Cranium

Question 1

what is the most common symptom of head injury?

Answer 1

disturbance in level of consciousness

Question 2

what age group experiences the most head injuries?

Answer 2

15-24

Question 3

what are neuralgias?

Answer 3

severe throbbing or stabbing pain in the course of a nerve caused by a demyelinating lesion
-common cause of facial pain

Question 4

what is otalgia?

Answer 4

earache

Question 5

what is odontalgia?

Answer 5

toothache

Question 6

what can injury to the superciliary arches cause?

Answer 6

• laceration of skin + bleeding

- bruising of skin around orbit gravitates around eye = black eye

Question 7

what is malar flush?

Answer 7

• redness of skin covering zygomatic process/malar eminence

- associated w/ rise in temperature in various fevers (TB, lupus)

Question 8

Le Fort fractures in general

Answer 8

3 common fractures of the maxilla

Question 9

describe Le Fort I fracture

Answer 9

• horizontal fracture
• superior to maxillary alveolar process
• crossing bony nasal septum and possibly pterygoid plates

Question 10

describe Le Fort II fracture

Answer 10

• from posterolateral parts of maxillary sinuses superomedially through infra-orbital foramina, lacrimals, or ethmoids to the bridge of the nose
• entire central part of face separated from rest of cranium

Question 11

describe Le Fort III fracture

Answer 11

• horizontal fracture through superior orbital fissures and ethmoid and nasal bones
• extends laterally through greater wings of sphenoid and frontozygomatic sutures

Question 12

describe fractures of mandible

Answer 12

usually involves two fractures, frequently on opposite sides

Question 13

what kind of mandible fractures are usually single?

Answer 13

fractures of coronoid process (uncommon)

Question 14

what is associated with fractures of neck of mandible?

Answer 14

dislocation of TMJ on same side

Question 15

what may be involved w/ fractures of angle of mandible?

Answer 15

these are oblique - may involve the bony socket or alveolus of 3rd molar

Question 16

what do fractures of the body of the mandible often pass through?

Answer 16

socket of a canine tooth

Question 17

what can extraction of teeth cause?

Answer 17

resorption of alveolar bone -> mental foramen and nerve more exposed -> can get pain

Question 18

what does loss of all teeth cause?

Answer 18

decrease in vertical facial dimension and mandibular prognathism (overclosure)

Question 19

what can cause depressed fractures?

Answer 19

hard blows in thin areas of calvaria

Question 20

what are the most common type of calvaria fracture?

Answer 20

linear calvarial fractures - occur at point of impact, but fracture lines often radiate away from it in two or more directions

Question 21

what is a contrecoup fracture?

Answer 21

counterblow fracture - no fracture occurs at point of impact, but one occurs on opposite side of cranium

Question 22

what is a craniotomy?

Answer 22

section of neurocranium (bone flap) is elevated or removed to access cranial cavity and brain

Question 23

what is a craniectomy?

Answer 23

craniotomy in which bone flap is not replaced (replaced instead by plastic or metal plate)

Question 24

which parts of skull develop via intramembranous ossification vs. endochondral ossification?

Answer 24

intramembranous: calvaria bones, some of cranial base
endochondral: most of cranial base

Question 25

in the adult, how much of the cranium is composed of facial skeleton?

Answer 25

1/3

Question 26

describe neonatal skull: sutures, symphyses, etc.

Answer 26

- frontal suture - coronal suture - intermaxillary suture - mandibular symphysis - no mastoid, styloid processes - anterior, posterior, spheonidal, and mastoid fontanelles

Question 27

what can a physician determine from palpating an infant's fontanelles?

Answer 27

- progress of growth of frontal and parietal bones - degree of hydration of infant (depressed = dehydrated) - level of intracranial pressure (bulge = increased pressure)

Question 28

describe the anterior fontanelle

Answer 28

- largest one - bounded by frontal and parietal bones - diamond shaped - future site of bregma

Question 29

what is a metopic suture?

Answer 29

remnant of frontal suture in adults

Question 30

describe the posterior fontanelle

Answer 30

- triangular - bounded by parietal and occipital bones - future site of lambda

Question 31

what is the most dynamic bone?

Answer 31

mandible

Question 32

describe growth of paranasal sinuses

Answer 32

- not usually present at birth - expand as frontal and facial regions enlarge - growth important in altering shape of face and adding resonance to voice

Question 33

describe obliteration of cranial sutures

Answer 33

- begins about 30-40 y/o | - begins at bregma and continues sequentially in sagittal, coronal, and lambdoid sutures

Question 34

age changes in cranium

Answer 34

- cranial bones become thinner and lighter | - diploe becomes filled w/ gray gelatinous material

Question 35

what is primary craniosynostosis?

Answer 35

premature closure of cranial sutures - more common in males - type of malformed cranium depends on which sutures close prematurely

Question 36

hypothesis for cause of primary craniosynostosis

Answer 36

abnormal development of cranial base creates exaggerated forces on dura mater that disrupt normal cranial suture development

Question 37

what is scaphocephaly?

Answer 37

premature closure of sagittal suture | -long, narrow, wedge-shaped cranium

Question 38

what is plagiocephaly?

Answer 38

premature closure of coronal or lambdoid suture on one side only -twisted and asymmetrical cranium

Question 39

what is oxycephaly/turricephaly?

Answer 39

premature closure of the coronal suture | -high, tower-like cranium

Question 40

which gender is oxycephaly/turricephaly more common in?

Answer 40

females

Question 41

does premature closure of sutures affect brain development?

Answer 41

no