Skull Fractures and Spinal Trauma Flashcards
What is the most common type of a skull fracture?
Linear skull fractures
What area is destroyed by a “blowout” fracture?
Inferior orbit (therefore leading to blood in the maxillary sinus)
In what plane is a CT administered?
Axial
A tripod fracture involves what anatomy?
All three attachments of the zygomatic bone to the face (zygomaticomaxillary complex)
What is the name of the fracture acquired in facial trauma e the maxillary bone and surrounding structures usually in a bilateral and either horizontal, pyramidal, or transverse way?
LeFort
What are the three types of LeFort fractures?
Type 1 = horizontal (nose only)
Type 2 = pyramidal (nose and teeth)
Type 3 = transverse (whole face)
Between what structures do subdural hematomas form?
Between the dura mater and brain
Are subdural hematomas usually concave or convex?
Convex
Which has a better prognosis: acute or chronic subdural hematomas?
Chronic (when properly managed)
What type of injury is the result when the damage is seen on the side opposite of the trauma?
Contra coup
What type of cranial hematoma is concave in shape?
Epidural or extradural (remember that subdural ones are conVEX)
What type of imaging should be done when a patient presents with signs and symptoms of a skull fracture?
Head CT
What mechanism of injury is the most common force to cause spinal trauma?
Flexion (hyperflexion most common to cause spinal trauma)
What is the most damaging injury to the cervical spine?
Flexion teardrop fracture (NOT EXTENSION)
What is the name for a spinous process fracture in the cervical spine?
Clay shoveler’s fracture
What is the most common fracture to occur due to a hyperflexion injury?
Simple wedge (compression) fracture
What kind of injury occurs due to hyperflexion and rotation?
Unilateral interfacetal dislocation and/or fracture
Is a teardrop fracture “better” to get with hyperflexion or hyperextension?
Hyperextension
In today’s society, what situation can cause a hangman’s fracture?
MVA
Are Hangman’s fractures associated with hyperflexion or hyperextension?
Hyperextension
What kinds of anatomical fractures are seen with hyperextension-rotation injuries?
Pillar fractures or pedicolaminar fractures
What is another name for a Jefferson’s fracture of C1?
Burst fracture
How many fractures occur with Jefferson’s fracture?
4
What are the most common areas for spinal trauma?
C1-C2, C5-C7, T12-L1
Why is T12-L1 a vulnerable area for fractures?
1 no articulating ribs to the sternum for protection
2 skinny psoas muscle attachment at top compared to bottom
3 transitional zone
What is the Davis Series for?
7 view cervical spine series to check for fractures
What are the 7 views of the Davis series in order from first to last?
Lateral, APOM, AP cervical, left and right obliques, flexion/extension, “swimmers”
Which view is done first in the Davis Series and why?
Lateral view - every other view requires movement by the patient which can be potentially dangerous if a fracture is present
The segment is considered unstable if which specific column of the vertebra is disrupted?
Middle
Which ligament is particularly at risk with a middle column disruption of a segment?
Posterior longitudinal ligament
What four things can contribute to increased soft tissue swelling seen near the cervical spine?
Edema, blood, pus, tumors
What are the normal limits for the retropharyngeal space?
No more than 7mm at C2, no more than 5mm at C3/C4
What is the normal limit for the retrotracheal space?
No more than 22mm in adults, no more than 14mm in children younger than 15 years of age (found at C6)
What can cause a displaced prevertebral fat stripe?
SOL
On what view do we see the tracheal air shadows?
AP cervical
What contour lines are used to assess vertebral alignment?
Anterior vertebral line, posterior vertebral line, spinolaminar line (and also posterior spinous line)
What signs are seen with spinal trauma that are indicative of abnormal joints?
Increased ADI, abnormal disc height, widened apophyseal joints
What are the maximum ADI measurements for both adults and children?
Adults = 3mm Children = 5mm
What measurement of horizontal body displacement is considered to be unstable?
Greater than 3.5mm
What measurement of vertebral flexion is indicative of spinal trauma when compared to the rest?
Greater than 11 degrees of flexion
A vacuum cleft disc is indicative of what overlying condition?
DJD
How long does it take for spinal fractures to heal?
3-6 months (slow healing…much slower than extremities)
Do body fractures or arch fractures heal more with fibrosis? Which heal more with callus?
Body fractures - fibrosis
Arch fractures - callus
