Сочетанные и комбинированные повреждения челюстно-лицевой области и других областей тела. Клиника, диагностика, особенности течения
#255
*!A 34 years old man complained of limitation of mouth opening. History - gunshot wound to the right side of my face 2 years ago. On examination: severe scarring in the temporal and cheek areas on the right. Mouth opening limited to 1 cm of Motion at the temporomandibular joints are almost not defined.
Which of the following preliminary diagnoses is MOST probable?
*lockjaw
*muscle contracture of the lower jaw
*neurogenic contracture of the lower jaw
*+scar contracture of the lower jaw
*inflammatory contracture of the lower jaw
#256
*!A 43 years old man, was admitted to the emergency Department of oral and maxillofacial surgery after injury at the plant. On examination - multiple abrasions, swelling of the tissues of the Malar area on the right. The mouth opening is limited. Determined symptom steps on lower orbital edge and numbness of the skin infraorbital area and the wing of the nose to the right.
Which of the following preliminary diagnoses is MOST probable?
*Zygomatic bone fracture with displacement of fragments
*+Combined injury
*Le-Fort 2
*Associated trauma
*Soft tissue contusion of the zygomatic region
#257
*!A 33 years old man was taken to the hospital after the injury. From the anamnesis during installation work was electrocuted, fell from a height of 5 meters. Objectively, pain in region of mandible, thoracic spine, and burn marks in the left forearm. The pain increases with movements of the body. Violations of the motor and sensory areas revealed no violations of functions of pelvic organs is not defined. X-rays revealed a compression fracture of the body Th12 vertebra without the introduction of bone fragments into the spinal canal. On the left forearm there are two areas of 3rd degree burn the size of 3x3 cm and 4x3 cm
What type of spinal injury MOST likely in this patient?
*associated -uncomplicated
*associated complicated
*Traumatic brain injury
*Isolated complicated
*+Combined
#258
*!A 23 years old man turned to the maxillofacial Department due to the injury of the persons with complaints of dizziness, nausea, vomiting, painful mouth opening. During the inspection, there is abnormal mobility of the mandible between 4.6 and 4.7 teeth.
What is the MOST likely nature of this fracture?
*Distal
*Bifocal
*Multiple
*Comminuted
*+associated
#259
*!A 20 years old man delivered in an unconsciousness with an injury of the maxillofacial region. On examination, liquorrhea from nose and ears.
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Which of the following preliminary diagnoses is MOST probable?
*concussion;
*compression of the brain;
*gunshot wound of the jaw;
*fracture of the nose;
*+skull base fracture.
#260
*!A 35 years old man delivered after 2 hours after injury. Objectively – a patient is unconscious, tendon reflexes sluggish, live photo-reaction, edema of the soft tissues of the midface, abnormal mobility of the upper jaw bleeding from the nose. On X-ray: a fracture line passes through the root of the nose, the inner wall of the orbit to infraorbital fissure in the external wall of the orbit through the frontal-zygomatic suture and the zygomatic arch and pterygoid processes of the sphenoid bone
Which of the following examination methods is the MOST appropriate from the point of view of eliminating the presence of alcohol in the blood of the patient?
*NST test;
*+Rapoport test;
*ferritin in serum;
*thyrotoxic serum;
*clotting at the Sukharev.
#261
*!A 57 years old man, contacted the clinic in the first hours after injury, with complaints of the presence of a nodule in the buccal, infraorbital areas, dizziness, General weakness, pain in the upper jaw, slurred speech. Objectively: nasal bleeding, painful mouth opening, malocclusion, hematoma in the region of the root of the nose, a symptom of the lengthening of the midface. From the anamnesis: there was a temporary loss of consciousness, a sense of disorientation, vomiting.
Which of the following factors is the MOST likely cause impaired consciousness, dizziness and vomiting?
*the burden of oral and maxillofacial trauma;
*age of the victim;
*in terms of the treatment of the patient;
*+concussion;
*nosebleeds
#262
*!A 29 years old woman, was admitted with complaints of severe headache, nausea, was vomiting. History: fell and hit her head, momentarily lost consciousness. Objectively: consciousness – moderate stun, small nystagmus, lack of coordination more pronounced in the left extremities. Mild meningeal symptoms. On radiographs of the skull data of a skull fracture have not been identified. 2 hours after receipt degradation: level of consciousness – stupor, there was inhibition of photoreactivity on the right and weakness in the left extremities, increased meningeal symptoms.
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What clinical form of a TBI is MOST consistent with this clinical picture?
*brain injury mild
*concussion
*brain injury of medium degree of
*brain injury severe
*+the compression of the brain
#263
*!A 32 years old man was admitted with complaints of headache, nausea, was vomiting. History: fell and hit her head, momentarily lost consciousness. In neurological status: moderately expressed cerebral symptoms, small sweepy nystagmus, mild impaired coordination. Meningeal symptoms are not present. On brain CT scan data of a skull fracture foci of brain contusion and intracranial hemorrhage were not identified.
Which of the following preliminary diagnoses is MOST probable?
*brain injury mild
*+concussion
*brain injury of medium degree of
*brain injury severe
*compression of the brain
#264
*!A 54 years old man, was beaten by unknown assailants. According to witnesses, lost consciousness about 40 minutes. Complaints of headache, dizziness, pain in the upper jaw, which increases with the closing of the teeth and the chewing, foreign body sensation in the throat, difficulty in nasal breathing and nausea. Meningeal symptoms are positive.
