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Patologi Foresik > Head Injury > Flashcards

Head Injury Flashcards

Ciri khas, how to measure

1
Q

membran fibrosa yg tebal

A

galea aponeurotica

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2
Q

lapisan scalp (coronal section)

A
  1. kulit rambut dgn jar konektive tebal bvaskular.
  2. membran aponeurotica.
  3. jar konektive loose
  4. periosteum di pericranium

nb; emissary vein menembus dr jar ikat tebal menembus sinus venosa dura(skull) hingga kortex cerebral

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3
Q

pada kasus apakah perdarahan dscalp memicu kematian

A

intoksikasi alkohol akut yg memicu shok fisiologis

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4
Q

perdrahan scalp yg blanjut hg stlh mati pd kasus

A

luka d scalp dlm posisi kepala tergantung kbawah

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5
Q

why scalp mudh luka

A

jaringannx tdk elastis n tdk mudah menyerap

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6
Q

deteksi luka plg mudah

A

palpasi jari.

klo da pattern sbaiknya dcukur rambutnx

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7
Q

tangential forces n glancing blow pd scalp plg parah

A

tear large flap of tissue hingga tlihat skull, klo rambut terikat dgn roda bs tcabut (avulsion)

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8
Q

skeleton di kepala tbagi mjd

A
  1. mandibula.
  2. kalvaria.
  3. facialis
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9
Q

kalvaria tdiri dr 8 plate sebutkn

A
  1. frontalis.
  2. temporalis.
  3. parietalis.
  4. sphenoidalis.
  5. occipitalis.
  6. zygomaticus.
  7. maxillaris.
  8. ethmoidalis
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10
Q

force yg bs membuat fraktur kepala

A

trauma tumpul yg posisinx tegak lurus dgn tulang n kekuatannx lbh besar drpd tahanan tulang

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11
Q

proses tjdnx ‘hinge fracture’/engsel

A

blow dr ujung atas kpl -> fraktur panjang n linear spanjang parietaln-> kekuatannx msh ada mjalar ke dlm melewati dasar tengkorak, biasanx d anterior os temporal petrosa dlm fossa cranii media -> klo force dr 2 arah bertemu dtgh/fossa pituitary -> fracture basal tengkorak = hinge fracture.

klo benturan dr kaki(terjun dgn kaki dluan) -> transmisi lewat spinal -> frakture cincin basal skitar foramen magnum -> mjalar mlewati os parietalis mbtk jaring laba2 radiasi sesuai lingkaran konsentris

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12
Q

ciri khas fraktur akibat hantaman palu

A

fraktur depresi (legokan) dgn kontur bulat sesuai dgn ukuran palu, kedalaman bvariasi hingga mengenai otak

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13
Q

blow out orbital

A

krn tulang orbital bag atas tipis jd mudah fraktur, baik lgs atau tdk lgs

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14
Q

patofisiologi perdarahan intrakranial yg menyebabkan kematian dan disability

A

perdarahan menyebabkan kompresi pada jaringan otak -> peningkatan tekanan ruang intrakranial (SOL=space occupying lesion) -> menekan pembuluh darah ke otak -> klo tekanan sama ato sama dgn tekanan drh arteri maka aliran drh ke otak berhenti -> otak tdk mendapat suplai -> infark

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15
Q

lokasi pembuluh drh di otak

A
  1. a. meningeal = dlm inner table tengkorak n dluar dura, ikut rusak klo da fraktur, aman dr luka akibat pergerakan otak n skull
  2. sinus venosa = dlm dura, mrpkn p.drh yg menghubungkan v.sinus n v di kortikal, mudah luka bila da pbedaan pergerakan otak n skull
  3. a.v cerebralis = dlm m.arachnoid, djaga dr semua pergerakan kecuali ada penetrasi
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16
Q

tipe perdarahan intrakranial

A
  1. extradural

2. subdural

17
Q

perdarahan ruang extradural disebabkan oleh rusaknya arteri?

A

a.meningeal trutama a.meningeal media yg njalan sepanjang os temporal

18
Q

lucid interval plg cepat

A

1.5 jam

19
Q

proses terjadinya lucid interval

A

perdarahan extradural (memisahkan dura n skull) -> tidak menyebabkan kerusakan sistem venosa -> perdarahan yg tjd lambat

20
Q

perdarahan subdural dsebabkan oleh

A

rusaknya vena communicating yg melewati spasium subdural

21
Q

penyebab rupturnya vena communicating

A
  • mudah rusak
  • blm tentu bhubungan dgn cedera kepala
  • bhub dgn rotasi/pergerakan otak atau bag dlm skull n menggesek dinding tipis vena
22
Q

otopsi perdarahan subdural

A
  • warna merah gelap n bkilau (awal), coklat (bbrp hari)
  • mikroskop : hemosiderin dgn pewarnaan stein (+)
  • kronik : mbtk membran gelatin yg dpt mengeras mjd kapsul elastis yg kuat, sering pada elderly yg mempunyai atrofi cerebral atau kecanduan alkohol
23
Q

penyebab terparah dr SOL

A

herniasi internal (ex tentorium hernia)

24
Q

penyebab pdrhan sub-arachnoid

A
  • trauma lgs/fraktur depresi
  • pergerakan otak dgn skull akibat akselerasi n deselerasi injury
  • non trauma : ruptur aneurisma berry (salah satu arteri dlm circulus willis)
25
Q

patofisiologi pdrhan sub arachnoid basal

A

trauma -> a.vertebralis d foramina lateral 6 os cervical (spina dura yg masuk ke fossa posterior skull) damage ->pdrhan subarachnoid basal

trauma :

  • lgs di bawah telinga or leher bagian atas yg sejajar dgn teling
  • rotasi n diikuti flexi tiba2 kepala
26
Q

patofisiologi herniasi internal

A

edema otak akibat transudasi kdlm sasium extraselular -> tekanan intrakranial meningkat -> otak terjepit krn lapisan meninges -> tek pindah kebawah ke arah :

  1. tentorium cerebelli -> menekan unci lobus temporal -> menekan brain stem
  2. for.magnum -> mengerucut -> injury tonsil cerebellar -> menekan brainstem
27
Q

penampakan pada edema cerebri

A
  1. peningkatan berat cerebri >1500 g
  2. sulcus terisi
  3. gyrus mendatar
  4. uncus bcelah (groove), perdarahan n nekrosis
  5. gyrus hipocampus bengkak
  6. hernia pada tonsil cerebellar
  7. perpindahan garis tgh otak (midline shift) unilateral
  8. kompresi ventrikel
28
Q

gliding lesion di? akibat dr?

A

di junction of grey matter n white matter

akibat dr deselerasi n akselerasi dr benturan kepala, bagian dr proses shearing di kortex

29
Q

gambaran shearing effect d mikroskop

A

diffuse traumatic axonal injury (gambarannx : udem axon n axonal retraction bulb/parah n >12 jam) dgn pewarnaan B-amiloid precursor protein (B-APP)
non traumatic injury : hipoksia iskemia

30
Q

countercoup contusio tjd apabila

A

injury tjd pada bagian yg jauh dr pusat hantaman (dibaliknya, klo kena kanan, yg luka kiri) akibat dr deselerasi yg menghantam bagian yg iregular

31
Q

daerah yg sering tjd countercoup contusio

A
  • lobus frontalis

- lobus temporalis

Patologi Foresik (10 decks)

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