Downloaded 143 times
More Related Content
Similar to Basal skull fractures
Basal skull fractures
- 1. Basal Skull Fractures (AnatomicalBase for Signs) M D 1 0 8 : M OT I O N A N D S T R E N G T H P R E S E N T E R : A L I C E M A R I E TA O S D E PA R T M E N T O F M E D I C I N E FA C U LT Y O F M E D I C I N E A N D H E A LT H S C I E N C E S D I V I N E W O R D U N I V E R S I T Y
- 2. Outline Definition of terms SkullBase Anatomy Signs /Clinical Presentations
- 3. Definition Basal Skull –base of the skull Fossa - a depression or hollow (Oxford Concise Medical Dictionary, 2010) Ecchymosis: Passage of blood from ruptured blood vessels into subcutaneous tissue marked by a purple discoloration of the skin
- 4. What is basalskull fracture Basal Skull Fracture - ◦ Type of skull fracture which occurs in the floor of the skull that is around the eyes, ears, nose or back near the spine (Ellis, 2015) ◦ Fracture of the base of the skull specifically involves the temporal bone, occipital bone, sphenoid bone, and/or ethmoid bone (Wikipedia, 2016) Morgan, B. (1999, November 19). Overview of Adult Brain Function. Retrieved from https://web.archive.org/web/20080227162001/http://www.orlandoregional.org/pdf%20folder/overview%20adult%20brain% 20injury.pdf
- 5. Morgan, B. (1999,November 19). Overview of Adult Brain Function. Retrieved from https://web.archive.org/web/20080227162001/http://www.orlandoregional.org/pdf%20folder/overview%20adult%20brain% 20injury.pdf
- 6. Skull Base Anatomy TheBase of the skull is Made up of 5 bones (Martinez, 2013) ◦ Frontal Bone ◦ Cribriform of the last ethmoid ◦ Sphenoid bone ◦ Squamous of the temporal bone ◦ Occipital bone Saladin, K. S. (1998). Anatomy and Physiology: The Unity of Form and Function. Boston: McGraw-Hill.
- 7. Type of BasalFractures Anterior Skull Base Fracture Middle Skull Base Fracture Posterior Fossa Fracture Martinez, L. (2013, December). Basilar Skull Fractures. Retrieved July 14, 2016, from https://www.utmb.edu/otoref/Grnds/basilar-skull-fx-2013-12/_basilar-skull-fx-pic-2013-12.pdf
- 8.
- 9. Signs/Clinical Presentations Diagnosed byclinical findings – Clinical assessment critical Clinical findings consistent with basal skull fracture ◦ Anterior Fossa: rhinorrhea (discharge from the nose), raccoon eyes (periorbital ecchymosis). Anosmia (loss of smell), oculomotor palsies ◦ Middle Fossa: Hemotympanum (blood in the middle ear), otorrhea vertigo, “Battle’s sign (mastoid ecchymosis), unilateral hearing loss. ◦ Posterior Fossa: hypotension, tachycardia, alteration in respirations due to compression of the brainstem. (Orlando Regional, Healthcare, Education & Development, 2004)
- 10. Periorbital Ecchymosis Orlando Regional,Healthcare, Education & Development. (2004). Adult Traumatic Brain Injuries. Retrieved from Overview of Adult Brain Injury: https://web.archive.org/web/20080227162001/http://www.orlandoregional.org/pdf%20folder/overview%20adult%20brain%20injury.pdf
- 12.
- 13.
- 14.
- 15.
