1. Facial Injuries Chapter 15

2. The Anterior Eye The Eye sits in the Orbital Foramen (Orbit). The Eye sits in the Orbital Foramen (Orbit). The white outer portion of the eye is called the Sclera. The white outer portion of the eye is called the Sclera. If the Sclera turns yellow = liver disease If the Sclera turns yellow = liver disease Bluish/grey = lack of oxygen or poisoning Bluish/grey = lack of oxygen or poisoning The clear center of the eye is the Cornea which can be scratched. The clear center of the eye is the Cornea which can be scratched. The Lens focuses the light onto the Retina. The Lens focuses the light onto the Retina. Conjunctiva = lining of inner surface of eye. Conjunctiva = lining of inner surface of eye.

3. The Iris and Pupil The Iris is the colored portion of the eye. The Iris is the colored portion of the eye. It responds to light and changes the size of the Pupil. It responds to light and changes the size of the Pupil. The Pupil is the opening in the center of the Iris that dilates when it is dark to let more light in and constricts when there is a lot of light. The Pupil is the opening in the center of the Iris that dilates when it is dark to let more light in and constricts when there is a lot of light.

4. The Posterior Eye The Retina lines the back of the eye and has Rods and Cones. The Retina lines the back of the eye and has Rods and Cones. Rods = black and white vision Rods = black and white vision Cones = color vision Cones = color vision The Lens sends an image to the Retina and is then converted into chemical and nerve signals to the Optic Nerve. The Lens sends an image to the Retina and is then converted into chemical and nerve signals to the Optic Nerve. The Optic Nerve signals the brain and vision occurs. The Optic Nerve signals the brain and vision occurs. A damaged Optic Nerve can cause blindness. A damaged Optic Nerve can cause blindness.

6. The Ear The Ear has 3 distinct areas: external, middle, and inner ear. The Ear has 3 distinct areas: external, middle, and inner ear. External ear = Pinna (cartilage covered by skin), Ear Canal, and Tympanic Membrane (Eardrum). External ear = Pinna (cartilage covered by skin), Ear Canal, and Tympanic Membrane (Eardrum). Earwax keeps dirt away from the eardrum. Earwax keeps dirt away from the eardrum.

8. The Nose The 1 inch nasal bones make up the bridge of the nose and the rest is cartilage. The 1 inch nasal bones make up the bridge of the nose and the rest is cartilage. The Septum separates the nose into left and right (Nostrils). The Septum separates the nose into left and right (Nostrils). Nose hairs filter impurities from the air. Nose hairs filter impurities from the air. The Palate (roof of the mouth) separates the mouth from the bottom of the nose. The Palate (roof of the mouth) separates the mouth from the bottom of the nose. Moist warm air breathed through the nose helps athletes with asthma breathe better. Moist warm air breathed through the nose helps athletes with asthma breathe better.

9. The Mouth An adult has 32 permanent teeth. An adult has 32 permanent teeth. The Crown of the tooth is covered with a thin layer of Enamel which protects against tooth decay. The Crown of the tooth is covered with a thin layer of Enamel which protects against tooth decay. The Root contains Pulp and Dentin. The Root contains Pulp and Dentin. Pulp = soft portion of tooth with nerve and blood supply. Pulp = soft portion of tooth with nerve and blood supply. Dentin = bony portion of the tooth. Dentin = bony portion of the tooth. A dead tooth will appear dark gray. A dead tooth will appear dark gray. Saliva helps break down food and bind it together for digestion. Saliva helps break down food and bind it together for digestion.

11. Preventing Facial Injuries Wear proper equipment. Wear proper equipment. Helmets Helmets Mouth guards Mouth guards Face masks Face masks Goggles Goggles Protective eyewear Protective eyewear Headgear Headgear

12. Treating Eye Injuries Corneal Abrasion or Laceration – caused by an object in the eye, being poked, or wearing contacts too long. Corneal Abrasion or Laceration – caused by an object in the eye, being poked, or wearing contacts too long. Painful, tearing, sensitivity to light. Painful, tearing, sensitivity to light. Florescent dye test with black light. Florescent dye test with black light. Patch for 24 hours and use ointment. Patch for 24 hours and use ointment. Detached Retina – caused by a blow to the eye or a hard sneeze. Detached Retina – caused by a blow to the eye or a hard sneeze. Painful, seeing sparks, lights, and flashes. Painful, seeing sparks, lights, and flashes. Difficulty seeing, things look foggy. Difficulty seeing, things look foggy. Must have laser surgery to repair. Must have laser surgery to repair.

14. Eye Injuries Continued Black Eye – ecchymosis, swelling, and pain caused by a contusion. Use ice. Black Eye – ecchymosis, swelling, and pain caused by a contusion. Use ice. Foreign Bodies – will cause tears, might need irrigation to flush out. May need to invert eyelid and use cotton swab to remove. Foreign Bodies – will cause tears, might need irrigation to flush out. May need to invert eyelid and use cotton swab to remove. Embedded Object – pain, visual impairment, anxiety. Use an eye shield over both eyes, refer to a physician. Embedded Object – pain, visual impairment, anxiety. Use an eye shield over both eyes, refer to a physician.

