Thursday, 12 January 2017

You MUST GET EVERTHING IN YOUR HEAD ABOUT " HEAD INJURY"

                 HEAD INJURY CLASSIFICATION

Depending on the state of dura:
—Closed head injury- dura intact, irrespective of skull fracture
—Open head injury - dura open, torn by penetrating injury, bone fragment or due to skull fracture
Contents:—Scalp injury.——Injury to face.——skull fracture.——Injury to meninges.——Injury to brain.
Head injury: It is defined as a morbid state resulting from gross or subtle structural changes in the scalp , skull and/or the contents of the skull produced by mechanical force.SCALP INJURIESScalp is covering of head extending from eyebrows superiorly to posterior nuchal line and laterally bounded by temporal lines  
Layers are:—
Skin—
Connective tissue
—Aponeurosis—
Loose areolar tissue—
Periosteum


Following injuries may occur on  scalp:
1.Abrasion
2.Contusion
3.Laceration ( linear y- shaped, stellate , cruciate, penetration, crescent.etc)
4.Incise wound
5.Avulsion
6.Puncture wounds—
Contusion of scalp:Ectopic bruises:
Mobile contusion of ant. scalp may shift downwards producing black eye or spectacle haematoma/racoon eyeContusion in temporal scalp shifting downwards behind ear is similar to battle sign.Hematoma below the aponeurotica is commonly called under scalp hematoma.

—Under scalp haematoma: Beneath aponeurotica—INJURY TO FACE-
  —Abrasion
—Contusion
—Laceration—Incised wound—Chop—Penetrating wound—Fracture of bone.
— INJURY TO TEETH-—of tooth/teeth.—Dislocation of tooth/ teeth—Contusion of gums—Laceration of gums—Fracture of alveolar margins.SKULL FRACTURE- General deformation:    Skull behaves like an elastic sphere. Fracture may be due to :—Impact on one plane—Compression between two objectsFracture seen at distal site.  Combination of focal and general deformation produces spider web pattern
Puppe’s rule:  When 2 or more separate fractures occur from successive impacts and meet each other , the second fracture will terminate in the first fracture.FORCE APPLIED TO CHIN-

Types of skull fracture

1.VAULT FRACTURE

1.Linear/fissured
2.Depressed
3.Comminuted/spider web
4.Pond orindented
5.Gutter
6.Sutural
7.Perforating
8.Cut 

2.BASILAR  FRACTURES
1.Linear/fissured
2.Ring
3.Hinge
4.Longitudinal
5.Secondary
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