Term
| How does a black eye occur? |
|
Definition
| Superciliary arches are sharp. Injury to them can lacerate the skin and cause bruising around the orbit. Tissue fluid and blood accumulates and gravitates to the upper eyelid and around the eye. |
|
|
Term
Zygomatic bones were once called the ________ bones. Describe malar flush.
What diseases is it associated with? |
|
Definition
malar.
Redness of the skin covering the zygomatic prominence associated with a rise in temperature
tuberculosis and systemic lupus erythematosus disease |
|
|
Term
| A Le Fort I fracture is a _______ fracture of the maxillae passing ______________ to the maxillary alveolar process, crossing the bony nasal septum and possibly the pterygoid plates |
|
Definition
|
|
Term
| A Le Fort II fracture passes from the posterolateral parts of the _______________ superiormedially through the _________________ , ______________ , or _________________ to bridge of the nose. What results? |
|
Definition
maxillary sinuses
infraorbital foramina
lacrimals
ethmoids
The central part of the face, including the hard palate and alveolar processes, is separated from the rest of the cranium. |
|
|
Term
| A Le Fort III fracture is a ____________ fracture that passes through the __________________ and the ______ and ____________ and extends laterally through the ______________ and the _________________ sutures. This causes the maxillae and zygomatic bones to separate from the cranium. |
|
Definition
horizontal
superior orbital fissures
ethmoid
nasal bones
greater wings of the sphenoid |
|
|
Term
A fracture of the mandible usually involves ____ fractures.
A blow to the jaw will fracture the neck of the mandible and its body in the region of the ___________ |
|
Definition
two.
Opposite canine tooth |
|
|
Term
| Fractures of the neck of the mandible are often ___________ and are associated with what? |
|
Definition
Transverse
Associated with dislocation of TMJ on the same side. |
|
|
Term
Fractures at the angle of the mandible are usually _________.
Extraction of the teeth causes the mandible to...?
What may result in pain if this occurs?
What is mandibular prognathism |
|
Definition
oblique
Resorb in the affected regions
The mandibular nerves to the face may be exposed, causing pain when eating
Decrease in the vertical facial dimension caused by loss of all the teeth |
|
|
Term
Hard blows to thin areas of the calvaria result in ______.
Define a contrecoup (counterblow) fracture |
|
Definition
depressed fractures
A fracture that occurs on the opposite side of the cranium from where the blow occurred. |
|
|
Term
| Why is fracture of the pterion life-threatening? |
|
Definition
| Anterior branches of the middle meningeal artery lie just deep to the skull. |
|
|
Term
In the adult, the facial skeleton forms _______ of the cranium. In infants the facial skeleton is _____. Why?
The smallness of the face results from what? |
|
Definition
1/3
Disproportionately large
Growth of brain and eyes.
Rudimentary development of the maxillae, mandible, and paranasal sinuses, the absence of erupted teeth, and the small size of the nasal cavities. |
|
|
Term
The halves of the frontal bone in newborns are separated by what?
The frontal and parietal bones are separated by?
Maxillae is separated by?
Mandibular is separated by?
|
|
Definition
Frontal suture
Coronal suture
intermaxillary suture
mandibular symphysis |
|
|
Term
What two bony parts of the skull don't exist in newborns? When do they form?
What nerves may be injured because there is no mastoid process? |
|
Definition
Mastoid and styloid processes
Over the first year.
Facial nn. |
|
|
Term
| What 3 things can you determine from palpation of the fontanelles? |
|
Definition
1 - progress of growth of the frontal and parietal bones.
2 - Degree of hydration of the infant
3 - Level of ICP
|
|
|
Term
Describe the boundaries of the anterior fontanelle?
Location?
How old is an infant when the anterior fontanelle fuses? |
|
Definition
Anterior - halves of the frontal bone
Posterior - parietal bones
Located at the junction of sagittal, coronal, and frontal sutures. Future sight of the Bregma.
18 months.
|
|
|
Term
What is the metopic suture a remnant of?
Define the borders of the posterior fontanelle?
Location?
When is the posterior fontanelle closed? |
|
Definition
The frontal suture (8% of people have one)
Anteriorly - parietal bones
Posteriorly - occipital bones
Located at the junction of the lambdoid and sagittal sutures.
By the end of the 1st year |
|
|
Term
What fontanelles are overlain by the temporal muscle?
When do these fuse?
When do the halves of the mandible fuse during infancy?
What is the cartilaginous joint between them called?
Increase in size of the calvaria is greatest when? |
|
Definition
Sphenoidal and mastoid fontanelles.
Fuse during infancy.
early in year 2.
mandibular symphysis.
