Head and Neck. 407 



border of the bone outwards against the squamous por- 

 tion of the temporal, and then passing through the tem- 

 poral, the effects of the blow would be conveyed to the 

 zygoma and expend itself in the malar bone, and since this 

 malar articulates with the superior maxillary and the 

 frontal, we can understand the aching present in the 

 region of the face. When the blow has been received on 

 the upper part of the frontal, the same train of events 

 would follow, as in the case of the parietal, since the upper 

 part of the frontal rests on the parietal. 



It is claimed that the vibrations set up by the applica- 

 tion of violence to the vault are transmitted to the sella 

 turcica through buttresses which diverge from the centre 

 of the vault to converge, beneath, near the sella turcica. 

 These buttresses are : One, in front, the fr on to- ethmoid ; 

 one, behind, the.occipital, and two on either side, viz., the 

 orbito-sphenoid and the petro-mastoid. Fractures of the 

 skull may be either direct or indirect. Direct fractures 

 result from the direct application of force to a limited area 

 of the skull, the bone yielding at the point struck. While 

 the great majority of direct fractures are limited to the 

 vertex, occasionally they may occur at the base, as from 

 punctured wounds or from falls on the feet causing frac- 

 tures in the neighborhood of the foramen magnum, or from 

 falls on the lower jaw fracturing the glenoid fossa. Indi- 

 rect fractures arise from a diffused blow, as in falls on the 

 head, etc. Fractures of the vault may be fissured, punc- 

 tured, depressed, star-shaped and comminuted, and, with 

 the exception of the punctured variety, which is neces- 

 sarily compound, they may be either simple or compound. 

 A fissure which is present in a compound fracture may 

 present some difficulty in diagnosis, since it might be mis- 

 taken for the line of a suture, but the knowledge of the 

 direction of a suture would assist in the diagnosis, and 



