Head, Face, Ear, and Head, Face, Ear, and Mouth ConditionsMouth Conditions

Injuries to the headInjuries to the head• Skull FracturesSkull Fractures

• ConcussionsConcussions– Second Impact Second Impact

SyndromeSyndrome

• Scalp injuriesScalp injuries– Lacerations, Lacerations,

abrasions, abrasions, contusions, and contusions, and hematomashematomas

Injuries to the faceInjuries to the face

• Mandible fracture/dislocationMandible fracture/dislocation– Mandible is the Jaw BoneMandible is the Jaw Bone

• Temporomandibular Joint dysfunction Temporomandibular Joint dysfunction (TMJ)(TMJ)

• Zygomatic Complex fractures Zygomatic Complex fractures (cheekbone)(cheekbone)

• Maxillary fractureMaxillary fracture

• Face LacerationsFace Lacerations

Mandible Mandible fracture/dislocationfracture/dislocation

• SX:SX:– Pain when biting Pain when biting

downdown– Unable to move jawUnable to move jaw– DeformityDeformity– Bleeding around Bleeding around

teethteeth– Numbness of lower Numbness of lower

liplip– Bottom jaw forwardBottom jaw forward

Temporomandibular Joint Temporomandibular Joint dysfunction (TMJ)dysfunction (TMJ)

• SX:SX:– HeadachesHeadaches– EaracheEarache– VertigoVertigo– InflammationInflammation– Neck painNeck pain– Hypomobility or Hypomobility or

hypermobilityhypermobility– MalocculsionMalocculsion– Limited ROMLimited ROM

Zygomatic Complex fractures Zygomatic Complex fractures (cheekbone)(cheekbone)• Bones:Bones:

– ZygomaticZygomatic– MaxillaryMaxillary

• SX:SX:– Obvious deformityObvious deformity– Epistaxis Epistaxis

(nosebleed)(nosebleed)– Diplopia (seeing Diplopia (seeing

double)double)– Numbness in the Numbness in the

cheekcheek• TX:TX:

– Ice and ReferralIce and Referral

Maxillary fractureMaxillary fracture

• SX:SX:– Pain while Pain while

chewingchewing– MalocclusionMalocclusion– EpistaxisEpistaxis– DiplopiaDiplopia– Numbness in lip Numbness in lip

and cheek areaand cheek area

Dental InjuriesDental Injuries

• Tooth fractureTooth fracture

• Tooth subluxation, luxation, avulsionTooth subluxation, luxation, avulsion– Subluxation (slightly loose)Subluxation (slightly loose)– Luxation (no fx, but very loose) Luxation (no fx, but very loose)

•Moves either forward or backwardMoves either forward or backward

– Avulsion (tooth is completely removed)Avulsion (tooth is completely removed)

Nasal InjuriesNasal Injuries

• Nasal fractures (most Nasal fractures (most common fractured face common fractured face bones)bones)– Sx:Sx:

• DeformityDeformity• SwellingSwelling• EpistaxisEpistaxis• CreptiusCreptius

• Deviated SeptumDeviated Septum• EpistaxisEpistaxis

Auricular Hematoma Auricular Hematoma aka Cauliflower Earaka Cauliflower Ear

– CompressionCompression– Shearing force (single or Shearing force (single or

repetitive)repetitive)– Tears overlying tissue away from Tears overlying tissue away from

cartilage and then fluid collects in cartilage and then fluid collects in the pocketsthe pockets• Body is unable to remove as fast Body is unable to remove as fast

as it appearsas it appears– May be drained but ultimately will May be drained but ultimately will

require surgery to fixrequire surgery to fix

• SX:SX:– HotHot– SwellingSwelling

Rupture of Tympanic Rupture of Tympanic MembraneMembrane• Seen in contact or collision sportsSeen in contact or collision sports

• Fall or slap to the unprotected ear or Fall or slap to the unprotected ear or sudden underwater variationsudden underwater variation– SX:SX:

• Loud popLoud pop

• Pain in earPain in ear

• NauseaNausea

• VomitingVomiting

• DizzinessDizziness

• Hearing lossHearing loss

Swimmer’s Ear (Ortitis Swimmer’s Ear (Ortitis Externa)Externa)• Infection of ear canal (not a fungal Infection of ear canal (not a fungal

infection)infection)• Water gets trapped due to obstructions:Water gets trapped due to obstructions:

– Cysts, bone growths, plugs of earwax, or Cysts, bone growths, plugs of earwax, or swelling caused by allergiesswelling caused by allergies

• SX:SX:– PainPain– DizzinessDizziness– ItchingItching– DischargeDischarge– Partial hearing lossPartial hearing loss

