Trauma Exam 6 Skull and Facial bones

What are the 4 bones of the Calvarium

Frontal, occipital, right and left parietal

What's another name for the calvarium

Skullcap

What are the four bones of the floor

Ethmoid, sphenoid, right and left temporal

What cranium bone is the vertical and horizontal portion of the calvarium

Frontal

What cranium bone is the Inferoposterior portion of the calvarium

Occipital

What cranium bones are the walls and roof of the calvarium

Right and left parietal

What cranium bone is between the orbits

Ethmoid

What cranium bone is centrally located that forms the posterior wall of the orbits

Sphenoid

What cranium bone are the walls and base of the floor

Right and left temporal bone

What landmark is between the eyebrows

glabella

What landmark is the depression at the top of the nose where the nasal bones and frontal bone meet

Nasion

What landmark is the midline point at the junction of the upper lip and nasal septum

Acantion

What landmark is the lower posterior angle of the mandible

Gonion

What landmark is the opening of the external auditory canal

External acoustic meatus (EAM)

What landmark is the superior attachment of the auricle, corresponds to the level of the petrous ridge of the temporal bone

TEA

Line that connects the outer canthi of one eye to the other

Interpupillary line (IPL)

The interpupillary line must be _ to the IR to ensure a true lateral projection

Perpendicular

Line from outer canthus to EAM

Orbitomeatal line (OML)

Line from the infraorbital margin (inferior rim of orbit) to the EAM

Infraorbitalmeatal line (IOML)

There's a ____ average difference between IOML and OML

7 degree

There's an _ difference between OML and GML

8 degree

Used for trauma to the head and brain

Computed tomography

The ____ ___ ___ is often the diagnostic indicator for necessity of a head CT scan

Glasgow coma scale

What are the two types of head injuries

Closed, open (penetrating)

Any head injury that doesn't break your skull

Closed head injury

Head injury in which something breaks your scalp and skull and enters your brain

Open (penetrating) head injury

Minor head injury symptoms

Headache, lightheadedness, a spinning sensation, mild confusion, nausea, temporary ringing in the ears

Severe head injury symptoms

Loss of consciousness, vomiting, seizure, balance/coordination, serious disorientation, abnormal eye movement, loss of muscle control, worsening headache, memory loss, changes in mood, clear fluid leaking from ear or nose

Fractures of the base of the skull are indicated by ____ ___ in the ____ sinus

Air-fluid levels, sphenoid

Bleeding from the nose indicates a fracture of the

Cribriform plate

Bleeding from the ears indicates a fracture of the of ____ ____

Petrous portion, temporal bone

Fractures of the base of the skull should have the blood tested for ____ ____

Cerebrospinal fluid (CSF)

6 signs of a basal skull fx

Raccoon eyes, CSF Rhinorrhea, CSF Otorrhea, battle sign, hemotympanum, bump

Periorbital ecchymosis, blood tracking into the upper and lower eyelids leads to

Racoon eyes

Spinal fluid from the nose and sinuses

CSF rhinorrhea

Spinal fluid from the ear, often leads to hearing loss

CSF otorrhea

Mastoid ecchymosis, bruising under the skin from bleeding

Battle sign

blood in the tympanic cavity of the middle ear

hemotympanum

Anterior fossa fx of the basal skull occurs ____ of the time

70%

Middle fossa fx of the basal skull occurs ____ of the time

20-25%

Posterior fossa fx of the basal skull occurs ____ of the time

A middle fossa fx of the basal skull causes a ____ ____ injury

Carotid artery

_ ____ has to be ruled out before manipulating the head

C-spine injury

For the lateral skull where do you center

2" superior to EAM

For a lateral skull make sure you don't clip the ____ ____

Occipital bone

A sphenoid sinus effusion is a sign of

Basal skull fracture

For the AP skull with c collar the CR is angled _ to ____

Parallel to OML

For the AP skull with clearance the _ is perp to IR

OML

For the AP skull with clearance the CR enters at the ___

Nasion

For the AP skull with a c collar the CR is angled approximately ____ _____

10-15 degrees caudad

For the AP skull with a c collar the CR is centered to _

Glabella

For the AP skull (reverse Caldwell) what is the CR angle

15 degrees cephalic to the OML

For the AP 15 degree skull (reverse Caldwell) where do you center the CR

Nasion

For the AP towne skull what is the angle of the CR

30 degrees caudad for the OML and 37 degrees caudad for IOML

For the AP axial towne skull the CR angle should not exceed _

45 degrees

The AP reverse Caldwell 15 degrees cephalad demonstrates _ of the skull and has more mag of the ____