- 17. References 1. Ellis, M.E. (2015, September 29). Skull Fractures. Retrieved July 12, 2016, from Healthline: http://www.healthline.com/health/skull-fracture#Overview1 2. Martinez, L. (2013, December). Basilar Skull Fractures. Retrieved July 14, 2016, from https://www.utmb.edu/otoref/Grnds/basilar-skull-fx-2013-12/_basilar-skull-fx-pic-2013-12.pdf 3. Morgan, B. (1999, November 19). Basal Skull Fractures. Retrieved from London Health Sciences Centre: http://www.lhsc.on.ca/Health_Professionals/CCTC/edubriefs/baseskull.htm 4. Orlando Regional, Healthcare, Education & Development. (2004). Adult Traumatic Brain Injuries. Retrieved from Overview of Adult Brain Injury: https://web.archive.org/web/20080227162001/http://www.orlandoregional.org/pdf%20folder/overvie w%20adult%20brain%20injury.pdf 5. Oxford Concise Medical Dictionary. (2010). New York: Oxford University Press. 6. Saladin, K. S. (1998). Anatomy and Physiology: The Unity of Form and Function. Boston: McGraw-Hill. 7. Wikipedia. (2016, May 31). Retrieved from Basilar skull Fracture: https://en.m.wikipedia.org/wiki/Basilar_skull_fracture
Editor's Notes
- #5 Skull bones surround the entire Brain extending underneath to create the base of the skull (Morgan, 1999) Caused by Motor vehicle accidents Motor Racing.
- #6 The Occipital bone (green at the base of the skull) continues under the brain to produce the posterior fossa of the basal skull. Temporal and Sphenoid bone make up the major structure of the Middle Fossa of the Base of the skull Frontal Bone primarily makes up the Anterior Fossa. However, most of the frontal bone is covered by the maxilla (in the left, your right) A small portion of the parietal bone extends under the brain to produce the lateral edge of the base of the skull.
- #7 Superior view of sphenoid bone in the floor of cranium The Occipital bone (green at the base of the skull) continues under the brain to produce the posterior fossa of the basal skull. Temporal and Sphenoid bone make up the major structure of the Middle Fossa of the Base of the skull Frontal Bone primarily makes up the Anterior Fossa. However, most of the frontal bone is covered by the maxilla (in the left, your right) A small portion of the parietal bone extends under the brain to produce the lateral edge of the base of the skull. Black line – Anterior Fossa Yellow line – Middle Fossa Red Circle – Posterior Fossa
- #8 Fractures are assessed according to type, size, location and neurological signs and symptoms that accompany it. Treatment of Skull Fracture is specific to fracture and patient assessment
- #10 Not detectable with skull x-rays or even CT scans Hymotympanum – presence of blood in the tympanic cavity of the middle ear result of the basal skull fracture Optic nerve Intrapment Occurs Optic nerve is compressed by the broken skull bones causing irregularities to vision. Intracranial Pressure – due to fractures Medulla oblongata detects the level of oxygen and carbondioxide concentrations and send signals the muscle and the heart, lungs and diaphragm to increase or decrease breathing. Pons control the speed of inhalation and exhalation or respiration rate depending on the need of the body.
- #11 Racoon Eyes – single or doubled Indicates an Anterior Fossa Fracture Blood from the Skull fracture seeps into the soft tissue around the eyes. Bilateral Hemorrhage occurs when damage at the time of the facial fracture tears the Meninges and cause venous sinuses to bleed into Arachnoid villi (Small protrusion of the arachnoid – thin layer covering the brain) and Cranial Sinus ( Cranial Sinus - Venous Channels found between layer of dura mater in the brain They receive blood from internal and external veins of the brain Receive CSF from Subarachnoid space and ultimately empty into the internal Jugular vein (Collects blood from the brain)
- #13 Posterior Fossa Fracture 100% associated with Basal skull fracture – Bruising of the mastoid process as a result of the extravasation (leaking of blood/fluid) of the blood along the path of the Posterior Auricular Artery (Slightly Below the ear) Or Battle’s Sign – Indicates middle or posterior Fossa fracture of the skull. Ecchymosis usually occur immediately after accident, or appear within first 24-48 hours
- #15 When the base of the skull is fractured, disruption of the dura (tough outer membrane enveloping the brain and the spinal chord) can allow CSF to leak into the sinuses or foramen that are close to the injury. Bleeding from surrounding blood vessels can also enter these channels. Symptoms of basal skull fracture include CSF leaks or bleeding into sinuses and canals and/or injuries to adjacent nerves. Most common place for leaks are ethmoid and orbital bone, temporal bone, sphenoid bone and occipital bones Leaks tend to resolve spontaneously, however 24% of leaks need to have intervention for treatment.