Modern surgery, general and operative . e jaw breaking themiddle fossa), or from falls upon the buttocks, the knees, or the feet (fractureoccurring in the posterior fossa). The base is not broken by contre-coup. Symptoms.—Fractures of the base of the skull are apt to be compound. Asolution of continuity in the pharynx, roof of the nares, orbit, or ear permitsaccess of air to the seat of fracture and allows blood and cerebrospinal fluid toflow externally. In fracture of the anterior fossa the fracture may be com-pound because of laceration of the mucous membrane of the nares or of theconjunctiv
Modern surgery, general and operative . e jaw breaking themiddle fossa), or from falls upon the buttocks, the knees, or the feet (fractureoccurring in the posterior fossa). The base is not broken by contre-coup. Symptoms.—Fractures of the base of the skull are apt to be compound. Asolution of continuity in the pharynx, roof of the nares, orbit, or ear permitsaccess of air to the seat of fracture and allows blood and cerebrospinal fluid toflow externally. In fracture of the anterior fossa the fracture may be com-pound because of laceration of the mucous membrane of the nares or of theconjunctiva. Blood may run from the nose, its source being the vessels ofthe mucous membrane or the dura, the fracture being compound. Epistaxisdoes not prove the fracture to be compound, but only suggests it; but if theepistaxis is prolonged, the probability is greatly increased; and if the flow ofblood is succeeded by a flow of cerebrospinal fluid the diagnosis of compoundfracture is positive. Cerebrospinal fluid appears only when the mucous. Fig. -Extensive fracture of the base of the skull (AmericanText-Book of Surgery). 792 Diseases and Injuries of the Head membrane, the dura, and the arachnoid are each lacerated. In fracturesof the anterior fossa blood is apt to flow into the orbit, producing s2ibcon-jimctival ecchymosis, and perhaps pushing the globe of the eye forward. Someblood is often swallowed and vomited. In fractures of the middle fossa bloodmay flow from the ear through a tear in the tympanum, its source being thevessels of the tympanum, the meningeal vessels, or a sinus. Blood may flowthrough the Eustachian tube and come from the nose, may be spat up, or maybe swallowed and vomited. In some cases a quantity of cerebrospinal fluidflows from the ear, the discharge being increased by expiratory effort and aposition which favors gravity. Cerebrospinal fluid is at first blood-stained,but later becomes clear. The cerebrospinal fluid must not be confused witheither blood
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Keywords: ., bookcentury1900, bookdecade1910, bookpublishe, booksubjectsurgery