Middle Ear Infection (Otitis Middle Ear Infection (Otitis Media)Media)• Accumulation of fluid in middle ear canal caused Accumulation of fluid in middle ear canal caused

by local or systematic inflammation or infectionby local or systematic inflammation or infection• SX:SX:

– Intense PainIntense Pain– Fluid drainingFluid draining– Transient loss of hearingTransient loss of hearing

• Systematic infection SX:Systematic infection SX:– FeverFever– HeadacheHeadache– IrritabilityIrritability– Loss of appetiteLoss of appetite– nauseanausea

• 1: Normal1: Normal

• 2: Waxy2: Waxy

• 3:Otitis Media 3:Otitis Media c infusion c infusion

• 4:Otitis Media4:Otitis Media

• 5:Severe 5:Severe Otitis MediaOtitis Media

• 6:Otitis Media 6:Otitis Media c secretionc secretion

• 7:Fluid 7:Fluid (asymptoma(asymptomatic child)tic child)

• 8:Healing of 8:Healing of OM c fluidOM c fluid

• 9:Severe OM9:Severe OM• 10:Formatio10:Formatio

n of scar n of scar tissue from tissue from Severe OMSevere OM

• 11:Rupture 11:Rupture of Membraneof Membrane

• 12: Tubes12: Tubes

Eye InjuriesEye Injuries

• Orbital HematomaOrbital Hematoma• Orbital FxOrbital Fx• Retinal Retinal

DetachmentDetachment• Rupture of the Rupture of the

GlobeGlobe• Corneal AbrasionCorneal Abrasion• Acute Acute

ConjunctivitisConjunctivitis• StySty• HyphemaHyphema

Orbital Hematoma (black Orbital Hematoma (black eye)eye)

• Mild Bruising to Orbital fxMild Bruising to Orbital fx

• Orbital fxOrbital fx– Eyeball forced posteriorly compressing orbital fat Eyeball forced posteriorly compressing orbital fat

until a blowout or rupture occurs until a blowout or rupture occurs • Fat and interior extraocular muscles can herniate Fat and interior extraocular muscles can herniate

through fx)through fx)

– Sx:Sx:• Diplopia Diplopia

• Restricted mvmt of eyeRestricted mvmt of eye

• A downward displacement of the eyeA downward displacement of the eye

• Pain w/ swelling and hemorragePain w/ swelling and hemorrage

• Numbness (infraorbital nerve)Numbness (infraorbital nerve)

– TX: SurgicalTX: Surgical

Orbital Blowout (fracture)Orbital Blowout (fracture)

Retinal DetachmentRetinal Detachment• Blow to athlete’s eye can Blow to athlete’s eye can

partially or completely partially or completely detach retinadetach retina

• Sx:Sx:– Detachment is painlessDetachment is painless

•Specks floating before eyeSpecks floating before eye•Flashes of lightFlashes of light•Blurred visionBlurred vision•““curtain falling” over field of curtain falling” over field of

visionvision

• Tx:Tx:– Refer to OphthalmologistRefer to Ophthalmologist

Rupture of the globeRupture of the globe

Rupture of globeRupture of globe

• SX: SX: – Severe painSevere pain– Decreased visual acuity Decreased visual acuity – DilopiaDilopia– Irregular pupilsIrregular pupils– Increased intraocular pressureIncreased intraocular pressure– Orbital leakageOrbital leakage

HyphemaHyphema• Collection of blood within the anterior chamber Collection of blood within the anterior chamber

(direct blow)(direct blow)• SX:SX:

– Visible reddish tint to ant. ChamberVisible reddish tint to ant. Chamber– Within 2 hrs blood settles inferiorly or may fill entire Within 2 hrs blood settles inferiorly or may fill entire

chamberchamber– Blood may turn pea green colorBlood may turn pea green color– Vision is partially or completely blockedVision is partially or completely blocked

• Tx:Tx:– Hospitalization w/ bed restHospitalization w/ bed rest– Head @ 30 -40 degreesHead @ 30 -40 degrees– Patch B eyesPatch B eyes– Sedation and medication to relieve pressureSedation and medication to relieve pressure

Subconjunctival Subconjunctival HemorrhageHemorrhage

Tooth InjuriesTooth Injuries

• TX:TX:– If at all possible it is best to put tooth back in If at all possible it is best to put tooth back in

socket for transport to dentist or hospitalsocket for transport to dentist or hospital• Other acceptable forms of transport are:Other acceptable forms of transport are:

– Save-a-tooth or milk Save-a-tooth or milk

• Mouth-guards are thought to prevent Mouth-guards are thought to prevent concussionsconcussions– Homework: find an article online or in a paper Homework: find an article online or in a paper

that either supports or refutes this statementthat either supports or refutes this statement– BE prepared to share!BE prepared to share!