Evolution of the Trauma Cycle strac创伤的周期演化结构.pptxVIP

Maxillofacial and Ocular Injuries Objectives At the conclusion of this presentation the participant will be able to: Identify the key anatomical structures of the face and eye and the impact of force on those structures Discuss assessment priorities for a patient with maxillofacial and ocular injuries Prioritize the care of a patient with facial and ocular injuries Discuss psychosocial support for a patient with maxillofacial and ocular injuries Mechanism of Injury Low velocity High velocity Pathophysiology Bones of face make up the most complex skeletal area of the body Maxillofacial fractures result from either blunt or penetrating trauma Pathophysiology ‘G’ force is a measure of acceleration not produced by gravity High Impact: Supraorbital rim – 200 G Symphysis Mandible –100 G Frontal – 100 G Angle mandible – 70 G Low Impact: Zygoma – 50 G Nasal bone – 30 G Etiology 60% of patients with severe facial trauma have multisystem trauma and the potential for airway compromise Etiology 25% of women with facial trauma are victims of domestic violence Increases to 30% if an orbital wall fx is present 25% of patients with severe facial trauma will develop Post Traumatic Stress Disorder Ocular Structures Human Eye Anatomy Bony Orbit Roof Frontal bone Sphenoid Medial wall Maxilla, lacrimal, ethmoid body of sphenoid Floor Maxilla Palatine Zygoma Lateral Zygoma and greater sphenoid Frontal Maxilla Zygoma Sphenoid Cranial Nerves Orbital Fractures Image found on W Orbital Fractures Orbital Fractures Usually through floor or medial wall Enophthalmos Anesthesia Diplopia Infraorbital stepoff deformity Subcutaneous emphysema Image found on R Orbital Fractures Symptoms Periorbital swelling Crepitus Proptosis Ophthalmoplegia Enophthalmos Palpable defects Assess for globe injury Avoid nose blowing Assess for entrapment Facial Structures LeFort I Fracture Image found on W LeFort II Fracture Image found on W LeFort III Fracture Image found on W Le Fort Fractures Le Fort III Fractur