bones of the skull - clinical Flashcards
what do the majority of skull fractures result from?
blunt force / penetrating trauma
what are the obvious clinical features of skull fractures?
visible injuries and bleeding
what are the subtle signs of fracture?
clear fluid draining from ears + nose (cerebrospinal fluid leak of base of skull fracture) poor balance confusion slurred speech stiff neck
what are the areas of the skull that are natural points of weakness?
pterion
anterior cranial fossa
middle cranial fossa
posterior cranial fossa
what is the pterion?
an ‘H-shaped’ junction between temporal, parietal, frontal and sphenoid bones
thinnest part of the skull
what can a fracture at the pterion lead to?
lacerate an underlying artery (anterior branch of middle meningeal artery), resulting in a extradural haematoma
where is the anterior cranial fossa?
depression of the skull formed by frontal, ethmoid and sphenoid bones
where is the middle cranial fossa?
depression formed by sphenoid, temporal and parietal bones
where is the posterior cranial fossa?
depression formed by squamous and mastoid temporal bone, plus occipital bone
what are the 4 major types of cranial fractures?
depressed
linear
basal skull
diastatic
what is a depressed fracture?
a fracture of the bone with depression of the bone inwards
when does a depressed fracture occur?
as a result of direct blow
causing skull indentation, with possible underlying brain injury
what is a linear fracture?
simple break in bone, traversing its full thickness have radiating (stellate) fracture lines away from the point of impact
which is the most common type of cranial fracture?
linear
what is a basal skull fracture?
affects base of skull
What does a basal skull fracture present with?
characteristically present with bruising behind ears (Battle’s sign) - mastoid ecchymosis
OR
bruising around eyes/orbits (Raccoon eye’s)
what is a diastatic fracture?
fracture occurs along a suture line
causing a widening of the suture
which age group is diastatic fracture most commonly seen in?
children
are facial fractures common? related to which type of injury?
yes
trauma related - road traffic collisions, fights and falls
what are the clinical features of facial fractures?
profuse bleeding, swelling, deformity and anaesthesia of the skin
which bone is most frequently fractured in facial fractures? why?
nasal bones
due to their prominent position at the bridge of the nose
what is a maxillofacial fracture?
a fracture that affects the maxillae bones
how does a maxillofacial fracture occur?
trauma with a large amount of force
how can facial fractures affecting the maxillary bones be identified?
using the Le Fort classification, depending on the bones involved, ranging from 1-3
3 = most serious