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HNN > Session 3 > Flashcards

Session 3 Flashcards

1
Q

What is the skull

A

Collective term referring to the complete skeleton of the head

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2
Q

Cranium can be further divided into the

A

Neurocranium and viscerocranium

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3
Q

What is neurocranium

A

Bones forming a protective box around the brain

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4
Q

What is visacerocranium

A

Bones forming the facial skeleton

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5
Q

What is the cranial cavity

A

Space within the cranium which holds the brain

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6
Q

Neurocranium consists of the

A

Calvaria (Skull or cranial cap or roof of cranium)
Cranial floor

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7
Q

Bones of the calvaria consist of

A

2 layers of compact bone separated by a layer of spongy bone known as diploe

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8
Q

What is the arrangement of the calvaria called

A

Tri-lamina

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9
Q

Tri-lamina arrangement of compact and spongy bone conveys

A

Protective strength without adding significant weight

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10
Q

What is the orange region

A

linear skull fracture

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11
Q

What is the red region

A

Depressed skull fracture

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12
Q

What is the pink region

A

Comminuted skull fracture

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13
Q

What is the blue region

A

Pterion

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14
Q

What is the green region

A

Basilar fracture

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15
Q

Features of the pterion

A

Lies on lateral aspect of the skull
Thinnest part of calvaria
Weak

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16
Q

Risk of fracture at pterion

A

Can injury the middle meningeal artery (anterior branch)- bleeding will cause extradural haematoma, exerts pressure on brain

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17
Q

What is extradural haematoma

A

Blood accumulating between the periosteal layer of the dura mater and the bone

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18
Q

What are between the large flat bones forming the calvaria

A

Serrated, immobile joints known as sutures (coronal, sagittal and lambdoid)

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19
Q

Features of sutures

A

Interlocking nature of joints makes it very difficulty for the bones forming the joint to dislocate- as we age they ossify

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20
Q

The cranial floor is divided into

A

3 depressions or fossae- anterior, middle and posterior

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21
Q

What are blue and orange

A

Frontal and Occipital

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22
Q

What are purple and yellow

A

Ethmoid and Sphenoid

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23
Q

What are red and green

A

Temporal and parietal

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24
Q

What are found within the cranial floor

A

A number of foramina - allow passage for structures such a cranial nerves and blood vessels

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25
Q

Bleeding within the cranial cavity causes

A

Intracranial haematoma- can compress and damage the underlying brain tissue

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26
Q

What needs to be done when a patient presents with a head injury

A

Neurological assessment and CT imaging of head- check for injury or cervical spine is significant injury

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27
Q

What can happen if significant force is transmitted to the skull base through the vertebral column

A

Fractures can occur through the cranial floor- basilar skull fracture
Least common fracture

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28
Q

Clinical signs of basilar skull fractures

A

Battle’s sign (bruising over mastoid process)
Raccoon eyes (bruising around both eyes)
Haemotypanum (blood behind ear drum)
CSF rhinorrhea/otorrhoea (CSF from nose or ear)

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29
Q

What is this

A

Battles sign indicative of basilar skull fracture

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30
Q

What is this

A

Raccoon eyes (periorbital haematoma) indicative of basilar skull fracture

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31
Q

Significance of supraorbital ridge

A

Easily split when blunt force injury

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32
Q

What does the frontal bone do

A

Form skeleton of forehead and forms roof of orbit and part of floor of cranial cavity

33
Q

Why is the mandible moveable

A

Articulates with the cranial base at the TMJ

34
Q

Most common facial fractures involve the

A

Nasal bones (due to prominence of nose)
Zygomatic or mandible

35
Q

A hard blow to the lower jaw often results in

A

Fracture of the neck of mandible and its body
May be associated with TMJ dislocation

36
Q

Why are fractures to the bones of the mid face particularly concerning

A

They cause a separation of some or all of the mid face from skull base and can present problems for the airway

37
Q

How do you classify injuries to the mid face

A

Le Fort Classification Type 1,2,3
Depending on plane of injury and bones

38
Q

What is light green and dark green

A

Nasal and maxilla

39
Q

What is purple and pink

A

Mandible and vomer

40
Q

What is dark blue and light blue

A

lacrimal and inferior nasal concha

41
Q

What is red and yellow

A

Palatine and zygomatic

42
Q

What is the outermost layer of the meninges

A

Dura- involved in creating a number of folds/partitions and venous channels (dural venous sinuses)

