Head & Spinal injuries

HEAD INJURIES

HISTORY

    • Type of accident-

    • Level of consciousness-

    • Post traumatic amnesia & Retrograde traumatic amnesia-

    • Vomiting-

    • Epileptic fits or seizures-

    • Swelling & pain in the head-

    • Other complaints-

    • Past history-

    • Personal history-

    • Family history-

PHYSICAL EXAMINATION:

    • Head-

    • Position of the patient-

    • Depth of unconsciousness-

    • Bleeding from the nose, ear or mouth-

    • Eyes-

    • Pulse & Blood pressure-

    • Respiration-

    • Temperature-

    • Presence of neurological deficits-

    • Rigidity of the neck-

    • Cranial nerves-

    • Other CNS manifestations-

CLASSIFICATION OF HEAD INJURIES

    • Injury to the scalp-

    • Injury to the vault of the skull- Fracture of the vaults of the skull are mainly caused by- (i) compression of the sphere, (ii) by local indentation and (iii) by tangential injury

    • Injury to base of the skull-

      • Fracture of the anterior cranial fossa-

      • Fracture of the middle cranial fossa-

      • Fracture of the posterior cranial fossa-

    • Injury to the duramater-

    • Injury to the brain-

      • Cerebral concussion-

      • Cerebral contusion-

      • Cerebral irritation-

      • Cerebral laceration-

    • Injury to the blood vessels-

    • Escape of cerebrospinal fluid-

    • Injury to the cranial nerves-

Investigation of Intracranial Space-Occupying Lesions

EXAMINATION OF SPINAL INJURIES

HISTORY-

EXAMINATION FOR SPINAL CORD INJURIES:

    • UPPER LIMBS-

      • Attitude-

      • Sensation-

      • Muscle power-

    • LOWER LIMBS-

      • Attitude-

      • Muscle power-

      • Sensation-

      • Reflexes-

EXAMINATION OF THE SPINAL COLUMN-

    • Inspection-

    • Palpation-

    • Percussion-

    • Movements-

    • Rectal examination-

DIAGNOSIS-

FRACTURE OF THE SPINE-

    • Burst fracture-

    • Backward hinge (Extension injury)-

    • Forward hinge (Flexion injury)-

    • Shearing force-

    • Dislocation of the spine-

    • Injury to the cord-

      • Cord concussion (shock)-

      • Complete contusion of the cord-

      • Root transection-

      • Traumatic intra-spinal haemorrhage-

EXAMINATION OF SPINAL ABNORMALITIES