16. Eye Injuries Continued Subconjunctival Hemorrhage – broken blood vessels in eye causing redness. Subconjunctival Hemorrhage – broken blood vessels in eye causing redness. Hyphema – blood in the anterior chamber of the eye. Cover eyes, do not ice, refer to physician. Hyphema – blood in the anterior chamber of the eye. Cover eyes, do not ice, refer to physician. Blowout Fracture – athlete may have double vision, numbness of lip and upper jaw on same side of injury, may not be able to control injured eye, may appear sunken in socket. Call 911. Blowout Fracture – athlete may have double vision, numbness of lip and upper jaw on same side of injury, may not be able to control injured eye, may appear sunken in socket. Call 911. Fracture of Orbital Roof – pain, headache, S & S of a concussion and hematoma. Nose may bleed an cerebrospinal fluid may come out of nose. Call 911. Fracture of Orbital Roof – pain, headache, S & S of a concussion and hematoma. Nose may bleed an cerebrospinal fluid may come out of nose. Call 911.

18. Eye Injuries Continued Sinus Fracture – caused by a sharp blow to the face (stick to the face). Headache, dizziness, unsteadiness. Nose may bleed on same side, crackling sensation when touched. Apply ice, refer to physician. Sinus Fracture – caused by a sharp blow to the face (stick to the face). Headache, dizziness, unsteadiness. Nose may bleed on same side, crackling sensation when touched. Apply ice, refer to physician. Dislodged Contact Lens – vision will be impaired and eye will be irritated. Help athlete retrieve lens, maybe using a small suction cup for a hard lens. Dislodged Contact Lens – vision will be impaired and eye will be irritated. Help athlete retrieve lens, maybe using a small suction cup for a hard lens.

19. Last 2 Eye Injuries!!! Eyelid Laceration – Cut above eye, control bleeding, refer to a physician for stitches. Cut fingernails and wear goggles to prevent this injury. Eyelid Laceration – Cut above eye, control bleeding, refer to a physician for stitches. Cut fingernails and wear goggles to prevent this injury. Ruptured Globe – the eyeball itself. Lack of roundness upon evaluation and a hemorrhage of the eye. Cover eye, call 911. Ruptured Globe – the eyeball itself. Lack of roundness upon evaluation and a hemorrhage of the eye. Cover eye, call 911.

20. Treating Ear Injuries Laceration of the Pinna – Do not wear earrings to avoid this injury. Control bleeding, ice, and refer for stitches. Laceration of the Pinna – Do not wear earrings to avoid this injury. Control bleeding, ice, and refer for stitches. Cauliflower Ear – (Hematoma Auris) Most common in wrestlers who don’t wear head hear. Bleeding, swelling, redness, and pain in ear. Heals with excessive scar tissue to cause deformity. Physician may lance or drain ear to decrease swelling. Cauliflower Ear – (Hematoma Auris) Most common in wrestlers who don’t wear head hear. Bleeding, swelling, redness, and pain in ear. Heals with excessive scar tissue to cause deformity. Physician may lance or drain ear to decrease swelling.

22. Ear Injuries Continued Otitis Externa – (Swimmer’s Ear) Inflammation of the ear canal from water that does not dry out. Pain, itching, hearing loss, possible smelly discharge. Refer to physician for drops and antibiotics, use ear plugs for prevention. Otitis Externa – (Swimmer’s Ear) Inflammation of the ear canal from water that does not dry out. Pain, itching, hearing loss, possible smelly discharge. Refer to physician for drops and antibiotics, use ear plugs for prevention. Foreign Bodies in the Ear – refer to a physician so that you don’t push the object further in. Foreign Bodies in the Ear – refer to a physician so that you don’t push the object further in.

23. Treating Nose Injuries Epistaxis (Nosebleed) – lean forward, pinch nose, apply ice, pack with gauze. Refer to physician if bleeding doesn’t stop. Epistaxis (Nosebleed) – lean forward, pinch nose, apply ice, pack with gauze. Refer to physician if bleeding doesn’t stop. Deviated Septum – movement of the nasal passage from a blow. Block of one side of nose to check air flow. Deviated Septum – movement of the nasal passage from a blow. Block of one side of nose to check air flow. Nasal Fracture – severe nosebleed, may hear a snap, obvious deformity, crepitus, deviated septum. Refer to a physician. Nasal Fracture – severe nosebleed, may hear a snap, obvious deformity, crepitus, deviated septum. Refer to a physician.

25. Treating Mouth Injuries Fracture (Maxilla, Mandible) – swelling, teeth won’t line up, crepitus, guarding. Apply ice, refer to a physician. Fracture (Maxilla, Mandible) – swelling, teeth won’t line up, crepitus, guarding. Apply ice, refer to a physician. Temporomandibular Dislocation – blow to the chin or a violent forced opening of the mouth. Jaw will lock due to muscle spasm. Refer to a physician for relocation and wiring the jaw shut. Temporomandibular Dislocation – blow to the chin or a violent forced opening of the mouth. Jaw will lock due to muscle spasm. Refer to a physician for relocation and wiring the jaw shut.

26. Mouth Injuries Continued Tooth Dislocation – knocked out tooth. Pain, bleeding, and swelling. Use gloves and sterile gauze to pick up tooth, place in saline or glass of milk. Refer to dentist immediately after controlling bleeding. Tooth Dislocation – knocked out tooth. Pain, bleeding, and swelling. Use gloves and sterile gauze to pick up tooth, place in saline or glass of milk. Refer to dentist immediately after controlling bleeding. Fractured Tooth – pain, difficulty closing mouth. If a portion is missing, send with athlete to dentist for help in reconstruction. Fractured Tooth – pain, difficulty closing mouth. If a portion is missing, send with athlete to dentist for help in reconstruction.