Pre Lab sauerland

Question 1

Where are most skull fractures?

Answer 1

at the pterion (meeting point of 4 bones. Frontal, parietal, temporal, and sphenoid)

Question 2

What will a fracture through the pterion result in?

Answer 2

tearing of the middle meningeal artery and epidural hematoma

Question 3

What happens when you have an epidural hematoma?

Answer 3

herniation of temporal lobe
compression of CN 3
pupil dilation and CN 3 palsy
herniation of cerebellar tonsil
compression of corticospinal and ass. pathways resulting in contralateral hemiparesis, 
deep tendon hypereflexia and babinski sign.
shift of brainstem to opp. side 
compression of post. cerebral artery
shift of normal midline structures.

Question 4

What does arterial blood build up in epidural hematomas?

Answer 4

between bony skull and dura mater

Question 5

What is the usual shape of the epidural hematoma?

Answer 5

lentiform or lenticular

Question 6

What is an epidural hematoma potentially deadly?

Answer 6

because of compression of brain and increase in intracranial pressure
(15-20% of pnts die)

Question 7

What is the diagnostic hallmark of epidural hematoma?

Answer 7

lucid interval
(talk and die syndrome)
Must treat them immediately during their lucid interval and you may be able to save them with surgery

Question 8

is the subdural space (between the dura and arachnoid) a potential space or a real space?

Answer 8

potential

Question 9

What is this:
Blood occurs quickly in subdural space
Occurs mostly in patients with traumatic brain injury (TBI)
Often associated with other injuries
Often associated with cerebral edema
Poor outcome (50% mortality rate) and sequelae
Surgery is essential

Answer 9

acute subdural hematoma (Acute SDH)

Question 10

What is this:
Blood appears slowly in subdural space
Long time course
Patients often do not remember an injury
Careful observation or slow drainage
Outcome is relatively good

Answer 10

Chronic subdural hematoma (Chronic SDH)

Question 11

what happens if you get punched in the eye?

Answer 11

blow out of fracture of the floor of the orbit into your maxillary sinus

Question 12

Hemorrhage into the maxillary sinus and/or displacement of orbital structures into the maxillary sinus may cause what?

Answer 12

airway

obstruction, infection, and even displacement of maxillary teeth.

Question 13

What is the most dangerous glaucoma?

Answer 13

getting an angle-closure
(severe pain, DONT WANT to dilate their pupil, lose vision)

*** iris closes drainage angle and obstructs outflow of aqueous)

Question 14

What is this:

rare; pigment deposited from iris clogs the draining angles and prevents aqueous humor from leaving the eye.

Answer 14

pigmentary glaucoma

Question 15

What is this:

Most common cause of blindness. At age of 80, about 10% of the population is affected.

Progressive optic nerve damage:
Peripheral visual field loss, followed by loss of central vision. Blindness.

Answer 15

glaucoma

Question 16

What are all the things you will see in papilledema?

Answer 16

edema of optic disc
venous engorgement
engorged tortous retinal veins
hyperemic and swollen optic disc
retinal hemorrhages around the disc