Certified Registered Nurse Anesthetist (CRNA) Practice Exam

Which sign is associated with a basilar skull fracture?

1. Battle sign

2. Bradycardia

3. Hypertension

4. Hepatomegaly

The correct answer is: Battle sign

A basilar skull fracture is a type of skull fracture that occurs at the base of the skull and can present with specific clinical signs due to the involvement of certain cranial structures. Among the signs associated with this type of fracture, Battle sign is particularly significant. This sign manifests as bruising behind the ear, often referred to as "mastoid ecchymosis," and occurs due to blood leaking from the skull to the soft tissues in that area. This bruising is a result of the fracture's proximity to vascular structures and the potential tearing of blood vessels. In contrast, the other signs listed do not specifically correlate with basilar skull fractures. Bradycardia (a slow heart rate) can occur in various medical conditions, especially those affecting the central nervous system or due to medications, but it is not a hallmark of a skull fracture. Hypertension (elevated blood pressure) is not directly related to fractures but can be seen in different clinical scenarios, and hepatomegaly (enlargement of the liver) is unrelated to head injuries and suggests liver pathology instead. Thus, Battle sign serves as a key indicator of a basilar skull fracture and highlights the importance of recognizing specific trauma-related signs in clinical practice.