Chapter 17: Regional Injuries

comprise of injuries to various anatomical regions of the body having medicolegal significance and include injuries to the — head, neck, spine and spinal cord, chest, abdomen, limb bones and joints.

a morbid state, resulting from gross or subtle structural changes in the scalp, skull, and/ or the contents of the skull, produced by mechanical forces

______ is the outermost covering of the head and is continuous with the skin of the face and has five layers from outside to inwards.

This is a condition due to the bleeding in the soft tissue around the eye owing to blunt trauma of the forehead rupturing the blood vessels and the blood tracks along the facial attachments around the lower margin of the orbits.

This is a condition in which the blood is collected in the soft tissue around the eyes, due to the fracture of the base of the skull – anterior cranial fossa fractures.

____ is a diploic bone having an outer table and inner table.

the spongy bone in between the tables and gives greater elasticity to the bone.

Here the forces acting directly on the bone produce a fracture

Here the force is acting on the skull indirectly, through some other structures, which receive the primary impact.

a linear fracture involving only outer or inner table or both tables simultaneously. Also called as crack fracture.

a fracture that occurs when head is stationary.

A fracture occurs when the moving head strikes a stationary object.

A fracture that  occurs on the vertex and may extend up to the base of the skull or vice versa, when the head is compressed between mechanical force on one side and a hard surface on other side.

fracture wherein the fractured bone fragment is driven inwards for some distance below the rest of the adjacent skull's contour.

a fracture, wherein the bone is broken into several pieces of different sizes, also known as crushed fracture.

a comminuted fracture with fissured fractured fragments radiating from it and held intact.

a non-depressed comminuted fracture where fractured site appears in the form of several fissures forming a spider's web or cob web.

a fracture, wherein one end of the fractured fragment is elevated above the surface of skull, while the other end may dip down into the cranial cavity and injure the dura mater of the brain directly.

a fracture occurring along skull sutures, and occurs in children and young persons.

a fracture wherein the thickness of the skull bone is affected leading to an irregular depressed fracture of the inner table.

a simple dent in the skull, which results from an obstetric forceps blade, or a blow from blunt object or forcible impact against some protruding object

an open fracture caused by a projectile (bullet) passing through the affected bone.

A heavy cutting weapon can cause straight chops of the skull, involving either the outer table alone, or sometimes affecting both tables.

a fracture, wherein there is a combination of more than one.

It is due to direct impact or as a result of contracoup injuries, resulting in a black eye or escape of CSF and blood from the nose and damage to the roof of the orbit.

It is due to direct impact behind the ears or crush injuries of the head resulting in escape of CSF and blood from the ear when the petrous part of the temporal bone is fractured.

It is due to the impact on the back of the head, resulting in escape of CSF and blood into the tissues of the back of the neck.

It is a fissured fracture occurring around the foramen magnum, situated 3 to 5 cm outside foramen magnum at the back, the middle ear on either side and the roof of the nose anteriorly.

a fracture of the base of the skull where the fracture line runs from side to side across the floor of the middle cranial fossa, passing through the pituitary fossa in the midline following the course of least structural resistance.

the strong and gray/bluish connective tissue membrane and is firmly attached to the skull, penetrated by bridging veins (emissary veins) along the vertex.

A thin, vascular meshwork-like membrane beneath dura.

a surface network of glial fibers that are inseparable from underlying brain.

brain injuries of traumatic origin, which happens to be the major cause of death among the population less than 45 years age.

When a moving object hits the head, which is static, the skull picks up the momentum first and hits the brain, which is still at rest, yet to pick up the momentum a fraction of a second later.

When a non-moving object suddenly arrests the head in motion, the skull loses its momentum much prior to brain, which hits the inner aspects of the skull before becoming static.

This is due to side to side or rotational movement of the head, which makes the brain to get jolted on the sharp edges of the tentorial attachments in the interior of the skull and on the bony buttresses produced by the bones of the base of the skull and get injured.

