Face/Head

Question 1

Most likely area to fracture in skull?

Answer 1

Temporal bone

Question 2

Coup Injury

Answer 2

Brain injury right under area of contact.

- Linear velocity

Question 3

Contrecoup

Answer 3

• Diffuse Injury
• Impact deceleration
• Shaking
  Injury results on side of head opposite to that which received the blow because head is accelerating before contact

Question 4

Coup and Contrecoup Mortality

Answer 4

Coup is most deadly

Contrecoup can be deadly but also can just lead to a concussion

Question 5

Skull Fx types

Answer 5

Linear
- low energy blunt trauma (fall)
Depressed
- High energy direct blow (open or closed)
Comminuted
- Multiple pieces
Basilar
- Linear fx at base of skull (temporal bone 75% of time)

Question 6

Epidural Hematoma

Answer 6

• Outside dura, arterial injury, bleeds faster
• Tear of meningeal arteries from blow to head
• Pushes brain inwards
• Lucid
• Deteriorating consciousness

Question 7

Subdural Hematoma

Answer 7

Acceleration/deceleration forces that tear blood vessels

• More common than epidurals
• Venous bleeding that accumulates slower

Question 8

Glasgow and TBI Severity

Answer 8

Severe TBI = score of 3-8
Moderate TBI = 9-12
Mild TBI = 13-15
** Glasgow <9 usually requires craniotomy to relieve pressure

Question 9

Glasgow Categories

Answer 9

Eye Opening
4- spontaneous
3- to speech
2- to painful stimulation
1- no response

Motor Response
6- Follows commands
5- Localized movements to pain
4- withdrawal movements to pain
3- decorticate
2- decerebrate
1- no response

Verbal Response
5- oriented to person, palce, and date
4-converses but disoriented
3-innapropiate words
2-incomprehensible sounds
1- no response

Question 10

3 Concussion Symptom Scales

Answer 10

Post-Concussion Symptom Scale
Checklist form SCAT 2 or SCAT 3
Concussion Symptom Inventory

Question 11

Second Impact Syndrome

Answer 11

Second concussion occurs before first is healed, rapid and severe brain swelling and catastrophic results

Symptoms:
dilated pupils
LOC
Loss of eye movement
Respiratory failure
Death

Question 12

Chronic Post-Concussion Syndrome

Answer 12

• Poorly understood
• Possibly from Diffuse Axonal Injury (DAI)
• Athletes have this when concussion symptoms are:
  1. Longer than 3 months

Question 13

Chronic Traumatic Encephalopathy

Answer 13

Progressive neurodegenerative disease

• Can only be dx during autopsy
• Accumulation of tau protein

Question 14

CTE clinical presentation
Cognitive
Mood
Behavioral

Answer 14

Cognitive- memory impairment, problems with planning, organizing, multi-tasking

Mood- Depression, apathy, irritable, suicidal

Behavioral- Impulsive, lack of inhibition, aggression, prone to addiction

Question 15

2 Most commonly fractured bones in facial region

Answer 15

1. Nasal

2. Mandibular