Skull Fractures Flashcards
About 90% of pediatric skull fractures are linear and involve the calvaria. Linear skull fractures over the convexity rarely require surgical intervention. How can linear skull fractures be differentiated from normal plain film findings?
● A. Density of linear skull fracture is dark black while that in case of vessel groove and suture line it is gray in color
● B. Linear skull fractures are straight in course while vessel groove is more like curve and suture line follows course of known suture lines
● C. Linear skull fractures are usually nonbranching while vessel groove is often branching and suture line joins other suture lines
● D. Linear skull fractures are very thin while vessel groove is thicker than fracture line and suture line is jagged and wide
● E. All of the above are correct
E. All of the above are correct
Surgery is considered for depressed skull fractures with deficit referable to underlying brain and for fractures depressed more than the thickness of calvaria. Nonsurgical management of depressed skull fracture may be considered in the following
situations except?
● A. Fractures overlying a major dural sinus always needs to be operated
● B. No evidence (clinical or CT) of dural penetration
● C. No significant intracranial hematoma
● D. Depression is less than 1 cm
● E. No frontal sinus involvement and no wound infection or gross contamination
● F. No gross cosmetic deformity
A. Fractures overlying a major dural sinus always needs to be operated
Following are the technical considerations during the surgery for depressed skull fracture except?
● A. Debridement of skin edges
● B. Elevation of bone fragments
● C. Dural laceration is never repaired
● D. Debridement of devitalized brain
● E. Reconstruction of the skull
C. Dural laceration is never repaired
A patient presents in the emergency with a lateral blow to the head. The fracture line passes though the petrosquamosal suture parallel to and through the EAC. It may cause a conductive hearing loss by disrupting the ossicular chain and/or by producing hemotympanum. What type of fracture produces
this kind of deficit?
● A. Longitudinal fracture
● B. Anterior posterior fracture
● C. Transverse fracture
● D. Multiple basal skull fractures
● E. None of the above
A. Longitudinal fracture
What is the management option for post-traumatic facial palsy?
● A. Steroids are often utilized
● B. Consult with ENT surgeon
● C. Surgical nerve 7th decompression
● D. Surgical decompression
● E. All of the above
E. All of the above
Which of the following are the clinical signals for basal skull fracture?
● A. CSF otorrhea or rhinorrhea
● B. Hemotympanum or laceration of the external auditory
meatus
● C. Postauricular ecchymoses (battle’s sign)
● D. Periorbital ecchymoses (raccoon’s eye)
● E. All of the above
E. All of the above
Which of the following conditions may be associated with basal skull fractures that may require specific management?
● A. Traumatic aneurysm
● B. Post-traumatic cavernous carotid fistula
● C. Meningitis or cerebral abscess
● D. Cosmetic deformities
● E. CSF fistula
● F. All of the above
F. All of the above
In the presence of a frontal sinus fracture, intracranial air on CT must be presumed to be due to dural laceration. Risks of posterior wall fractures include brain abscess, CSF leak, and cyst or mucocele formation. At what age, frontal sinus becomes radiographically evident?
● A. At 6 years
● B. At 8 years
● C. At 10 years
● D. At 11 years
● E. None of the above
B. At 8 years
How is a fracture of the frontal air sinus dealt with?
● A. The rear wall of the sinus is removed
● B. Mucosa is then stripped off from the wall of the sinus down to the nasofrontal duct
● C. Temporalis muscle plugs are then packed into the frontonasal ducts
● D. Bony wall of the sinus is drilled and removed
● E. All of the above are steps in dealing with a frontal sinus fracture
E. All of the above are steps in dealing with a frontal sinus fracture
Which of the following is an etiology of pneumocephalus?
● A. Skull defects including postneurosurgical procedures, post traumatic, congenital, or neoplastic
● B. Infection with gas-producing organism or mastoiditis
● C. Post invasive procedures like lumbar puncture, ventriculostomy, or spinal anesthesia
● D. Spinal trauma or barotrauma
● E. All of the above
E. All of the above
When can nonsurgical management be considered for open, depressed skull fracture?
● A. There is evidence of dural penetration
● B. Significant intracranial hematoma
● C. Depression is < 1 cm
● D. Frontal sinus involvement
● E. No gross cosmetic deformity
C. Depression is < 1 cm
Sensorineural hearing loss is caused by what type of temporal bone fractures?
● A. Transverse
● B. Longitudinal
● C. Oblique
● D. Axial
● E. Parallel to IAC axis
A. Transverse
Clivus fracture may be associated with injury to which cranial nerve?
● A. I
● B. II
● C. VI
● D. IX
C. VI
The frontal sinus is lined with respiratory epithelium, the mucous secretion of which drains through the frontonasal duct medially and inferiorly into which of the following?
● A. Inferior nasal meatus
● B. Middle nasal meatus
● C. Superior nasal meatus
● D. Lateral nasal meatus
● E. Anterior nasal meatus
B. Middle nasal meatus
Cranialization of frontal air sinus refers to which of the following?
● A. Removal of rear wall
● B. Stripping off the mucosa
● C. Packing with gelfoam
● D. Packing with temporalis muscle
● E. Obliteration of frontonasal duct
A. Removal of rear wall
