SB82 Trauma - loosely taken from Fiser's ABSITE review
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| Most common cause of trauma death within the first hour ___________ | Hemorrhage
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| Organ most commonly injured after penetrating injury ____________ | Small bowel
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| Indications for DPL | Hypotensive patients with blunt trauma
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| DPL and FAST scan both miss this injury ______________________ | Retroperitoneal bleed
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| LD50 for a fall _____________ stories | Four
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| Bladder pressure indicative of compartment syndrome (range) | 25-30 mmHg
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| Second peak for trauma-related deaths occurs over which time frame? | 30 minutes to 4 hours
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| Deaths during the second trauma peak are usually due to which 2 causes? | Head injury and hemorrhage
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| Most common organ injured with blunt trauma ____________ | Liver
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| Blood pressure is usually okay until what percentage of blood volume is lost? ________ | Thirty
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| Most common cause of death after trauma in the long term ________________ | Infection
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| Best site for cutdown for access ___________________ | Saphenous vein at the ankle
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| FAST can be difficult to perform in this population of patients ____________ | Obese
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| Penetrating injuries near the abdomen can be locally explored without ex lap under this condition _________________ | Fascia was not violated
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| Decreased cardiac output with abdominal compartment syndrome is caused by _____________________ | IVC compression
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| Treatment for abdominal compartment syndrome _________________ | Decompressive laparotomy
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| ED thoracotomy should be performed for blunt trauma only if pressure or pulse is lost in what time frame? _______________ | In the trauma bay
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| 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
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| After ED thoracotomy, take patient to go OR if BP improves to greater than ____________ systolic | Seventy
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| Catecholamines peak how long after injury? ________________ | 24-48 hours
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| A patient who withdraws to pain, opens eyes spontaneously, and vocalizes incoherently has a GCS of ______________ | Ten
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| A patient who has appropriate strength with commands, opens eyes to pain, and answers appropriately has a GCS of __________ | Thirteen
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| A GCS of ten or less has bought the patient this intervention ___________ | Intubation
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| An epidural hematoma is usually due to bleeding from this artery __________________ | Middle Meningeal
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| Epidural hematomas usually have initial LOC followed by _________________, after which they undergo rapid deterioration | Lucid Interval
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| Patients with epidural hematomas should go to OR if they have neurologic deterioration or midline shift of greater than mom | Five
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| Subdural hematomas are usually due to tearing of what structures? _________________ | Bridging veins
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| With subdural hematomas, head CT usually shows this shape of head bleed ___________ | Crescent
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| Patients with traumatic interventricular hemorrhage who develop hydrocephalus need this intervention ___________________ | Ventriculostomy
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| CPP equals _____________ - _____________ | MAP ICP
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| Normal ICP is ______________ mmHg | Ten
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| For patient with traumatic head injury, keep cerebral perfusion pressure (CPP) greater than ______________ mmHg | Sixty
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| Peak intracranial pressure (ICP) occurs in what time frame after injury? | 48-72 hours
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| Findings of a unilateral dilated pupil with traumatic head injury indicates what? | CN III compression due to ipsilateral temporal pressure
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| Raccoon eyes are a sign of what fracture? ___________ | Anterior Fossa
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| Middle fossa basal scull fracture usually results in what clinical sign?_____________ | Battle’s Sign
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| This nerve can be injured with middle fossal basal skull fracture ___________ - if acute, needs exploration | Facial
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| Most common cause of facial nerve injury ______________ | Temporal bone fracture
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| Most common site of facial nerve injury __________________ | Geniculate ganglion
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| C1 burst fracture is caused by axial loading and is also known as ___________ fracture | Jefferson
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| Treatment for C1 burst fracture ______________ | Rigid collar
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| C2 fracture is often caused by this injury ________________ | Distraction and extension
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| Treatment for C2 fracture ________________ | Traction and halo
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| 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
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| Facet fractures or dislocations can cause further injury to this structure ____________ | Spinal cord
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| 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
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| Compression fractures of the spine usually involve which column(s) of the spine? ______________ | Anterior
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| Burst fractures usually involve which column(s) of the spine? ____________ | Anterior and Middle
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| Which spinal fractures are considered unstable, compression fractures or burst fractures? ___________ | Burst
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| Perform this diagnostic test if there are neurologic deficits without bony injury _________ | MRI
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| LeFort Type I facial fracture is through what structures? | Straight across the maxillary bone
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| LeFort Type II facial fracture is through what structures? | Lateral to nasal bone, underneath eyes, and diagonal toward maxilla
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| LeFort Type III facial fracture is through what structures? | Lateral orbital walls
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| Seventy percent of patients with nasoethmoidal bone fractures also have this finding ____________ | CSF leak
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| Initial treatment for nasoethmoidal bone fracture | Conservative therapy for 2 weeks
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| Posterior nosebleeds are difficult to compress externally and may be stopped initially with _______________ | Balloon tamponade
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| If initial management of posterior nosebleed does not work, attempt angioembolization of which 2 arteries? ______________ | Internal maxillary or ethmoidal
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| Malocclusion of the jaw indicated _____________ fracture | Mandibular
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| Repair of mandibular fracture is most commonly achieved by ______________ | Intermaxillary fixation
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| Zone 1 of neck is from _____________ to _______________ | Clavicle to cricoid cartilage
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| Zone 2 of neck is from _____________ to _______________ | Cricoid to angle of mandible
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| Zone 3 of neck is from _____________ to _______________ | Angle of mandible to base of skull
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| Penetrating injury to this neck zone mandates exploration in the OR ____________ | Zone Two
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| Treatment for SYMPTOMATIC blunt neck trauma _________________ | Exploration
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| Treatment for SYMPTOMATIC penetrating neck trauma _________________ | Exploration
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| Modality for diagnosing extent of esophageal injury __________________ | Rigid esophagoscopy and esophagram
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| Primary closure of non-contained esophageal injury may be attempted under what conditions? | Small injury, less than 24 hours, no significant contamination, stable patient
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| Operative approach to upper 2/3 of thoracic esophagus in trauma ________________ | Right thoracotomy
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| Operative approach to lower 1/3 of thoracic esophagus in trauma ________________ | Left thoracotomy
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