BIOS 252 Week 5 Case Study

BIOS 252 Week 5 Case Study

Name

Chamberlain University

BIOS-252 Anatomy & Physiology II with Lab

Prof. Name

Date

Introduction

The human body, a complex structure, is prone to injury from a variety of sources. In the scenario of the patient under discussion, they have sustained multiple injuries due to an explosion. Such injuries can be severe, necessitating a comprehensive assessment to evaluate their full extent. One of the most serious injuries suffered is the fracture of the cribriform plate, which is located in the ethmoid bone. The cribriform plate forms the roof of the nasal cavity and is particularly susceptible to fractures caused by blunt force trauma or the primary blast effect of an explosion. A fracture in this region poses a significant risk of cerebral spinal fluid (CSF) leakage, which can lead to further complications such as infection, meningitis, or pneumocephalus (Gomez & Pickup, 2022).

Injury Assessment and Diagnostic Procedures

To assess the severity of the patient’s injuries, a CT scan is initially performed. However, this may not always reveal the presence of CSF leakage. Consequently, a non-invasive Pledget study is carried out. This procedure involves inserting small cotton pads (pledgets) into the patient’s nasal cavity. The presence of a clear or yellowish fluid ring surrounding the blood-soaked pledget is indicative of CSF leakage. However, the study does not identify the exact location of the leakage. In addition to the cribriform plate injury, the patient presents with visual distortions, which may be attributed to ruptured blood vessels within the vitreous body. This jelly-like structure inside the eye plays a critical role in maintaining intraocular pressure and preventing distortion during eye movement (Saladin, 2020). Damage to this area can impair vision. To diagnose vitreous hemorrhage, a fluorescein angiography is performed, where a dye is injected into the bloodstream. This dye highlights any leakage from damaged vessels in the eye, helping confirm the condition.

Bilateral Tympanic Membrane Perforation

Additionally, the patient has suffered bilateral tympanic membrane perforation. The tympanic membrane, commonly known as the eardrum, is a thin barrier that separates the outer ear from the middle ear. It can only tolerate limited pressure differentials, and ruptures when exposed to pressures exceeding 35 Psi (Baum et al., 2010). Given the proximity of the patient to the explosion, it is reasonable to assume the blast waves exceeded this pressure threshold, causing the perforations. Furthermore, blast waves over 40 Psi can also affect hollow organs, such as the lungs, by shearing and fragmenting tissues due to the high pressure (Jorolemon et al., 2022).

Table Summary of Injuries and Diagnostic Procedures

Conclusion

The injuries sustained by the patient from the explosion are severe and warrant immediate medical intervention. The cribriform plate fracture presents the most significant risk due to the potential for CSF leakage, necessitating a CT scan and Pledget study for proper diagnosis. Visual distortions, potentially caused by vitreous hemorrhage, require fluorescein angiography to confirm the presence of hemorrhage. Lastly, the bilateral tympanic membrane perforation, caused by the blast wave, also requires prompt medical attention. A coordinated medical response is essential to develop an effective treatment plan that addresses each of these injuries.

References

Baum, J. D., Rattigan, M. I., Sills, E. S., & Walsh, A. P. (2010). Clinical presentation and conservative management of tympanic membrane perforation during intrapartum. https://doi.org/10.1155/2010/856045

Gomez, J., & Pickup, S. (2022). Cribriform Plate Fractures. https://www.ncbi.nlm.nih.gov/books/NBK562192/

Jorolemon, M. R., Lopez, R. A., & Krywko, D. M. (2022). Blast Injuries. https://www.ncbi.nlm.nih.gov/books/NBK430914/

BIOS 252 Week 5 Case Study

Saladin, K. S. (2020). Anatomy & Physiology: The Unity of Form and Function (9th ed.). McGraw-Hill Higher Education (US).