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