Anatomy for trauma

Question 1

name the three types of haemorrhages

Answer 1

1. sub arachnoid
2. sub-dural
3. extra-dural

Question 2

what is the percentage of pediatric trauma that result in hospitalisation

Answer 2

75%

Question 3

what percentage of pediatric trauma hospitalisation result in death

Answer 3

80%

Question 4

what factors can cause trauma in children

Answer 4

• abuse
• domestic falls
• recreational injuries
• motor vehicle accidents

Question 5

what is the percentage of pediatric firearm injuries results in death

Answer 5

12%

Question 6

what are the two main categories of head injuries
and what falls under each

Answer 6

general
- open and closed
specific
- lacerations
- coup-contrecoup
- haematoma
- contusions
- diffuse axonal injury
- concussions
-

Question 7

what falls under specific head injury

Answer 7

specific
- lacerations
- coup-contrecoup
- haematoma
- contusions
- diffuse axonal injury
- concussions
- anoxic
- hypoxic

Question 8

what are the three morphological classifications of head injuries

Answer 8

• scalp injuries
• scalp fracture
• brain injuries

Question 9

do skull fractures always correlate to brain injury

Answer 9

No, one may have skull injury without any significant brain injury or even have brain injury without skull injury

Question 10

what three factors result in skull fractures

Answer 10

• high velocity impact
• flat impact
• ring

Question 11

what are the possible four complications of skull fracture

Answer 11

• infections
• brain damage
• epilepsy
• intrusion of brain fragments into depressed skull fractures

Question 12

what happens in the event of open head injury

Answer 12

the skull is penetrated by a sharp object such as a knife or even a missile

Question 13

will you expect to find tissue damage in open injuries and if yes where?

Answer 13

yes, at the site of skull penetration or the even in the surrounding areas of the intruding object

Question 14

what are the 4 consequences of open injury

Answer 14

• swelling
• lacerations from the skull fragments
• vulnerability to infection
• further injury

Question 15

what happens under closed injury

Answer 15

this type of fractures are caused by blunt objects or blow to the head without penetrating the skull and this is the most common form of brain damage

Question 16

which type of injury is the most common for brain damage

Answer 16

closed injury

Question 17

what are the consequences of closed injury

Answer 17

• swelling
• increased intracranial pressure
• tissue compression

Question 18

what is a specific head injury

Answer 18

sudden impact to the head causing change in momentum or movement of the brain.

Question 19

what may happen to the vessels and cranial nerves in a event of SPECIFIC HEAD INJURY and what is the main cause of this

Answer 19

the vessels and cranial nerves may over stretch due to the sudden change in momentum

Question 20

what is COUP representative of?

Answer 20

primary impact

Question 21

what is CONTRECOUP representative of?

Answer 21

secondary impact

Question 22

what is the mechanism of closed injury

Answer 22

head starts in upright in neutral position and there is a sudden force that makes the head to move backwards in a high rate resulting in the initial impact from behind and the front of the brain impacts the anterior skull. and during the processes of head and neck rebound the brain will impact at the posterior skull eventually resulting in anterior-posterior trauma.

Question 23

under specific head injury you get concussions, how do they occur

Answer 23

??

Question 24

what is a contusion

Answer 24

a visible bruise/bleeding on the brain

Question 25

what causes diffuse axonal injury

Answer 25

- strong rotation forces of the head during events such as car accident where the unmoving brain lags behind the movement of the skull causing the brain structures to tear

Question 26

what causes Anoxic brain injury

Answer 26

- when the brain does not receive any oxygen causing the cells to die

Question 27

what causes Hypoxic brain Injury

Answer 27

when the brain does not receive enough oxygen

Question 28

what are the two most minor types of head injury

Answer 28

- laceration - hematoma

Question 29

what is the major complication of lacerations and hematoma

Answer 29

- infection

Question 30

what is the source epidural hematomas (3)

Answer 30

meningeal vessels, dural venous sinus and diploic vein from skull fractures

Question 31

where do 90% of the epidural hematomas occur

Answer 31

squamous portion of temporal bone

Question 32

in which age group of subdural hematomas common

Answer 32

infants

Question 33

what is the main cause of subdural hematoma

Answer 33

high velocity impact assault fall from significant height

Question 34

what is the source of subdural hematomas

Answer 34

dural venous sinuses cortical bridging veins

Question 35

where is the skull thickened

Answer 35

- Glabella - external occipital protuberance - mastoid processes - external angular process (zygomatic process) of frontal bone

Question 36

how many layers does the skull have

Answer 36

(5) 2 periosteum 2 compact 1 spongy

Question 37

what sites of the skull are prone to fracture

Answer 37

- sites of thin squamous temporal and parietal bones over the temples - the sphenoid sinus - the foramen magnum - the petrous temporal ridge - the inner parts of the sphenoid wings - the middle cranial fossa (the weakest with thin bones and multiple foramina) - the cribriform plate - the roof of orbits and the areas between the mastoid and dural sinuses in the posterior cranial fossa

Question 38

what factors can cause damage to CN1

Answer 38

damage at the cribriform plate blows to the frontal or occipital plate eodema or hematoma at the cribriform

Question 39

what factors can cause damage to CN2

Answer 39

blow to the region that causes displacement of the of the orbital wall. this will result to oscillations that causes the nerve to stretch and ultimately injury occurs. severe frontal impact can cause fracture in the region of sella and clinoid resulting in chiasmal injury.

Question 40

what factors can cause damage to CN3

Answer 40

- uncus in transtentorial herniation in the tentorial hiatus result in nerve compression. - stretch of the nerve at the mesencephalo-pontine junction ( cause isolated oculomotor palsy) - in most cases oculomotor palsy occurs with those of other nerves that involve the cavernous sinus. - injury at superior orbital fissure

Question 41

what factors can cause damage to CN4

Answer 41

blow that causes impact against the tentorium the nerve damage occurs at the medial dorsal midbrain or the free edge of the tentorium shacking children results in bilateral CN4 injury

Question 42

CN5 injury occurs due to what

Answer 42

- due to severe maxillofacial and skull base injury - supra and infraorbital are injured during trauma to the forehead