Emergency Medicine and Surgery Q&A: Part 4

Last Modified: Monday, 22 September 2008

1. What is Battle’s sign?

Mastoid ecchymoses, presenting after major trauma and without obvious regional trauma. Pathognomonic of basilar skull fracture.

2. How many vertebrae are there, and what are the 5 categories?

Cervical, 7; thoracic, 12; lumbar, 5; sacral, 2-3; and coccyx, 2-3.

3. Half of all spinal injuries occur to what part of the spine?

Half of all spinal injuries are in the atlantoaxial (or cervical) region. There is especial atlantoaxial instability in Down syndrome; in Freeman-Sheldon syndrome, the sternocleidomastoid and platysma, as well as many accessory muscles, are contracted, limiting rotation, flexion, and extension. They are also poorly developed and infants may have far less stability their average, normal peers. The regional muscle development is strongly negatively correlated with spinal fractures.

4. What are 2 major complications of a spinal cord injury?

Massive paralysis, loss of proprioception, sensation, control of vital organ function, exempli grata, lungs, and bladder control.
5. What are the degree classifications of burns?

First degree burns affect only the superficial epidermis, leaving intact integument. Second degree, i.e. partial-thickness, burns are subdivided as either superficial or deep. Superficial burns’ involvement ranges from the deep aspect of the epidermis to superficial aspect of the dermis. Deep burns’ involvement is in the deep dermis. Third degree, id est, full-thickness, burns are typically classified as any burn extending beyond the dermis. The American Society of Plastic Surgeons delineates between third and fourth degree burns, defining the former as involving the full-thickness of integument and subcutaneous tissue, while fourth degree involve muscle and deeper tissue.

6. Define seizures.

A clinical syndrome, associated with some type of underlying pathology, of multiple aetiologies and rapid onset, involving abnormal electrical CNS signaling, and characterised by loss of consciousness, amnesia, sensory disturbance, and may be associated with tonic-clonic movements and aura.
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