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Head and Neck > 2) Osteology and Radiology > Flashcards

2) Osteology and Radiology Flashcards

1
Q

What can the cranium be split up into?

A

Neurocranium - housing brain

Viscerocranium - facial skeleton

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2
Q

What does the neurocranium consist of?

A

Calvaria (roof) and base of skull

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3
Q

What bones form the calvarium?

A

Frontal, occipital and two parietal bones

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4
Q

What bones form the cranial base?

A

Frontal, sphenoid, ethmoid, occipital, parietal and temporal bones

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5
Q

How are the bones of the calvaria arranged?

And why?

A

Tri lamina arrangement, two layers of compact bone separated by layer of spongy bone (diploe)
Conveys strength without adding significant weight

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6
Q

Give examples of bones in the facial skeleton:

A

Zygomatic, maxilla, mandible,. lacrimal, nasal, sphenoid, vomer and palatine bone

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7
Q

What are the two types of joint in the skull?

Give an example of each

A

Immobile: joined by fibrous tissue e.g. sutures
Mobile: only one, temporomandibular joint

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8
Q

Give examples of sutures in the skull:

A

Coronal: between parietal and frontal
Squamous: temporal and parietal
Sagittal: between parietal bones
Lambdoid: between parital and occipital

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9
Q

What happens to the sutures as we age?

A

Ossify

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10
Q

What are fontanelles?

A

Membranous areas of unfused skull in babies

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11
Q

What is the function of fontanelles?

A

Allow for brain growth and flexibility eases passage through birth canal

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12
Q

What are the names of the fused anterior and posterior fontanelles?

A

Bregma

Lambda

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13
Q

What is the significance of sunken fontanelles?

A

Dehydration or malnutrition

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14
Q

What is the significance of bulging fontanelles?

A

Raised intracranial pressure or meningitis

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15
Q

What is the significance of enlarged fontanelles?

A

Premature birth or Down’s syndrome

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16
Q

What is the pterion?

A

Lateral aspect of skull where temporal, parietal, frontal and sphenoid bones meet. Thinnest part of skull

17
Q

What can a fracture at the pterion lead to?

A

Injury of anterior branch of middle meningeal artery causing extradural haematoma

18
Q

Why is it called an extradural haematoma?

A

Blood vessels run between periosteum and dura mater so dura is pushed away from bone by blood and pressure exerted on brain

19
Q

What are the 3 areas of the cranial floor?

A

Anterior, middle and posterior floor

20
Q

What allows neurovascular structures to pass into cranial compartment?

A

Foramina of cranial floor

21
Q

What causes skull fractures?

A

Severe trauma, blows/impact injury

22
Q

What are the consequences of skull fractures?

A

Damage underlying brain, blood vessels or cause intracranial haematoma

23
Q

What is the primary investigation used in suspected skull fractures?

A

CT scan

24
Q

What causes basilar skull fractures?

A

Force transmitted through vertebral column

25
Q

What suggestive signs of a basilar skull fracture?

A

Battle’s sign - bruising of mastoid process
Raccoon eyes - bilateral bruising around eyes
Haemotympanum - blood behind ear drum
CSF leakage from nose and ear

26
Q

What are the complications of basilar skull fractures?

A

Meningeal tears
Cranial nerve palsies
Meningitis

27
Q

What causes facial skeleton fractures?

A

Road traffic collisions, fights and falls

28
Q

What bones of the facial skeleton are commonly fractured?

A

Nasal, zygomatic and mandible

29
Q

If a patient has a suspected neck injury, what should be done?

A

Spinal immobilisation

30
Q

What investigations can confirm a spinal fracture in adults and children?

A

CT in adult

X-ray/MRI in children

31
Q

What is a Jefferson’s fracture and what causes it?

A

Burst fracture of C1, combination of anterior and posterior arch fractures. Caused by axial compression

32
Q

What is a Hangman’s fracture and what causes it?

A

Bilateral fracture of posterior arch of C2 and disruption of C2/3 junction. Caused by hyperextension of neck

33
Q

What are the complications of Hangman’s fractures?

A

May extend to transverse foramen and damage vertebral arteries
C2 may displace causing spinal cord damage

34
Q

What are vertebral crush fractures and what causes them?

A

Fractures of vertebral bodies causes by osteoporosis, hyperflexion and various others

35
Q

What degenerative disease can affect the spine?

A

Osteoarthritis -> cervical spondylosis

36
Q

What are the features of cervical spondylosis?

A 
Osteophytes
Facet joint hypertrophy
Disc herniation 
Disc space narrowing 
Sclerosis of end plates
37
Q

What is cervical spondylotic radiculopathy and what can it lead to?

A

Nerve root impingement

Dermatomal arm pain +/- mild weakness and sensory loss

38
Q

What is cervical spondylotic myelopathy and what can it lead to?

A

Spinal cord compression

Loss of function and fine motor skills in upper limb

Head and Neck (17 decks)

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