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SB82 Trauma
SB82 Trauma - loosely taken from Fiser's ABSITE review
| Question | Answer |
|---|---|
| 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
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