Magnification, orbits

T or F for the AP axial skull Townes trauma the OML and IOML are perp

F

for the AP axial skull Townes the CR passes

Midway between the EAMS

What are the 14 facial bones

2 maxillary, 2 palatine, 2 zygomatic, 2 lacrimal, 2 nasal, 2 inferior nasal conchae, 1 vomer, 1 mandible

The facials bones protect the ____ ____ and _ ____

Upper respiratory, digestive tracts

The facial bones construct the cavities of the ____, _____, _____

Orbits, nose, mouth

With facial injuries pts ability to _ becomes a concern

Breathe

____ and ____ bone fractures may interfere with breathing

Maxillary and nasal

____ ___ and ____ ____ May causes the tongue to obstruct throat and block the airway

Mandibular condyles and symphysis fractures

Mandibular condyles and symphysis fractures may cause the ____ to ____ the throat and ____ the ______

Tongue to obstruct, block the airway

Fractures of the are a concern because it's the main support between cranium and the maxilla

Zygoma

Fractures of the zygoma are a concern because it's the main support between and the _

Cranium, maxilla

Fractures of the zygoma can involve the ____ and ____ portions of the orbital rim

Inferior, lateral

For facial injuries expect ____ of ____

A lot of bleeding

When a pt has a facial injury and is bleeding turn pt ___ or on their ____ or use ____

Prone, side, suctioning

For lateral facial bones how is the CR directed and entering where

Perpendicular and entering the zygomatic arch 1/2 way between the outer canthus and EAM

For lateral facial bones what line is parallel to front edge of image receptor

MSP

For lateral facial bones what line is perp to front edge of image receptor

IPL and IOML

For the acanthioparietal projection facial bones reverse waters what line is perp to the IR

MML

For the acanthioparietal projection facial bones reverse waters in a c collar angle CR ____ as needed

Cephalad

For the acanthioparietal projection facial bones reverse waters align CR parallel to ___

MML

For the acanthioparietal projection facial bones reverse waters where is the CR directed

Acanthion

the acanthioparietal projection facial bones reverse waters best demonstrates

Maxilla and maxillary sinuses above the petrous ridges

The modified reverse waters for facial bones best demonstrates the ____ of the ___ and provides a view of the entire ___ ___

Floor, orbits, orbital rims

For the modified reverse waters facial bones the petrous ridges are visualized in ____ ____ region

Mid-maxillary sinus

For the reverse waters facial bones extend chin so ___ forms a ____ angle with plane of IR

OML 37

For the reverse waters facial bones the ____ is perp to plane of IR

MML

For the reverse waters facial bones where does the CR enter

Acanthion

A blowout fx can cause blood to fill ____ ____

Maxillary sinus

What are two signs of the blowout fx

Teardrop sign, eyebrow sign

What is the most common facial bone fracture

nasal bones

What is the most common cause of nasal fractures

Motor vehicle collision followed by assault

Angle where body and rami meet

Gonion

Vertical portion of mandible

rami (2)

The ____ unite with the body at the gonion

Rami

For the PA of the Rami what is on the IR

Pts forehead and nose

For the PA of the Rami what line is perp to the plane of the IR

OML

For the PA of the Rami where does the CR exit

Acanthion

For the PA axial of the mandible what is the angle of the CR

30 degrees cephalad

For the AP mandible the CR is parallel to what line

OML

For the AP of the mandible where does the CR enter

Mid-mandible (~junction of the lips)

For the AP axial of the mandible what is the angle of the CR

35-40 degrees caudad to OML

For the AP axial of the mandible where does the CR pass through

Region of condyloid processes and condyles (~2" anterior to EAMs)

For the axiolatetal oblique mandible what is the CR angle

Horizontal beam 25-30 degrees cephalad and 5-10 degrees Posteriorly

For the axiolateral oblique of the mandible how do you demonstrate the ramus

True lateral