Week 2

Question 1

How many bones of the skull and how are they divided

Answer 1

22 overall:

8 neurocranium
14 viscerocranium

Question 2

What is the neurocranium

Answer 2

Calvaria and base of skull together accommodating the brain

Question 3

What is the viscerocranium

Answer 3

Forms facial skeleton

Question 4

Name bones of the viscerocranium

Answer 4

Nasal
Lacrimal
Zygomatic
Inferior nasal concha 
Mandible (1)
Maxilla
Vomer (1) 
Palatine

Question 5

Name bones of the neurocranium

Answer 5

Parietal (2)
Frontal 
Sphenoid
Ethmoid
Occipital
Temporal (2)

Question 6

What are the immobile skull joints called

Answer 6

Sutures

Question 7

What is the mobile joint of the skull

Answer 7

Temperomandibular joint

Question 8

What are the sutures

Answer 8

Coronal - frontal/parietals
Squamous - temporal/parietal
Saggital - left and right parietal
Lambdoid - occipital/parietals

Question 9

What is the pterion

Answer 9

Where the frontal, parietal, temporal and sphenoid bones join together
Weakest point of the skull

Question 10

What is the lambda

Answer 10

Where the occipital bone fuses with both parietal bones

Question 11

What is the Bregma

Answer 11

Where the frontal bone fuses with both parietal bones

Question 12

What are fontanelles

Answer 12

Membranous areas of unfused skull which normally close in first 2 years of life
There is an:
Anterior - forms bregma
Posterior - forms lambda

Question 13

Functions or fontanelles

Answer 13

Eases passage through birth canal

Allows for brain growth

Question 14

What can go wrong with fontanelles

Answer 14

Sunken - dehydration
Bulging - raised intracranial pressure e.g meningitis
Enlarged - premature

Question 15

First line investigation for suspected head injury

Answer 15

Head CT scan because need to look for fracture complications e.g bleeding

Question 16

What can be damaged in trauma to the pterion

Answer 16

Middle meningeal artery can be damaged leading to extradural haemorrhage (bleeding between periosteum and dura mater)

Question 17

Characteristics of basilar skull fracture

Answer 17

Battle’s sign - bruising behind ears
Raccoon’s eyes - bruising around orbits
CSF rhinorrhoea
Hemotympanum (blood clot behind eardrum)

Question 18

Complications of basal skull fractures

Answer 18

Meningeal tears leading to leakage of CSF and bleeding into soft tissues, sinuses and tympanic cavity
Cranial nerve palsies
Risk of meningitis

Question 19

What should be done in any suspicion of cervical spine injury

Answer 19

Spinal immobilisation immediately

Clear spine clinically if possible, if not need imaging

Question 20

What is a Jefferson’s fracture

Answer 20

Fracture through anterior and posterior arches of atlas

Question 21

What is a Hangman’s fracture

Answer 21

Bilateral fracture through posterior arch of axis and disruption of C2/3 junction

Question 22

How do hangman’s fractures occur

Answer 22

Hyperflexion of neck

Question 23

Who are vertebral crush fractures common with

Answer 23

Associated with spinal degenerative diseases

Question 24

How can wedge fractures be diagnosed on X-ray

Answer 24

Loss of height of vertebral body

Question 25

What is cervical spondylosis

Answer 25

Osteoarthritis of cervical vertebrae

Question 26

Features of cervical spondylosis

Answer 26

``` Osteophytes Facet joint hypertrophy Disc herniation Disc space narrowing Sclerosis of end plates ```

Question 27

Complications of cervical spondylosis

Answer 27

Cervical spondylotic radiculopathy - nerve root impingement so causes dermatomal pain, sensory loss and mild weakness in upper limb Cervical spondylotic myelopathy - spinal cord impingement so causes loss of fine motor skills in upper limb

Question 28

What does the middle meningeal artery supply

Answer 28

Skull | Dura

Question 29

What is a craniotomy

Answer 29

Bone and scalp are reflected inferiorly to preserve blood supply. Allows access to cranial cavity