ATLS Ocular and Facial Trauma

Question 1

A patient presents with a blunt eye injury and decreased visual acuity. On exam, blood is visible in the anterior chamber. What is this condition called?

Accepted Answer

Hyphema

Answer

Vitreous hemorrhage

Answer

Retinal detachment

Answer

Corneal abrasion

Question 2

Which finding on examination of an eye injury warrants immediate ophthalmology consultation for possible open globe?

Accepted Answer

Teardrop-shaped pupil

Answer

Subconjunctival hemorrhage

Answer

Periorbital ecchymosis

Answer

Eyelid laceration

Question 3

What is the initial management priority for a patient with a suspected open globe injury?

Accepted Answer

Apply a rigid eye shield without pressure

Answer

Apply a pressure patch to both eyes

Answer

Irrigate the eye with saline

Answer

Attempt to remove any visible foreign body

Question 4

A 28-year-old sustains midface trauma and cannot open his mouth fully. CT shows comminuted fractures of the zygomatic arch bilaterally with posterior displacement. Which muscle movement is most impaired?

Accepted Answer

Masseter action during mouth opening

Answer

Tongue protrusion

Answer

Orbicularis oculi closure

Answer

Frontalis elevation

Question 5

Le Fort II fractures are characterized by which of the following?

Accepted Answer

Pyramidal fracture through the nasal bridge and orbital floors, separating the midface

Answer

Horizontal fracture separating the entire maxilla at the base

Answer

Fracture through the lateral orbital walls and zygomatic arches

Answer

Isolated nasal bone fracture only

Question 6

During trauma assessment, a patient has clear fluid draining from one nostril after a facial fracture. What is the most concerning etiology?

Accepted Answer

Cerebrospinal fluid rhinorrhea from a basilar skull fracture

Answer

Normal serous nasal secretions from mucosal irritation

Answer

Blood-tinged saline from nasal irrigation

Answer

Lacrimal duct injury