Which finding on scalp palpation would suggest a skull fracture?

• A. Freely movable scalp
• B. Smooth, non-tender scalp
• C. Tenderness, swelling, indentation, or depressions
• D. Uniform scalp texture

Answer: (C)

The key idea is that skull fractures often produce focal changes in the bone that you can feel with careful palpation. When you press over a specific area of the scalp and the underlying skull, tenderness plus a palpable deformity such as an indentation or depression suggests that the bone itself may be fractured. Swelling over the fracture site can accompany this. These signs point directly to a disruption of the skull rather than a non-bony scalp issue, which is why tenderness with swelling and an indentation or depressed area is the best clue.

In contrast, a scalp that is freely movable over the skull or a smooth, non-tender scalp implies no obvious fracture at that moment, and a uniformly textured scalp is not a reliable indicator of fracture.