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SB82 Trauma

SB82 Trauma - loosely taken from Fiser's ABSITE review

QuestionAnswer
Most common cause of trauma death within the first hour ___________ Hemorrhage
Organ most commonly injured after penetrating injury ____________ Small bowel
Indications for DPL Hypotensive patients with blunt trauma
DPL and FAST scan both miss this injury ______________________ Retroperitoneal bleed
LD50 for a fall _____________ stories Four
Bladder pressure indicative of compartment syndrome (range) 25-30 mmHg
Second peak for trauma-related deaths occurs over which time frame? 30 minutes to 4 hours
Deaths during the second trauma peak are usually due to which 2 causes? Head injury and hemorrhage
Most common organ injured with blunt trauma ____________ Liver
Blood pressure is usually okay until what percentage of blood volume is lost? ________ Thirty
Most common cause of death after trauma in the long term ________________ Infection
Best site for cutdown for access ___________________ Saphenous vein at the ankle
FAST can be difficult to perform in this population of patients ____________ Obese
Penetrating injuries near the abdomen can be locally explored without ex lap under this condition _________________ Fascia was not violated
Decreased cardiac output with abdominal compartment syndrome is caused by _____________________ IVC compression
Treatment for abdominal compartment syndrome _________________ Decompressive laparotomy
ED thoracotomy should be performed for blunt trauma only if pressure or pulse is lost in what time frame? _______________ In the trauma bay
How ED thoracotomy is performed Incision between ribs 4-5, open pericardium anterior to phrenic nerve, cross-clamp the aorta if abdominal injury, watch for esophagus
After ED thoracotomy, take patient to go OR if BP improves to greater than ____________ systolic Seventy
Catecholamines peak how long after injury? ________________ 24-48 hours
A patient who withdraws to pain, opens eyes spontaneously, and vocalizes incoherently has a GCS of ______________ Ten
A patient who has appropriate strength with commands, opens eyes to pain, and answers appropriately has a GCS of __________ Thirteen
A GCS of ten or less has bought the patient this intervention ___________ Intubation
An epidural hematoma is usually due to bleeding from this artery __________________ Middle Meningeal
Epidural hematomas usually have initial LOC followed by _________________, after which they undergo rapid deterioration Lucid Interval
Patients with epidural hematomas should go to OR if they have neurologic deterioration or midline shift of greater than mom Five
Subdural hematomas are usually due to tearing of what structures? _________________ Bridging veins
With subdural hematomas, head CT usually shows this shape of head bleed ___________ Crescent
Patients with traumatic interventricular hemorrhage who develop hydrocephalus need this intervention ___________________ Ventriculostomy
CPP equals _____________ - _____________ MAP ICP
Normal ICP is ______________ mmHg Ten
For patient with traumatic head injury, keep cerebral perfusion pressure (CPP) greater than ______________ mmHg Sixty
Peak intracranial pressure (ICP) occurs in what time frame after injury? 48-72 hours
Findings of a unilateral dilated pupil with traumatic head injury indicates what? CN III compression due to ipsilateral temporal pressure
Raccoon eyes are a sign of what fracture? ___________ Anterior Fossa
Middle fossa basal scull fracture usually results in what clinical sign?_____________ Battle’s Sign
This nerve can be injured with middle fossal basal skull fracture ___________ - if acute, needs exploration Facial
Most common cause of facial nerve injury ______________ Temporal bone fracture
Most common site of facial nerve injury __________________ Geniculate ganglion
C1 burst fracture is caused by axial loading and is also known as ___________ fracture Jefferson
Treatment for C1 burst fracture ______________ Rigid collar
C2 fracture is often caused by this injury ________________ Distraction and extension
Treatment for C2 fracture ________________ Traction and halo
C2 odontoid fracture has these 3 types – describe types and treatments Type 1 – above base – stable; Type 2 – at base – fusion or halo; Type 3 – into vertebral body – fusion or halo
Facet fractures or dislocations can cause further injury to this structure ____________ Spinal cord
What are the 3 columns of the spine and what are their boundaries? Anterior – anterior longitudinal ligament and anterior ½ of vertebral body; Middle – posterior ½ of vertebral body and posterior longitudinal ligament; Posterior – everything else
Compression fractures of the spine usually involve which column(s) of the spine? ______________ Anterior
Burst fractures usually involve which column(s) of the spine? ____________ Anterior and Middle
Which spinal fractures are considered unstable, compression fractures or burst fractures? ___________ Burst
Perform this diagnostic test if there are neurologic deficits without bony injury _________ MRI
LeFort Type I facial fracture is through what structures? Straight across the maxillary bone
LeFort Type II facial fracture is through what structures? Lateral to nasal bone, underneath eyes, and diagonal toward maxilla
LeFort Type III facial fracture is through what structures? Lateral orbital walls
Seventy percent of patients with nasoethmoidal bone fractures also have this finding ____________ CSF leak
Initial treatment for nasoethmoidal bone fracture Conservative therapy for 2 weeks
Posterior nosebleeds are difficult to compress externally and may be stopped initially with _______________ Balloon tamponade
If initial management of posterior nosebleed does not work, attempt angioembolization of which 2 arteries? ______________ Internal maxillary or ethmoidal
Malocclusion of the jaw indicated _____________ fracture Mandibular
Repair of mandibular fracture is most commonly achieved by ______________ Intermaxillary fixation
Zone 1 of neck is from _____________ to _______________ Clavicle to cricoid cartilage
Zone 2 of neck is from _____________ to _______________ Cricoid to angle of mandible
Zone 3 of neck is from _____________ to _______________ Angle of mandible to base of skull
Penetrating injury to this neck zone mandates exploration in the OR ____________ Zone Two
Treatment for SYMPTOMATIC blunt neck trauma _________________ Exploration
Treatment for SYMPTOMATIC penetrating neck trauma _________________ Exploration
Modality for diagnosing extent of esophageal injury __________________ Rigid esophagoscopy and esophagram
Primary closure of non-contained esophageal injury may be attempted under what conditions? Small injury, less than 24 hours, no significant contamination, stable patient
Operative approach to upper 2/3 of thoracic esophagus in trauma ________________ Right thoracotomy
Operative approach to lower 1/3 of thoracic esophagus in trauma ________________ Left thoracotomy
Created by: StudyBug82 on 2013-01-15



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