Head, Face, Ear, and Mouth Conditions

Injuries to the head Skull Fractures Skull Fractures Concussions Concussions –Second Impact Syndrome Scalp injuries Scalp injuries –Lacerations, abrasions, contusions, and hematomas

Injuries to the face Mandible fracture/dislocation Mandible fracture/dislocation –Mandible is the Jaw Bone Temporomandibular Joint dysfunction (TMJ) Temporomandibular Joint dysfunction (TMJ) Zygomatic Complex fractures (cheekbone) Zygomatic Complex fractures (cheekbone) Maxillary fracture Maxillary fracture Face Lacerations Face Lacerations

Mandible fracture/dislocation SX: SX: –Pain when biting down –Unable to move jaw –Deformity –Bleeding around teeth –Numbness of lower lip – Bottom jaw forward

Temporomandibular Joint dysfunction (TMJ) SX: SX: –Headaches –Earache –Vertigo –Inflammation –Neck pain –Hypomobility or hypermobility –Malocculsion –Limited ROM

Zygomatic Complex fractures (cheekbone) Bones: Bones: –Zygomatic –Maxillary SX: SX: –Obvious deformity –Epistaxis (nosebleed) –Diplopia (seeing double) –Numbness in the cheek TX: TX: –Ice and Referral

Maxillary fracture SX: SX: –Pain while chewing –Malocclusion –Epistaxis –Diplopia –Numbness in lip and cheek area

Dental Injuries Tooth fracture Tooth fracture Tooth subluxation, luxation, avulsion Tooth subluxation, luxation, avulsion –Subluxation (slightly loose) –Luxation (no fx, but very loose) Moves either forward or backward Moves either forward or backward –Avulsion (tooth is completely removed)

Nasal Injuries Nasal fractures (most common fractured face bones) Nasal fractures (most common fractured face bones) –Sx: Deformity Deformity Swelling Swelling Epistaxis Epistaxis Creptius Creptius Deviated Septum Deviated Septum Epistaxis Epistaxis

Auricular Hematoma aka Cauliflower Ear –Compression –Shearing force (single or repetitive) –Tears overlying tissue away from cartilage and then fluid collects in the pockets Body is unable to remove as fast as it appears Body is unable to remove as fast as it appears –May be drained but ultimately will require surgery to fix SX: SX: –Hot –Swelling

Rupture of Tympanic Membrane Seen in contact or collision sports Seen in contact or collision sports Fall or slap to the unprotected ear or sudden underwater variation Fall or slap to the unprotected ear or sudden underwater variation –SX: Loud pop Loud pop Pain in ear Pain in ear Nausea Nausea Vomiting Vomiting Dizziness Dizziness Hearing loss Hearing loss

Swimmer’s Ear (Ortitis Externa) Infection of ear canal (not a fungal infection) Infection of ear canal (not a fungal infection) Water gets trapped due to obstructions: Water gets trapped due to obstructions: –Cysts, bone growths, plugs of earwax, or swelling caused by allergies SX: SX: –Pain –Dizziness –Itching –Discharge –Partial hearing loss

Middle Ear Infection (Otitis Media) Accumulation of fluid in middle ear canal caused by local or systematic inflammation or infection Accumulation of fluid in middle ear canal caused by local or systematic inflammation or infection SX: SX: –Intense Pain –Fluid draining –Transient loss of hearing Systematic infection SX: Systematic infection SX: –Fever –Headache –Irritability –Loss of appetite –nausea

1: Normal 1: Normal 2: Waxy 2: Waxy 3:Otitis Media c infusion 3:Otitis Media c infusion 4:Otitis Media 4:Otitis Media 5:Severe Otitis Media 5:Severe Otitis Media 6:Otitis Media c secretion 6:Otitis Media c secretion

7:Fluid (asymptomatic child) 7:Fluid (asymptomatic child) 8:Healing of OM c fluid 8:Healing of OM c fluid 9:Severe OM 9:Severe OM 10:Formation of scar tissue from Severe OM 10:Formation of scar tissue from Severe OM 11:Rupture of Membrane 11:Rupture of Membrane 12: Tubes 12: Tubes

Eye Injuries Orbital Hematoma Orbital Hematoma Orbital Fx Orbital Fx Retinal Detachment Retinal Detachment Rupture of the Globe Rupture of the Globe Corneal Abrasion Corneal Abrasion Acute Conjunctivitis Acute Conjunctivitis Sty Sty Hyphema Hyphema

Orbital Hematoma (black eye) Mild Bruising to Orbital fx Mild Bruising to Orbital fx Orbital fx Orbital fx –Eyeball forced posteriorly compressing orbital fat until a blowout or rupture occurs Fat and interior extraocular muscles can herniate through fx) Fat and interior extraocular muscles can herniate through fx) –Sx: Diplopia Diplopia Restricted mvmt of eye Restricted mvmt of eye A downward displacement of the eye A downward displacement of the eye Pain w/ swelling and hemorrage Pain w/ swelling and hemorrage Numbness (infraorbital nerve) Numbness (infraorbital nerve) –TX: Surgical

Orbital Blowout (fracture)

Retinal Detachment Blow to athlete’s eye can partially or completely detach retina Blow to athlete’s eye can partially or completely detach retina Sx: Sx: –Detachment is painless Specks floating before eye Specks floating before eye Flashes of light Flashes of light Blurred vision Blurred vision “curtain falling” over field of vision “curtain falling” over field of vision Tx: Tx: –Refer to Ophthalmologist

Rupture of the globe

Rupture of globe SX: SX: –Severe pain –Decreased visual acuity –Dilopia –Irregular pupils –Increased intraocular pressure –Orbital leakage

Hyphema Collection of blood within the anterior chamber (direct blow) Collection of blood within the anterior chamber (direct blow) SX: SX: –Visible reddish tint to ant. Chamber –Within 2 hrs blood settles inferiorly or may fill entire chamber –Blood may turn pea green color –Vision is partially or completely blocked Tx: Tx: –Hospitalization w/ bed rest degrees –Patch B eyes –Sedation and medication to relieve pressure

Subconjunctival Hemorrhage

Tooth Injuries TX: TX: –If at all possible it is best to put tooth back in socket for transport to dentist or hospital Other acceptable forms of transport are: Other acceptable forms of transport are: –Save-a-tooth or milk Mouth-guards are thought to prevent concussions Mouth-guards are thought to prevent concussions –Homework: find an article online or in a paper that either supports or refutes this statement –BE prepared to share!