(PLEASE ANSWER ALL QUESTIONS)

A 32 year old male was brought to emergency when he became
unconscious after being hit in the head by a portion of a tree limb
that had been ejected from a pneumatic log splitter.

During transport to the hospital he regained consciousness. When
he arrived at the hospital he appeared dazed and complained he had
headache. He was coherent (knew the day, time, etc.) and he
confirmed that the accident occurred as reported by others.

His blood pressure, heart and respiratory rates were normal.
Upon physical examination facial abrasions to the left cheek and
temple were noted and there was a swelling above his left ear that
was tender to the touch. His pupils were normal in diameter and
responsive to light, and he exhibited normal extraoccular (muscles
of the eye) movements. He reported a numbness on the left side of
his face.

Radiographic analysis confirmed a small lateral skull fracture
at the left pterion and a CT scan revealed a dark lens-shaped
(biconvex) mass between the skull and brain.

1) Based on the diagnostic evidence what two clinical conditions
should be considered? (hint – consider the anatomy of the cranial
meninges and spaces)

2) What bones comprise the area known as the “pterion”?

3) After considering the above case, and associated vasculature
of this area (as we have not completed the lecture you will need to
read our text to answer this part!): would you keep this patient
for observation – and why or why not?

4) If the tree limb would have hit the man at the mandible what
joint would have been affected and what loss of function would be
expected?

5) If the tree limb would have hit the man in the occipital
region what loss of function could be expected?

6) If the tree limb would have hit the man in the maxillary
region what special senses would be affected?

7) If the tree limb hit the man in the maxillary region might he
have died – and why? (hint – consider the vasculature and keystone
of the skull)