Facial Anatomy & Injuries

Facial Anatomy There are 18 bones in the face Including maxillae & mandible (upper & lower jaw) Zygomatic (cheek bones) Some bones are paired Sinuses located above and below the eyes

Eye Anatomy The eye sits in a socket – the orbital foramen or orbit Protects the eye on three sides Muscles that move the eye attach to it Made up of 2 chambers (ant. & post.) that are filled with fluid (a loss of fluid is likely to cause permanent damage &/or blindness) Sclera – white outer covering of the eye A change of color in the sclera indicates a problem or illness (such as liver disease, lack of oxygen or poisoning [including steroid use]

Muscles of the Eye

Eye anatomy (cont’d) Posterior aspect of the eye includes the retina & optic nerve. Retina contains Rods (black & white) & Cones (color vision) Vision test – based on reading letters from 20 feet away. Reading the smallest letters on the chart indicated 20/20 vision.

Snellen Eye Chart

Prevention of Eye Injuries All sports have the potential for eye injuries to occur. Wearing proper equipment – face masks, goggles, face shields or protective eye wear. Protective eye wear should be designed specifically for the sport. ATC’s should err on the side of caution in evaluating eye injuries. Never cover/shield or patch just one eye. (Eyes move together – trying to see with uninjured eye would irritate injured eye)

Protection of injuries Broken nose or deviated septum Eye injuries Jaw injuries Eye injuries

Corneal Abrasion Caused by: Getting poked in the eye Wearing contact lens too long Symptoms include: pain, eye will tear & sensitivity to bright light Treatment Patch for 24 hours Antibiotic ointment Limited use of contacts Protective goggles

Blowout Fracture Occurs to the orbital bone Possible loss of eye movement Possible increased sinus infections/allergy symptoms

Detached Retina Caused by Blow to the eye A hard sneeze Symptoms include: pain, seeing sparks, lights and flashes or difficulty seeing (things look foggy) Treatment – laser surgery to repair must wear protective goggles upon return

Black Eye A contusion caused by a blow to the eye. Symptoms include swelling and pain followed by discoloration. Usually no visual impairment Treatment – ice and referral to physician if athlete complains of any other difficulty

The Ear Has 3 distinct parts – external, middle and inner ear Pinna – is the outer cartilaginous part of the ear; designed to catch sound Auditory Canal is the opening that the sound travels through to get to the inner ear.

Ear Diagram

Cauliflower Ear Cause – hard or repeated blows to pinna causing bleeding internally Treatment – ice and compression Prevention – wearing protective head gear.

Swimmer’s Ear Otitis Externa – Cause: inflammation of the auditory canal due to water left in the ear. Symptoms – pain, itching, hearing loss, possibly smelly discharge from the ear. Prevention – drying ear after swimming Use of ear plugs or alcohol based ear drops

Swimmer’s Ear

Hearing Loss

Hearing Loss The inner part of the ear contains tiny hair cells (nerve endings). The hair cells change sound into electric signals. Then nerves carry these signals to the brain, which recognizes them as sound. These tiny hair cells are easily damaged by loud sounds.

Hearing Loss The decibel (dB) is a unit to measure the level of sound. The softest sound that some humans can hear is 20 dB or lower. Normal talking is 40 dB to 60 dB. A rock concert is between 110 dB and 120 dB, and can be as high as 140 dB right in front of the speakers. Headphones at maximum volume are 105 dB.

Nose Anatomy Two Nasal bones and cartilage form the nose. Inside the nose is the septum that is made up of cartilage that separates the right & left halves (nostrils) Air inhaled through the nose is warmed, moisturized and cleansed (hair) before reaching the lungs

Nosebleeds Epistaxis – caused by a direct blow, blowing your nose, dry (& cold) air. Treatment – leaning forward, pinching the nose, applying ice and packing the nose with gauze (an astringent may be used) cauterization of the nostril maybe effective.

Deviated Septum When the cartilage is pushed to one side due to a direct blow. Usually accompanied by a nosebleed and possible fracture. Treatment – same as for a nosebleed plus referral to a physician to have septum cartilage reset. Prevention includes wearing a face mask

Deviated Septum

Tooth Anatomy There are 32 permanent teeth A tooth has: Crown: visible part above the gum line Root: part of the tooth below the gum line

Mouth Injuries Fractured Jaw – either maxilla or mandible Teeth may be misaligned Ice should be applied Referral to a physician who may realign jaw and wire it shut for 4-6 weeks Dislocated Jaw- hinge forced out of alignment. Referral to a physician who will realign jaw and possibly wire it shut.

Mouth Injuries cont’d Tooth dislocation (loosing a tooth) Bleeding, pain and swelling. Tooth should be handled as sterilely as possible (w/sterile gloves and gauze) Should be placed in a saline tooth container or a glass of milk. Tooth may be able to be replaced