43
Q

What are dural venous sinuses

A

Venous structures formed by the separation of the 2 layers of dura

44
Q

Where are cerebral veins and what do they do

A

Run in subarachnoid space
Connect and drain into the dural venous sinuses - drain brain tissue directly

45
Q

How do cerebral veins connect to dural Venus sinuses

A

Bridging veins at certain points
Particularly the length of the superior sagittal sinus

46
Q

What can happen to bridging veins in head injuries

A

Brain can move a little within CSF, can cause traction on bridging veins, they can snap.

This leads to extravasation of venous blood which fills the plane between the dura and arachnoid (sub dural space)

Gives rise to sub dural haemorrhage

47
Q

What does periosteum do in skull

A

Blood vessels sometimes run underneath e.g. middle meningeal

Covers surface of outer and inner table of skull bones- strongly adhered to bone edges at suture line and continuous through suture and onto inner table of same bone

48
Q

Which bones contribute to the vault of the neurocranium

A

Frontal, parietal and occipital bones

49
Q

What houses the structures of the middle and inner ear

A

Petrous part of the temporal bone

50
Q

When the middle meningeal artery ruptures, blood accumulates where

A

Extra-dural haemorrhage- inner table of bone and periosteum

51
Q

What is a basilar skull fracture

A

Fracture of bones of cranial floor

52
Q

Fracture involving which bone is particularly indicated by bleeding in ear drum or ear

A

Petrous bone

53
Q

What fracture is indicated by CSF out of nose

A

Ethmoid bone of anterior cranial fossa

54
Q

The cribriform plate and cribriform foramina are features of which bone?

A

Ethmoid

55
Q

Condyle of mandible lies anterior to

A

articular tubercle

56
Q

Act of TMJ rotational movement occurs within the

A

Inferior joint cavity

57
Q

Action of gliding movement of TMJ occurs within the

A

Superior joint cavity

58
Q

Which division of the trigeminal nerve innervates the muscles of mastication

A

7th

59
Q

Which muscle acts to retract the mandible at the TMJ

A

Temporalis

60
Q

Conditions related to the TMJ

A

TMJ disorder (pain often refers to ear, jaw, lateral side of head), clicking, locking

Dislocation (secondary to trauma/yawn)

Arthritis

61
Q

TMJ type of joint

A

Synovial hinge-type

62
Q

TMJ innervation

A

Auriculotemporal nerve

Branch of mandibular division of trigeminal Vc

63
Q

Anatomy of TMJ

A

Articular surfaces of bones lined with fibrocartilage

Do not come into direct contact

Separated by fibrocartilaginous disc

64
Q

TMJ is divided into

A

2 synovial line cavities filled with synovial fluid

Stabilised by joint capsule and 3 extracapsular ligaments

65
Q

What are red green and blue

A

Mandibular fossa of temporal bone
Fibrocartilaginous disc
Mandibular condyle (head of condyle)

66
Q

What area is the star and what happens there

A

Coronoid process- Temporalis muscle inserts

67
Q

Which joint capsule is responsible for gliding movement

A

Superior joint capsule

68
Q

Which joint capsule is responsible for hinge rotational movement

A

Inferior joint capsule

69
Q

What happens in gliding forward action

A

Condyle slides onto articular tubercle

70
Q

Elevation of TMJ

A

Masseter, Temporalis, medial pterygoid

71
Q

Depression of TMJ

A

Lateral pterygoid, gravity,

platysma and suprahyoids if against resistance

72
Q

Protrusion of TMJ

A

Lateral pterygoid, medial pterygoid assist

73
Q

Retraction of TMJ

A

Posterior fibres of Temporalis

74
Q

Grinding of TMJ

A

Lateral pterygoids laterally deviate mandible

75
Q

What happens to condyle in normal depression

A

Does not pass in front of articular process

76
Q

Wide opening (depression) of mandible requires

A

Rotation hinge action and gliding forward

77
Q

Why does jaw lock

A

Joint fixes in open position due to anterior dislocation of condyle over the articular tubercle

Contraction of muscles around joint (muscles of mastication)

78
Q

Venous connection between scalp veins and dural venous sinuses

A

Emissary

HNN (19 decks)

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