First 2 years. |
|
|
Term
Which bone is most dynamic? Why?
When do deciduous teeth begin to erupt in infants?
How does the mandible change for this?
When do secondary teeth begin to erupt? |
|
Definition
Mandible.
Size, shape, number of teeth change with age.
6 months.
Elongates, especially posterior to mental foramen.
6th year. |
|
|
Term
Vertical growth of the upper face results from ________ development.
Increase in the paranasal sinuses is associated with ______________.
Paranasal sinuses are _____ at birth.
What are they important for? |
|
Definition
dentoalveolar development
Frontal and facial region enlargement
absent
Alter the shape of the face and add resonance to the voice. |
|
|
Term
When are the sutures of the calvaria gone?
Where does this begin? |
|
Definition
Externally: 30-40 years
Internally: 40-50 years
The bregma
|
|
|
Term
What happens to the cranial bones as you age (3)
Define primary craniosynostosis
How is it believed to occur? |
|
Definition
They become thinner, lighter, and the diploe become filled with a gray gelatinous material due to the loss of blood cells and fat cells in the marrow.
Primary craniosynostosis: premature closing of the cranial sutures.
Abnormal development of the cranial base exerts pressure on the dura mater the disrupts suture development. |
|
|
Term
Premature closure of the sagittal suture causes?
Premature closure of the coronal or lambdoid suture causes? (one side only)
Premature closure of the coronal suture? |
|
Definition
Scaphocephaly - Long, narrow, wedge-shaped cranium
Plagiocephaly - Twisted and asymmetrical cranium
Oxycephaly or turricephaly - high, tower-like cranium |
|
|
Term
What holds wounds of the scalp together and causes them not to gape?
Why do deep scalp wounds gape widely in the coronal plane?
|
|
Definition
epicranial aponeurosis
The epicranial aponeurosis is lacerated and the frontal and occipital bellies of the occipitofrontalis pull in opposite directions. |
|
|
Term
| What is the most dangerous layer of the scalp and why? |
|
Definition
Loose connective tissue layer.
Pus or blood spreads easily and infection can pass into the cranial cavity via the emissary vv. which pass through the parietal foramina |
|
|
Term
Infections of the scalp can't pass easily into the neck because __________.
Infections of the scalp can't pass the zygomatic arches because _______. |
|
Definition
The occipital bellies of the occipitofrontalis muscle attach to occipital bone and mastoid parts of temporal bones.
Epicranial aponeurosis is continuous with the temporal fascia that attaches to these arches. |
|
|
Term
Why can you get a black eye from an injury to the scalp and/or forehead?
Define ecchymosis |
|
Definition
Infections and flued can enter eyelids and the root of the nose because the frontalis inters into the skin and subcutaneous tissue and doesn't attach to bone.
Ecchymosis - purple patches. Develop as a result of extravasation of blood into subcutaneous tissue and skin of the eyelids and surrounding regions. |
|
|
Term
| What's the difference between a bruise and ecchymosis? |
|
Definition
| Ecchymosis is a type of bruise. Ecchymosis isn't caused by trauma whereas a bruise typically is. |
|
|
Term
Define sebaceous cysts.
What is a cephalhematoma and when is it most common? |
|
Definition
Sebaecous cysts: obstructed sebaceous ducts (associated with hair follicle)
Cephalhematoma: bleeding bt the pericranium and calvaria.
Typically results from trauma at birth |
|
|
Term
A blow to the head can detach the _______ layer from the calvaria without fracturing the cranial bones.
However, in the _______________ the dural layers are firmly attached to the bone.
This means that a fracture here usually results in..... |
|
Definition
periosteal
cranial base.
Tearing the dura and leakage of CSF |
|
|
Term
The innermost level of the dura is the _____________ and it's composed of __________ separated by _______.
This later constitutes a plane of structural weakness where? |
|
Definition
dural border cell layer
flattened fibroblasts
large extracellular spaces
At the dura-arachnoid junction |
|
|
Term
What is the tentorial notch?
What is tentorial herniation? What may occur?
Which nerve is in danger? |
|
Definition
The opening in the cerebellar tentorium for the brainstem
temporal lobe of brain herniates through the tentorial notch.
temporal lobe may be lacerated.
Oculomotor (CN III)
|
|
|
Term
| Pituitary tumors may put pressure on ________, producing endocrine function disturbances or _________ if it presses on the optic chiasm. |
|
Definition
sellar diaphragm
visual symptoms |
|
|
Term
Which dural sinuses are most frequently thrombosed? (3)
Describe the clinical importance of the facial --> cavernous sinus connection. |
|
Definition
Transverse, cavernous, superior sagittal sinuses
Facial v. --> Ophthalmic v. --> cavernous sinus v.
