatment: clean with milk or water and return to socket if possible (if completely dislocated) If partially dislocated do not try to push it back in place 30 minutes before tooth dies...send to dentist immediately

VI. INJURIES TO THE MOUTH REGION D. TOOTH FRACTURE Breaking off of the tooth Treatment: - place fractured piece in milk, water, or saliva of athlete and refer imediately to a dentist.