Facial Injuries Evaluation

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Facial Injuries Evaluation
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Evaluation of Facial Injuries

• You may need to rule out a concussion.
• You may have to perform all the memory,
  analytical tests for a concussion.
• You may have to perform a cranial nerve
  assessment.

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Nose Anatomy Injuries

• Nasal bones
• Nasal septum
• Nasal cartilage
• Nostrils
• Fracture
• Contusion
• Rhinitis
• Epistaxis

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Nose Evaluation

• History
• Normal questions youd ask for every injury
• Does it look normal to them?
• Can they breathe normally?
• Did it bleed?
• Observation
• General appearance
• Is it swollen?
• Do they have raccoon eyes or is there any
  discoloration?
• Is it straight when looking from front, side,
  superior views?
• Any unusual bumps?
• Is it bleeding?

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Nose Evaluation

• Palpation
• Where is it sore?
• Are there any deformities?
• Is crepitis present?
• Special Tests
• Penlight
• Cranial Assessment
• Concussion Assessment

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Ear Anatomy
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Ear Anatomy
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Ear Injuries

• Hematoma Auris (cauliflower ear)
• Swimmers Ear (external otitis)
• Infection
• Laceration

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Ear Evaluation

• History
• Normal questions youd ask for every injury
• Exact location of pain
• Do they have a history of ear infections?
• Are they sick or have they been sick? Are they
  lightheaded or dizzy?
• Have they had any excess discharge from the ear?
• Are they having trouble with their throat? Lymph
  nodes?
• Observation
• General appearance
• Are they wearing earrings?
• Is there swelling or bleeding?
• Any abnormal deformities
• Palpation
• Is it warm to the touch?
• Where is it sore?
• Special Tests
• Hearing
• Balance
• Look in canal

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Eye Anatomy
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Eye Anatomy
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Eye Injuries

• Corneal Abrasion
• Orbital Hematoma (periorbital/black eye)
• Hyphema
• Blowout Fracture (Orbital fracture)
• Detached Retina

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Eye Evaluation

• History
• Do they feel anything abnormal? Does it feel
  like there is sand in the eye (excess debris or
  scratch)?
• Observation
• General appearance
• Eyelids, eyeball (globe), eyelashes, orbit,
  conjunctive sclera, iris
• Palpation
• Where is it tender? Are there any divots,
  swelling, etc?
• Special Tests
• Visual acuity
• Peripheral
• Reaction to light
• Tracking
• Eyelid ROM

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Other Facial Anatomy

• Mandible
• Maxilla
• Zygomatic Arch
• Temporomandibular joint (TMJ)
• Teeth
• Tongue
• Throat

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Other Facial Injuries

• Zygoma Fracture
• Temporomandibular joint (TMJ) sprain,
  dislocation, fracture
• Laceration of the face/scalp
• Mandible or Maxilla fracture
• Tooth chip, fracture, dislocation
• Tongue laceration
• Other

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Mandible Maxilla Evaluations

• History
• Do they have a normal bite? When they bite down
  does it feel the same?
• Observation
• General appearance
• When looking from the front, do they appear to
  have a normal appearance?
• Does the jaw look crooked?
• Palpation
• Special tests
• Jaw ROM (open/close side to side)
• Tongue blade test
• Facial expression

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TMJ Evaluation

• History
• Do they have clicking when they open/close their
  mouth?
• Can they open/close their mouth?
• Observation
• General appearance
• Is there any swelling present over the TMJ?
• Palpation
• Do you feel any clicking when they move their
  mouth open/close or side/side?
• Special tests ROM, Jaw clenching

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Teeth Evaluation

• History
• Are they sensitive to anything?
• How long has it been painful?
• Observation
• Are any parts of the tooth missing or is the
  whole thing gone?
• Palpation
• Special Tests
• Have them wiggle the tooth
• You may have to wiggle the tooth

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Tongue Throat Evaluations

• History
• Did they bite down on their tongue?
• Did they get hit in the throat?
• Observation
• Palpation
• Special Tests
• Stick out their tongue
• Swallow
• Speak
• ROM