Head Injuries

Question 1

Classification of blunt force wounds

Answer 1

abrasions (falling off skateboard, superficial)
Contusions (bruises)
Lacerations

Question 2

What are the classification of sharp force wounds?

Answer 2

Incised wounds

Stab wounds

Question 3

What are abrasions?

Answer 3

Blunt force
Generally no blood loss
Superficial

Question 4

What are contusions?

Answer 4

Bruises
Different colours due to the release of haemoglobin from red blood cells- the degradation of haemoglobin at different phases gives different colours
Blunt force

Question 5

What are lacerations?

Answer 5

Blunt force over the bone

Jagged edges

Question 6

What are incised wounds?

Answer 6

Falling/stepping on glass
Tend to be longer than deeper
Can tell direction of cut, starting point- usually deeper at entry point

Question 7

What are stab wounds?

Answer 7

More deep than they are wide
Narrow
Can puncture lungs if in the intercostal spaces

Question 8

What is the scull composed of?

Answer 8

The cranium (at the top) (neurocranium- protects the brain)
And
The bones of the face- the viscerocranium (forms the face skeleton)

Question 9

Is the mandible considered part of the skull?

Answer 9

No, the jaw bone

Question 10

What bones of the skull have air inside them?

Answer 10

Frontal, sphenoid and ethmoid

Question 11

What is it called when bones have air in them?

Answer 11

Pneumatised

Question 12

What are the benefits to having pneumatised bones?

Answer 12

They are lighter

Question 13

What is the weakest part of the skull?

Answer 13

Where the frontal, sphenoid, parietal and temporal bones meet

Question 14

What two types of head injuries are there?

Answer 14

Primary- direct cause, trauma
And
Secondary- problem somewhere else leads to it

Question 15

What do primary head injuries consist of?

Answer 15

Injury to the S.C.A.L.P
The skin, connective tissue and aponeurosis tend to tear off together
Surface contusions or lacerations
Intracranial haemorrhage
Diffuse axonal injury

Question 16

What does S.C.A.L.P stand for?

Answer 16

Skin
Connective tissue
Aponeurosis
           (Blood vessels here)
Loose connective tissue
Periosteum

Question 17

What are examples of secondary head injuries?

Answer 17

Meningitis- caused by bacteria
Ischaemia- reduction of blood supply
Increased Intra-cranial pressure
Oedema

Question 18

What are the five types of skull fractures?

Answer 18

Linear
Hinge
Comminuted
Ring
Distant

Question 19

What are linear skull fractures?

Answer 19

In a straight line

Question 20

What are hinge skull fractures?

Answer 20

Tend to be back of the skull

One part of skull moves relative to another part

Question 21

What are comminuted skull fractures?

Answer 21

Less common

Lots of different pieces

Question 22

What are ring skull fractures?

Answer 22

There is a ring all the way round the skull

The most serious type of fracture

Question 23

What are distant skull fractures?

Answer 23

There has been impact at one point and damage somewhere else

Question 24

What are sutures?

Answer 24

They hold different bones in the head together
Allow bones to move over eachother
Still present in children

Question 25

What does NAI stand for?

Answer 25

Non accidental injury

Question 26

What scans are best for bone injuries?

Answer 26

CT scans

Question 27

What scans are best for soft tissue injury?

Answer 27

MRI scans

Question 28

What are basal skull fractures?

Answer 28

Occur at high impact, generally occipital or temporal trains CSF rhinorrhoea- the fluid leaks through the nose Panda/raccoon eyes Bottom of the skull

Question 29

What is a cerebral contusion?

Answer 29

High impact force inside the brain Pia stripped from brain so motion of brain within skull Hit with bat at coup (contact site) brain gets forced back without skull to contrecoup (opposite point of impact) Primary and secondary impact (Picture egg in water box)

Question 30

What is the pia?

Answer 30

The lining around the brain

Question 31

Give an example of when a cerebral contusion may occur

Answer 31

Being hit by a bat Or in a car accident High impact forcing brain to back of skull

Question 32

What are the meninges?

Answer 32

The dura mater- most superficial The arachnoid mater- in the middle The pia matter- in direct contact with brain, goes into dips of brain matter

Question 33

What are the types of intracranial haemorrhage?

Answer 33

Extradural haemorrhage Subdural haemorrhage Subarachnoid haemorrhage (Intracerebral haemorrhage)

Question 34

What happens in an extradural haemorrhage?

Answer 34

Bleeding above dura but under the surface of the skull | Usually middle meningeal artery

Question 35

What happens in a subdural haemorrhage?

Answer 35

Bleeding above arachnoid but below the dura matter | Tearing of the superior cerebral vein

Question 36

Who is most susceptible to subdural haemorrhages?

Answer 36

The elderly and alcoholics | Due to cerebral atrophy- shrinking of the brain

Question 37

What happens in a subarachnoid haemorrhage?

Answer 37

Occurs in natural disease or injury Arterial venous (AV) malformation or rupture of berry aneurism Can be associated with cranial fractures

Question 38

What does DAI stand for

Answer 38

Diffuse axonal injury

Question 39

What is DAI?

Answer 39

Brain injury without obvious lesion Can be unconscious straight away Microscopic diagnosis so can't diagnose clinically until death Tearing of bit between grey and white matter?

Question 40

What is the GCS?

Answer 40

``` The glasgow coma scale Marked out of 15 4- can open eyes 5- verbal response 6- motor response ```

Question 41

What is the weakest point of the skull?

Answer 41

Pterion

Question 42

What are the zygomatic bones for?

Answer 42

To protect eyes from injury | Impact crash barrier

Question 43

What are the facial features?

Answer 43

``` Eyes Nose Maxilla (upper teeth) Mandible Teeth ```

Question 44

What is aponeurosis?

Answer 44

Tearing of the first three layers of the head | The skin, connective tissue and the aponeurosis?

Question 45

What is battles sign?

Answer 45

Mastoid process, bleeding causes bruising

Question 46

What causes panda eyes?

Answer 46

Blood leaking out of the brain

Question 47

What are the effects of basal skull fracture?

Answer 47

CSF rhinorrhea Battles sign Panda eyes