Here the injury to skull and brain both occurs at the site of impact.

Here the injury to skull and brain occurs on the opposite side of the site of impact.

Here clinically the patient will present with loss of consciousness and flaccidity of muscles, followed by recovery of the consciousness, leading to a second loss of consciousness later.

the period of recovered consciousness between two bouts of unconsciousness.

severe trauma can bring about brainstem (vital centre) damage resulting in fatality.

Victim is unable to recollect the exact manner in which the injury occurred and even the events occurring before and after the accident.

a syndrome of confusion in a setting of impaired physical function resembling Parkinson's disease. Usually caused by repeated blows to the head. It also resembles the condition found in chronic alcoholics.

a clinical condition, which is one of the most common and devastating types of brain injuries occurring in almost half of all cases of severe head trauma.

it is the bruising of the cerebral tissue. There may not be any apparent injury of the scalp or skull outside.

It includes a peculiar set of symptoms that may follow cerebral concussion, victim lies curled up in the bed, with face hidden beneath the clothes, resents all forms of interference and exposure to light.

a clinical condition due to increased intracranial pressure, which disturbs the function of the brain.

Bleeding within the brain itself.

Bleeding within the brain tissue.

Bleeding within the brain's ventricles.

bleeding that occurs within the skull but outside of the brain tissue

It is caused by trauma, and results from laceration of an artery, most commonly the middle meningeal artery.

It results from tearing of the bridging veins in the subdural space between the dura and arachnoid mater.

It result either from trauma or from rupture of aneurysms or arteriovenous malformations.

especially the squamous portion can result in rupture of the middle meningeal artery or vein, leading to heavy bleeding into the temporal fossa.

It can result in rupture of anterior meningeal artery or vein, leading to anterior cranial fossa hemorrhage, which in turn can press upon the frontal lobe.

It can result in rupture of posterior meningeal artery or vein, leading to posterior cranial fossa hemorrhage, which can develop a large hematoma, which in turn can press upon the cerebellum and the occipital lobes.

It can result in rupture of superior sagittal sinus or diploic veins and lead to hematoma formation.

a type of intracranial hemorrhage wherein bleeding occurs in the pons or brain stem.

occurs due to a localised or diffuse abnormal accumulation of water and sodium, which increases the volume of the brain

A condition wherein the victim develops transient paralysis without loss of sexual power.

A trauma suffered by small children as the result of deliberate abuse.

It is killing by pushing a fine needle into nape of neck between base of skull and first cervical vertebra and is a concealed punctured wound

A fracture in which bone fragments separate completely.

A fracture in which the bone fragments are still partially joined.

A fracture that is parallel to the bone's long axis.

A fracture that is at a right angle to the bone's long axis.

A fracture that is diagonal to a bone's long axis.

A fracture that usually occurs in the vertebrae.

A fracture where at least one part of the bone has been twisted.

A fracture causing many fragments.

A fracture caused when bone fragments are driven into each other

A fracture when the bone reaches the skin.

A fracture when the bone is in place, but the fracture has the appearance of a crushed insect.

Occurs because the bone is not as brittle as it would be in an adult, and thus does not completely fracture, but rather exhibits bowing without complete disruption of the bone's cortex.

growth plate injuries that require careful treatment and accurate reduction to make sure that the bone continues to grow normally.

Occurs especially the squamous portion can result in rupture of the middle meningeal artery or vein, leading to heavy bleeding into the temporal fossa.

It can result in rupture of the anterior meningeal artery or vein, leading to anterior cranial fossa hemorrhage, which in turn can press upon the frontal lobe.

It can result in rupture of the posterior meningeal artery or vein, leading to posterior cranial fossa hemorrhage, which can develop a large hematoma, which in turn can press upon the cerebellum and the occipital lobes.

It can result in rupture of superior sagittal sinus or diploic veins and lead to hematoma formation.