JBL Questions Chapter 33 Face and Neck Trauma

Following blunt trauma to the face a 30-year old man presents with epistaxis, double vision, and an inability to look upward. You should suspect: A. An orbital blowout fracture B. Traumatic conjunctivitis C. Traumatic retinal detachment D. Fracture of the cribriform plate

A. An orbital blowout fracture

Vascular injury following trauma to the anterior neck would MOST likely present with: A. Pulse deficits B. Dysphagia C. Parathesia D. Hemoptysis

A. Pulse deficits

A flattened appearance to the face and loss of sensation over the chest following blunt facial trauma is MOST indicative of a/an: A. Zygomatic fracture B. Orbital skull fracture C. Le Fort I fracture D. Temporomandibular joint dislocation

A. Zygomatic fracture

A young man was assaulted and has extensive maxillofacial injuries. Your initial assessment reveals that he is semiconscious, has poor respiratory effort, and has blood draining from the corner of his mouth. Initial management for this patient involves: A. Applying a cervical collar, performing a blind finger sweep to clear his airway, and providing ventilatory assistance with a bag-mask device B. Manually stabilizing his head in a neutral position, suctioning his oropharynx, and assisting ventilations with a bag-mask device and 100% oxygen C. Fully immobilizing his spine, inserting a nasopharyngeal airway, and hyperventilating him with a bag-mask device at a rate of 20 breaths/min D. Inserting an oropharyngeal airway, preoxygenating him with a bag-mask device for 2 min and then intubating his trachea

B. Manually stabilizing his head in a neutral position, suctioning his oropharynx, and assisting ventilations with a bag-mask device and 100% oxygen

If you are unable to orotracheally intubate a patient due to massive maxillofacial trauma and sever oropharyngeal and nasopharyngeal bleeding, you would MOST likely have to perform: A. Digital (tactile) intubation B. A needle or surgical cricothyrotomy C. Pharmacologically assisted intubation D. Nasotracheal intubation

B. A needle or surgical cricothyrotomy

Significant blunt injuries to the larynx or trachea pose an IMMEDIATE risk of: A. Hypovolemic shock B. Airway compromise C. Aspiration of gastric contents D. Mediastinal inflammation

B. Airway compromise

The primary risk associated with oral and dental injuries is: A. Malocclusion B. Airway compromise C. Permanent tooth loss D. Intraoral infection

B. Airway compromise

A 51-year-old woman sustained a large laceration to her cheek when she was cut by a knife during a robbery attempt. The patient is conscious and alert and has severe oral bleeding. She denies any other trauma. Your FIRST action should be to: A. Suction her oropharynx for up to 15 seconds B. Ensure that she is sitting up and leaning forward C. Control the intraoral bleeding with sterile gauze D. Manually stabilize her head in a neutral position

B. Ensure that she is sitting up and leaning forward

A fracture of all midfacial bones, separating the entire midface from the cranium: A. Is almost always accompanied by multiple severe fractures of the mandible B. Is commonly associated with facial elongation and dental malocclusion C. Should be stabilized by placing bulky dressings across the fractured area D. Is referred to as a Le Fort I fracture and most commonly results from a fall

B. Is commonly associated with facial elongation and dental malocclusion

Proper treatment for an open wound to the neck includes: A. Applying a circumfrential pressure dressing B. Seating the wound with an occlusive dressing C. Administering 2 L of IV crystalloid solution D. Prompt transportation to a hyperbaric chamber

B. Seating the wound with an occlusive dressing

Because significant force is required to fracture the mandible: A. Patients with a possible mandibular fracture should be intubated routinely B. Most mandibular fractures are associated with a spinal fracture C. It is often fractured in more than one place and is unstable to palpation D. A mandibular fracture can be ruled out in cases of minor blunt facial trauma

C. It is often fractured in more than one place and is unstable to palpation

In addition to massive bleeding, injury to a carotid or vertebral artery would MOST likely cause: A. Hemiparalysis B. Severe bradycardia C. An air embolism D. Cerebral hypoxia

D. Cerebral hypoxia

During an explosion, a 42-year-old construction worker sustained a large laceration to the lateral aspect of his neck when he was struck by a piece of flying debris. The patient is conscious, but complains of difficulty hearing. In addition to protecting his spine, you should be MOST concerned with: A. Carefully examining his ear to determine if his tympanic membrane is ruptured B. Administering high-flow oxygen via nonrebreathing mask as soon as possible C. Applying a bulky dressing to the laceration and securing it firmly with a bandage D. Covering the laceration with an occlusive dressing and controlling the bleeding

D. Covering the laceration with an occlusive dressing and controlling the bleeding

You are transporting a conscious middle-aged woman with anterior neck trauma. She is on high-flow oxygen, has spinal precautions in place, and has a large-bore IV line of normal saline in place. When you reassess her vital signs, you note that her blood pressure is 90/64 mmHg, her pulse rate is 120bpm, and her respirations are 22 breaths/min with adequate depth. You should: A. Start a second IV line and administer crystalloid IV fluids until her systolic blood pressure is at least 100 mmHg B. Elevate her legs, apply a blanket, and administer IV fluid boluses until her heart rate is within a normal range C. Begin assisting her ventilations with a bag-mask device, rapidly infuse 2L of IV fluid, and reassess D. Keep the patient warm and infuse enough isotonic crystalloid solution to maintain adequate perfusion

D. Keep the patient warm and infuse enough isotonic crystalloid solution to maintain adequate perfusion

Open soft-tissue facial trauma following a significant mechanism of injury: A. Dictates the need for immediate intubation to protect the patients airway B. Often requires removal of foreign bodies that are impaled in the face C. Is of most concern due to the possibility of permanent disfigurement D. Suggests that the patient may have a closed head injury or spinal injury

D. Suggests that the patient may have a closed head injury or spinal injury