Which of the following preliminary diagnoses is MOST probable?
*brain concussion, bruises of soft tissues of face
*brain contusion, a fracture of bones of nose with displacement
*brain concussion, fracture of the type Le Fort II
*+brain contusion, fracture of the type Le Fort I
*concussion, alcohol intoxication
#265
*!A 37 years old woman was beaten. Complains of headache, vomiting, dizziness, pain in the upper jaw, which increases with the closing of the teeth and the chewing, foreign body sensation in the throat, difficulty in nasal breathing, nausea, numbness of skin in the infraorbital region, upper lip. During the inspection of edema and hemorrhage in the soft tissues of infraorbital region. Bruise in the right lower eyelid, the medial corner of the eye and the medial division of the upper eyelid. Acts as the conjunctiva of the palpebral fissures, abundant bleeding from the nose. Palpation - digest and displacement of the bone fragment of the upper jaw.
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Which of the following preliminary diagnoses is MOST probable?
*brain concussion, bruises of soft tissues of face
*brain contusion, a fracture of bones of nose with displacement
*+brain contusion, fracture of the type Le Fort II
*brain contusion, fracture of the type Le Fort I
*brain concussion, fracture of the type Le Fort III
#266
*!Teen, 16 years, fell while skiing. Delivered in a serious condition. Opens eyes to a shout, coordinates protective movement in pain and confused answers to questions. When viewed face - puffy "Crescent-shaped" form, a symptom of "points". In the horizontal position of the face is flattened, while the vertical is the elongation of the face. Palpebral aperture widens, your eyeballs move down. On palpation determined by the signs of violation of the integrity of facial bones, reacts to palpation.
Which of the following diagnoses is MOST likely in this patient?
*brain concussion, bruises of soft tissues of face
*brain contusion, fracture of the upper jaw of the type Le Fort II
*brain contusion, skull base fractures, upper jaw fracture type Le Fort I
*brain concussion, fracture of the upper jaw of the type Le Fort III
*+brain contusion, skull base fractures, upper jaw fracture type Le Fort III
#267
*!A25 years old man was in a car accident. On examination: the patient is in a coma, on the pain non-responsive, breathing noisy, frequent, and intermittent. Bleeding from the nose and ears, bleeding in the orbital tissue ("symptom score"), a hematoma in the left parietal region. "Floating" eyes, anisocoria with the left pupil extension. Intermittent tonic convulsions in the limbs.
Which of the following diagnoses is MOST likely?
*Craniofacial trauma. Concussion of the brain. Fracture type Le Fort 1
*+Severe TBI. Compression of the brain. A fracture of the skull base.
*TBI of moderate severity. Bruising of the brain. A fracture of the skull base.
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*Severe head injury. Diffuse axonal injury.
*Concussion of the brain. Fracture type Le Fort 2.
#268
*!A young man of 17 years delivered to the clinic with a wound of the face, resulting in the fall from the bike. In the anamnesis of the disease, there was a brief loss of consciousness and occasional vomiting. The examination found a wound in the buccal region on the left gaping and bleeding.
Which of the following preliminary diagnoses is MOST probable?
*brain contusion, fracture of the jaw
*fracture of the jaws, traumatic brain injury
*craniocerebral injury, contusion of the soft tissues of the face
*fracture of facial bones. traumatic brain injury
*+associated injury: concussion, buccal wound
#269
*!Teen 13 years old brought to the emergency Department of oral and maxillofacial surgery with a wound of the face, received when falling down the stairs at school. In the anamnesis of the disease, there was a brief loss of consciousness and occasional vomiting. The examination found a wound in the chin area that gapes and bleeds.
Which of the following preliminary diagnoses is MOST probable?
*brain contusion, fracture of the jaw
*fracture of the jaws, traumatic brain injury
*craniocerebral injury, contusion of the soft tissues of the face
*fracture of facial bones. traumatic brain injury
*+concussion, wound of the chin region
#270
*!Teen 12 years, during training I got injured. Consciousness is not lost, said weak headaches when driving. General condition udovletvoriteli. On examination: in the area of the supraorbital ridge to the right, the wound length of about 2.0 cm, bleeding, uneven edges, swelling of the surrounding soft tissues.
What preliminary diagnosis of the following is MOST likely?
*intracranial hematoma, torn-bruised wound of the supraorbital ridge to the right
*+closed cranial- brain trauma, torn-bruised wound of the supraorbital ridge to the right
*brain injury, bruised wound of the superciliary arches to the right
*torn-bruised wound of the supraorbital ridge to the right
*bruised wound of the superciliary arches to the right
#271
*!Teen 15 years delivered in the emergency Department. The injury was 1 hour ago, got hit by a car on a pedestrian lane. On examination: the General condition heavy, lethargic, contact does not come. Facial asymmetry due to swelling of the soft tissues of the upper jaw on the right. In infraorbital and zygomatic areas, scalped wound with a margin of the lower eyelid with a diameter of 6.0x5cm. on palpation the lower edge of the orbit is determined by the symptom of "steps". Mouth opening limited to 2 cm For the ECHO EG - there is a hematoma in the right temporal lobe of the brain.
What preliminary diagnosis of the following is MOST likely?
*fracture of the zygomatic bone on the right
*fracture of the maxilla at the Le-Fort – 2
*+the associated damage of the upper jaw and a brain injury
*torn-bruised wound infraorbital and zygomatic region on the right
*fracture of the anterior wall of the maxillary sinus on the right
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