1. THE FACE
Chapter 19

2. 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

3. 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

4. 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

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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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).

13. 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.

14. 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

15. 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)

16. 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

17. 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

18. 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

19. 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

20. 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

21. 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

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

23. 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

24. 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

25. 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

26. 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.