Dr. Gibbs' Trauma Pearls
II - Cricoid to angle of mandible
III - Angle of mandible to base of skull
*Zone II is more easily evaluated by surgical intervention; zones I and III by
a. Corneal staining, Increased pressure and acute glaucoma, Rebleeding
2. Globe rupture - DO NOT MEASURE PRESSURES
3. Medial canthus injury - think about damage to lacrimal duct
I. Fracture line passes through the alveolar ridge, lateral nose and inferior
wall of maxillary sinus.
II. Fracture arch passes through posterior alveolar ridge, lateral walls
of maxillary sinuses, inferior orbital rim and nasal bones
III. Fracture line passes through nasofrontal suture, maxillo-frontal
suture, orbital wall and zygomatic arch.
2. Mandibular Fractures - things to look for:
a. Sublingual hematoma (pathognomonic), malocclusion, tongue depressor
test (pain with biting down), limited mouth opening, mental nerve
3. Auricular Hematoma & septal hematomas - drain to avoid pressure necrosis
and cauliflower ear & saddle nose deformity respectively
2. Loss of aortic knob
3. R mainstem bronchus misplaced
4. Apical cap
5. Tracheal deviation
6. L pleural effusion
2. Jefferson's Fracture - fracture through posterior & anterior arches of C1 > caused by axial loading - the ring breaks outward
3. Pseudosubluxation - normal mobility of C-2 on C-3 in flexion which be mistaken for pathologic motion; (is normal in children < 8 years old);
4. When managed properly SDH = greater morbidity than epidurals
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