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The apex beat may also be displaced by other conditions: Pleural or pulmonary diseases; Deformities of the chest wall or the thoracic vertebrae; Sometimes, the apex beat may not be palpable, either due to a thick chest wall, or conditions where the stroke volume is reduced; such as during ventricular tachycardia or shock.
Transverse fracture: This type divides the base of the skull into a front and rear half. It occurs from impact on either side of the head or from side-to-side compression. The fracture typically runs through the petrous portion of the temporal bones and the sella turcica, potentially affecting the pituitary gland. Blood from both ears often ...
A skull fracture is a break in one or more of the eight bones that form the cranial portion of the skull, usually occurring as a result of blunt force trauma.If the force of the impact is excessive, the bone may fracture at or near the site of the impact and cause damage to the underlying structures within the skull such as the membranes, blood vessels, and brain.
Vehicle collisions and falls are common causes. A severe, sudden twist to the neck or a severe blow to the head or neck area can cause a cervical fracture. Although high energy trauma is often associated with cervical fractures in the younger population, low energy trauma is more common in the geriatric population.
The Hangman's fracture which is a fracture of the C2 vertebral body or dens of the cervical spine upon which the skull base sits to allow the head to rotate, can also be associated with atlanto-occipital dislocation. Despite its eponym, the fracture is not usually associated with a hanging mechanism of injury. [13]
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The apex beat is assessed for size, amplitude, location, impulse and duration. There are specific terms to describe the sensation such as tapping, heaving and thrusting. Often the apex beat is felt diffusely over a large area, in this case the most inferior and lateral position it can be felt in should be described as well as the location of ...
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