Anatomy for trauma Flashcards
name the three types of haemorrhages
- sub arachnoid
- sub-dural
- extra-dural
what is the percentage of pediatric trauma that result in hospitalisation
75%
what percentage of pediatric trauma hospitalisation result in death
80%
what factors can cause trauma in children
- abuse
- domestic falls
- recreational injuries
- motor vehicle accidents
what is the percentage of pediatric firearm injuries results in death
12%
what are the two main categories of head injuries
and what falls under each
general
- open and closed
specific
- lacerations
- coup-contrecoup
- haematoma
- contusions
- diffuse axonal injury
- concussions
-
what falls under specific head injury
specific
- lacerations
- coup-contrecoup
- haematoma
- contusions
- diffuse axonal injury
- concussions
- anoxic
- hypoxic
what are the three morphological classifications of head injuries
- scalp injuries
- scalp fracture
- brain injuries
do skull fractures always correlate to brain injury
No, one may have skull injury without any significant brain injury or even have brain injury without skull injury
what three factors result in skull fractures
- high velocity impact
- flat impact
- ring
what are the possible four complications of skull fracture
- infections
- brain damage
- epilepsy
- intrusion of brain fragments into depressed skull fractures
what happens in the event of open head injury
the skull is penetrated by a sharp object such as a knife or even a missile
will you expect to find tissue damage in open injuries and if yes where?
yes, at the site of skull penetration or the even in the surrounding areas of the intruding object
what are the 4 consequences of open injury
- swelling
- lacerations from the skull fragments
- vulnerability to infection
- further injury
what happens under closed injury
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
which type of injury is the most common for brain damage
closed injury
what are the consequences of closed injury
- swelling
- increased intracranial pressure
- tissue compression
what is a specific head injury
sudden impact to the head causing change in momentum or movement of the brain.
what may happen to the vessels and cranial nerves in a event of SPECIFIC HEAD INJURY and what is the main cause of this
the vessels and cranial nerves may over stretch due to the sudden change in momentum
what is COUP representative of?
primary impact
what is CONTRECOUP representative of?
secondary impact
what is the mechanism of closed injury
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.
under specific head injury you get concussions, how do they occur
??
what is a contusion
a visible bruise/bleeding on the brain
what causes diffuse axonal injury
- 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
what causes Anoxic brain injury
- when the brain does not receive any oxygen causing the cells to die
what causes Hypoxic brain Injury
when the brain does not receive enough oxygen
what are the two most minor types of head injury
- laceration
- hematoma
what is the major complication of lacerations and hematoma
- infection
what is the source epidural hematomas (3)
meningeal vessels, dural venous sinus and diploic vein from skull fractures
where do 90% of the epidural hematomas occur
squamous portion of temporal bone
in which age group of subdural hematomas common
infants
what is the main cause of subdural hematoma
high velocity impact
assault
fall from significant height
what is the source of subdural hematomas
dural venous sinuses
cortical bridging veins
where is the skull thickened
- Glabella
- external occipital protuberance
- mastoid processes
- external angular process (zygomatic process) of frontal bone
how many layers does the skull have
(5)
2 periosteum
2 compact
1 spongy
what sites of the skull are prone to fracture
- 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
what factors can cause damage to CN1
damage at the cribriform plate
blows to the frontal or occipital plate
eodema or hematoma at the cribriform
what factors can cause damage to CN2
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.
what factors can cause damage to CN3
- 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
what factors can cause damage to CN4
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
CN5 injury occurs due to what
- due to severe maxillofacial and skull base injury
- supra and infraorbital are injured during trauma to the forehead
