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A 46-Year-Old Man Was Seen in the Emergency Department After

Question 4

Multiple Choice

A 46-year-old man was seen in the emergency department after being knocked down in a street brawl. He had received a blow on the head with an empty bottle. On examination, the patient was conscious and had a large gaping wound on the top of the head.
-Why did the wound in this patient gape wide open when he was hit with a blunt object and not a knife?


A) The skin on the top of the head was excessively tight.
B) The blow of the bottle had split the epicranial aponeurosis against the underlying skull and the tone of the occipitofrontalis muscle had pulled the skin wound open.
C) The subcutaneous tissue of the scalp contains smooth muscle, which pulled the wound open.
D) A hematoma was formed beneath the scalp and forced the wound open.
E) The underlying parietal bone of the skull was fractured and forced the wound open.

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