Non-Invasive Diagnostic Approaches for Cribriform Plate Injury Following Explosion Trauma

Non-Invasive Diagnostic Approaches for Cribriform Plate Injury Following Explosion Trauma

Cribriform Plate Damage

A non-invasive test such as the “halo test” can be conducted to assess potential damage to the cribriform plate. This involves placing a piece of gauze or tissue at the nostrils to detect cerebrospinal fluid (CSF) leakage, which may present as a clear or yellowish ring around a central blood spot, resembling a halo. CSF leakage through the nose, known as rhinorrhea, is a strong indicator of a breach in the cribriform plate. This plate, a thin perforated section of the ethmoid bone, separates the nasal cavity from the brain and is crucial in maintaining the integrity of these regions.

Visual Distortions and Blind Spots

The patient’s constant blind spots and distorted lines in both eyes likely indicate damage to the macula, a crucial area of the retina responsible for central vision and detailed visual tasks. Conditions affecting the macula, such as macular edema or scarring, can cause visual distortions (Rehman et al., 2021). This suspicion can be verified through an Optical Coherence Tomography (OCT) scan. This non-invasive imaging test provides high-resolution cross-sectional images of the retina, allowing for a detailed examination of the macula’s structure and the identification of any abnormalities.

Lung Damage and Tympanic Membrane Rupture

The damage to both lungs and the rupture of both tympanic membranes can be attributed to the explosive force and rapid pressure changes experienced during the incident. The lungs are particularly susceptible to blast injuries due to the high-pressure waves that can cause alveolar rupture, pneumothorax, or contusions. Similarly, as supported by Venkatasivasai Sujith Sajja et al., (2020), the tympanic membranes, being delicate structures, can easily burst under the sudden and intense pressure changes from the explosion. The direct exposure to the blast’s shockwave likely caused these injuries, emphasizing the severe impact of such high-energy events on the body’s vulnerable structures.

References

Rehman, I., Hazhirkarzar, B., & Patel, B. C. (2021). Anatomy, Head and Neck, Eye. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK482428/

Venkatasivasai Sujith Sajja, Statz, J. K., Walker, P. B., Gist, I. D., Wilder, D. M., Ahlers, S. T., & Long, J. B. (2020). Pulmonary injury risk curves and behavioral changes from blast overpressure exposures of varying frequency and intensity in rats. Scientific Reports, 10(1). https://doi.org/10.1038/s41598-020-73643-7

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A 42-year-old male decides to try to break the world record of starting the hottest grill fire in history by pumping liquid oxygen into his grill. Needless to say, he now has arrived surprisingly conscious in your ER with several issues due to the ensuing explosion.

Non-Invasive Diagnostic Approaches for Cribriform Plate Injury Following Explosion Trauma

Instructions
Answer the following questions and save your responses in a Microsoft Word document. Provide a scholarly resource in APA format to support your answers.

The CT reveals several issues with the cranial structure, one of which might be in the cribriform plate but the image isn’t well defined. What non-invasive test can you do to test if the cribriform plate is severely damaged? Why?
The doctor tests the patient’s field of view with an astigmatism chart and finds that the patient states that there are blind spots and distorted lines in both eyes he never noticed before. These blind spots and distortions remain constant. What structure within the eye could cause these distortions? How can you verify your suspicion?
Both his lungs have received some damage and both tympanic membranes have burst during the explosion. Why?