Bacteria can enter the brain through this path from the face/nasal cavities/orbit |
|
|
Term
Thrombophlebitis may cause what?
What nerves are most likely to be affect by thrombophlebitis of the cavernous sinus? |
|
Definition
Acute meningitis
Abducens n. |
|
|
Term
Name a vein communication that can cause increased intracranial pressure and headaches from straining or coughing too hard.
How? |
|
Definition
Occipital and basilar sinuses communicate via the internal vertebral plexus.
Because they are valveless, hard coughing/straining can cause regurgitation of blood from the venous system back into these sinuses. |
|
|
Term
Define an arteriovenous fistula
When a fracture to the cranial base occurs, _______ artery may be torn - producing an arteriovenous fistula. Symptoms include __________ and ___________. |
|
Definition
Arteriovenous fistula - when an abnormal connection exists between an artery and vein.
exophthalmos, chemosis |
|
|
Term
Which nerves lie close to the lateral wall of the cavernous sinus and are affected when this sinus is injured?
Define pulsating exophthalmos |
|
Definition
CN III, CN IV, CN V-1, CN V-2, CN VI
Pulsating exophthalmos - protruding eyeball pulses with the radial pulse. |
|
|
Term
How can veins and arteries cause headaches?
What is an example of this? |
|
Definition
The dura mater is sensitive to pain. Pulling of arteries/veins near the cranial base where they pass through the dura will cause intense pain.
A lumbar puncture often causes intense headaches. |
|
|
Term
What are the leptomeninges?
How may bacteria enter the leptomeninges? Most commonly at what level? |
|
Definition
Pia mater, arachnoid mater
Bacteria enter through the blood (sepsis)
subarachnoid space |
|
|
Term
Define epidural hemorrhage
What is a common cause?
Describe the symptoms |
|
Definition
Arterial hemorrhage occurring outside the dura mater.
Middle meningeal laceration
Brief concussion --> hours of lucid behavior --> drowsiness, coma |
|
|
Term
Define subdural hematoma (dural border)
What vein is most likely to cause a subdural bleed? |
|
Definition
Blood that has split open that dural border cell layer between the dura and arachnoid mater.
Superior cerebral vein as it enters the superior sagittal sinus. |
|
|
Term
Define subarachnoid hemorrhage
Most result from what?
Symptoms? |
|
Definition
Escape of the blood, usually arterial, into the subarachnoid space.
A saccular aneurysm (sac-like dilation on an artery)
Meningeal irritation (headache), stiff neck, and loss of consciousness |
|
|
Term
Define cerebral concussion
If a person recovers in less than ____ hrs the outcome is good. More than that time and ______ usually occurs |
|
Definition
Cerebral concussion - sudden loss of consciousness after a head injury
6 hrs
brain tissue injury |
|
|
Term
What is chronic traumatic encephalopathy? (punchdrunk syndrome)
What are the symptoms?
Who is at greatest risk? |
|
Definition
Sheared/stretched axons in the brain as a result of acceleration and deceleration of the head repeatedly.
weakness in lower limbs, unsteady gait, slowness of muscular movements, tremors in hands, hesitancy of speech, slow cerebration (thought)
Boxers |
|
|
Term
Define cerebral contusion
How does this occur? |
|
Definition
Brain trauma wherein the pia mater is stripped from the surface of the brain and may be torn, allowing blood to enter the subarachnoid space.
Occurs from sudden impact of brain -> skull |
|
|
Term
Cranial CSF may be maintained from __________ by ___________. The needle goes through the ______________.
Who is this used for most? |
|
Definition
posterior cerebellomedullary cistern;
cisternal puncture;
posterior atlanto-occipital membrane
Infants and young children |
|
|
Term
Define obstructive hydrocephalus
Hydrocephalus _____ the ventricles, _____ the cerebral cortex, and separates the bones of calvaria in infants.
Blockages are normally in _____ or _______. |
|
Definition
enlargement of the head due to obstruction or overproduction of CSF flow
dilates;
thins
cerebral aqueduct or interventricular foramen |
|
|
Term
| Name three causes of aqueductal stenosis. |
|
Definition
Tumor in the midbrain near the aqueduct;
cellular debris following hemorrhage;
bacterial/fungal infections in CNS |
|
|
Term
What is CSF otorrhea
When does CSF rhinorrhea occur?
How can you distinguish CSF? |
|
Definition
Leakage of CSF out of the external acoustic meatus when the tympanic membrane is ruptures and meninges are torn
When the cribiform plate is ruptured
Glucose level is the same as blood |
|
|
