Head and Face

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Head and Face
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Overview

• Anatomy
• Injuries treatment
• Assessment

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Skeletal Anatomy

• Frontal Bone (1)
• Parietal bone (2)
• Occipital bone (1)
• Temporal bone (2)
• Mastoidprocess
• Sphenoid bone (1)
• Ethmoid bone (not visible) (1)

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Anatomy

• Inferior nasal concha (2)
• Lacrimal bone (2)
• Vomer (1)
• Nasal bone (2)
• Maxilla (2)
• Palatine bone (2)
• Zygomatic bone (2)
• Mandible (1)

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Anatomy Foramen

• supraorbital (supraorbital nerve vessels) Deep
  to frontalis m.
• infraorbital (infraorbital nerve vessels) Deep
  to levator labii superioris m.
• mental (mental nerve vessels) deep to the
  platysma m.
• zygomaticofacial (zygomaticofacial nerve)

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Anatomy

• glabella
• superciliary arch
• canine fossa
• alveolar processes
• anterior nasal spine

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Anatomy

• frontalis
• orbicularis oculi
• orbital portion
• palpebral portion
• zygomaticus major
• levator labii superioris alequae nasii
• levator anguli oris
• orbicularis oris
• risorius
• depressor anguli oris
• depressor labii inferioris
• mentalis
• platysma

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Anatomy

• Masseter
• Buccinator

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Injuries Treatment

• Facial injuries
• Tend to bleed profusely
• Highly vascular relatively delicate tissue
• Manage w/ Universal Precautions (UPs), direct
  pressure, sterile dressings
• Fractures/dislocations
• Check teeth occlusion

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Injuries Treatment

• Dental injuries
• Mandate mouth guard use to reduce injury rate
• Tooth avulsion care
• 30 minute window
• Store tooth in HBSS (Save a Tooth), in warm
  saline, or in whole milk (NOT 2 or skim!!)

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Injuries Treatment

• Nose fracture
• Control bleeding refer for x-rays
• Nosebleed
• Sit upright Use ice direct compression
• Do not blow nose for at least two hours
  (dislodges clot)

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Injuries Treatment

• Ear injuries
• Cauliflower ear
• Wrestlers rugby players
• Encourage to wear head gear
• Ice and/or aspirate to prevent
• Swimmers ear
• Bacterial infection (not typically fungal)
• Itching, pain, dizziness, partial hearing loss
• Prevent w/ boric acid alcohol drops, refer if
  necessary

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Injuries Treatment

• Ear injuries
• Ruptured ear drum
• Fall or slap to the ear can rupture tympanic
  membrane
• Loud pop followed by ringing (tinnitus), pain,
  nausea, vomiting, dizziness
• Usually resolves without treatment, but refer to
  physician for evaluation

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Injuries Treatment

• Ear injuries
• Impacted cerumen
• Hearing loss/muffled sound w/ no mechanism of
  injury (ear wax prevents reverberation of ear
  drum)
• Irrigate w/ warm water or commercially available
  cleansing irrigator
• If unsuccessful, physician may scrape away w/
  curette

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Injuries Treatment

• Eye injuries
• Orbital hematoma (black eye)
• Direct blow
• Treat w/ cold application
• Instruct athlete to avoid blowing the nose

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Injuries Treatment

• Eye injuries
• Foreign body removal
• Irrigate w/ saline before and after
• Always try to flush outonly use manual removal
  if absolutely necessary

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Injuries Treatment

• Eye injuries
• Corneal abrasions
• Patch and refer if suspected
• Photophobia
• fluorescein stain
• Hyphema
• Blood in anterior chamber

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Injuries Treatment

• Eye injuries
• Retinal detachment
• Curtain falling