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44-Year-Old Male with Skull Fracture
William Hancock, 44, fell from the scaffolding at a construction site. When emergency personnel arrived, they found him unconscious but with stable vital signs. As paramedics placed him on a backboard to stabilize his head, neck, and back, they noted watery blood leaking from his right ear. In the hospital, Mr. Hancock regained consciousness and was treated for deep lacerations on his scalp and face. Head CT scans revealed both longitudinal and transverse fractures of the right petrous temporal and sphenoid bones that extended through the foramen rotundum and foramen ovale.
The following observations were recorded on Mr. Hancock’s chart on admission:
•Complete loss of hearing in the right ear.
•Paresthesia (sensation of “pins and needles') at the right corner of the mouth, extending to the lower lip and chin.
•Numbness of the right upper lip, lower eyelid, and cheek.
•Right eye turned slightly inward when looking straight ahead. Diplopia (double vision), particularly when looking to the right.
Mr. Hancock was given a course of antibiotics, the head of his bed was elevated by 30
4. NCLEX-STYLE The observations after 24 hours suggest that yet another cranial nerve has been damaged. Which of the following choices best explains the new observations including the lack of tear production?
a. The oculomotor nerve has been damaged, including its parasympathetic branch.
b. The facial nerve has been damaged, including its parasympathetic branch.
c. The oculomotor nerve has been damaged, including its sympathetic branch.
d. The facial nerve has been damaged, including its sympathetic branch.
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Chapter 13 Solutions
HUMAN ANATOMY+PHYSIOLOGY-ACCESS(IAC)
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- A high-school football player died 2 days after a serious head wound received on the field during the game. He butted heads with another player hard enough to cause his skull to fracture. For a few moments, his injury did not seem serious; however, the referee ordered him off the field where he collapsed. Paramedics were called, and he was rushed to the emergency room. 1.How could such an injury be prevented? 2.As a parent or a coach, what precautions would you want to take during practices and games? 3.Identify the appropriate steps taken in this situation. ****PLEASE INCLUDE CITATIONS MLA 9TH EDITION PERDUE OWL****arrow_forward59 A 19-year-old college student sustained a fracture of the skull in an automobile collision. There is leakage of blood and cerebrospinal fluid from the nose. Which of the following structures is most likely to be involved? A) Cavernous sinus B) Cribriform plate of the ethmoid bone C) Nasal septum D) Orbital plate of the frontal bone E) Petrous part of the temporal bone F) Roof of the nasopharynxarrow_forwardWhy is concussion sometimes called an invisible injury?arrow_forward
- After falling off a horse, Mary complained of pain on the right side of her thorax that intensified when she took a deep breath or coughed. The emergency medical technician suspected a broken rib. Using palpation, how could the EMT identify the precise location of the injury?arrow_forwardAn 18-year-old high school football player suffered a torn anterior cruciate ligament (ACL) in the state playoffs. After undergoing repair, he found it difficult to ambulate with the knee brace. Weighing close to 140 kg (approximately 300 lbs) the athlete found it difficult to stand and balance on one leg. His mother was unable to support him by herself. After 1 week, the young man began to have increased pain and swelling in the calf of his affected leg. In the middle of the night, the teen called out to his mother, complaining of a shortness of breath and unexplained anxiety. His mother called 9-1-1, and he was taken to a local hospital. In the emergency department, he was diagnosed with a deep vein thrombosis and a pulmonary embolism. Oxygen and low-molecular-weight heparin were administered, and the young man was admitted to the intensive care unit. As a result of the thrombus lodging in the pulmonary circulation, the sympathetic nervous system is activated. Hemodynamically, this…arrow_forwardmatch the correct ans Column A Column B 1. Head of the humerus a.) Articulating surface at a joint 2. Foramen ovale in the skull b.) Attachment site for tendons or ligaments 3. Trochanter in the femur c.) Passageway for nerves or blood vessels 4. Costal facet in the thoracic vertebra 5. Mastoid process in the skull 6. Carotid canal in the skullarrow_forward
- Patient X had a malignant duodenal tumor that was removed. The surgeon removed the whole duodenum. Predict the long-term consequences for Patient X after recoveryarrow_forwardThe patient has complained of vertigo and hearing loss. Which cranial nerve is mostly likely affected?arrow_forwardLabel namearrow_forward
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