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Surgery > 4.2 - TRAUMA > Flashcards

4.2 - TRAUMA Flashcards

1
Q

leading cause of death in children and young adults

A

trauma

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2
Q

3 neurosurgical areas

A

traumatic brain injury
spinal cord injury
peripheral nerve injury

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3
Q

open fractures require

A

Debridement and scalp repair

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4
Q

indications for craniotomy

A

depression > cranial thickness
intracranial hematoma
frontal sinus involvement

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5
Q

craniotomy CI in skull fractures like?

A

dural venous sinus

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6
Q

fracture of the temporal bone leading to extravasation of the blood behind the ear

A

battles sign

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7
Q

raccoon eyes
anosmia
rhinorhea results from what fracture?

A

anterior skull base

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8
Q

a drop of fluid into an absorbent tissue. result shows red spot in the middle and surrounding layer

A

halo test

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9
Q

if halo test is indeterminate, what test to order?

A

beta-2 transferrrin testing

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10
Q

common tx for CSF leaks

A

elevate head for several days

lumbar drain

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11
Q

tx for facial nerver palsies

A

steroids

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12
Q

most common type of TBI

A

closed head injury

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13
Q

patients with a documented CHI and evidence of intracranial hemorrhage and depressed skull fracture should receive

A

17mg/kg phenytoin LD

300-400mg/d phenytoin

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14
Q

peptic ulcers occuring in patients w head injury

A

cushings ulcers

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15
Q

moderate head injury

A

gcs 9-12

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16
Q

risk in a patient: headache, dizziness, no loss of consciousness

A

low risk. can be discharged w/o CT

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17
Q

risk in a patient: depressed consciousness, changing neuro exam..

A

high risk. CT and then admit

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18
Q

temporary neuronal dysfunction following nonpenetrating head trauma

A

concussion

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19
Q

grade concussion based on the colorado grading system
1, px with amnesia
2, lost consciousness

A

grade2

grade 3

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20
Q

refers to when brain is more susceptible to minor head trauma in the first 1-2 weeks after concussion

A

second impact syndrome

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21
Q

bruise of the brain, impact causes breakage of small vessels; appear bright on CT

A

contussion

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22
Q

contussion occuring in the opposite site of i9njury

A

contrecoup injury

23
Q

two main subtypes of penetrating (CHI)

A 
missile (bullets)
non missile (knife)
24
Q

types of intracranial hematomas

A

epidural
subdural (acute and chronic)
intraparenchymal

25
Q

stage wherein EDH subclinically expands

A

lucid interval (patient is awake)

26
Q

EDh rarely occurs in

A

posterior fossa

27
Q

conservative management for EDH when all criteria is met

A

clot volume

28
Q

results from venous bleeding, typically from bridging vein from cerebral cortex to dural sinus

A

subdural hematoma

29
Q

higher risk population to have SDH d/t brain atrophy

A

elderly and alcoholic

30
Q

tor F: SDH cross the midline

A

F, no d/t falx

31
Q

indication for craniotomy in SDH

A

thickness >1cm
midline shift >5mm
gcs drop of 2pts

32
Q

at 2-3 weeks CT scan reading of SDH

33
Q

hyperdense up to ?

34
Q

small bleeds that expands the collection

A

acute - on -chronic SDH

35
Q

placed in order to prevent reaccumulation of blood

A

subdural/subgalcal drains

36
Q

isolated hematomas/ intraparenchymal hemorrhage are d/t?

A

hypertensive hemorrhage

AV mal

37
Q

indication for craniotomy with IPH

A
  1. clot volume >50cm
  2. clot volume >20cm with neuro deterioration (gcs6-8)
  3. midline shift >5mm, basal cistern compression
38
Q

violation of the vessel wall intima

A

dissection

39
Q

intradural dissection may present w

40
Q

angiographic abnormality in dissection

A

string sign

41
Q

surgical options for dissection

A

vessel ligation and bypass grafting

42
Q

presents with pulsatile proptosis, , retroorbital pain, loss of normal eye movement

A

carotid cavernous fistula

43
Q

tx for ccfs

A

balloon occlusion

44
Q

causes of vertebrobasilar dissection

A
  • sudden rotation of the neck
  • chiropractic manipulation
  • direct blow to the neck
45
Q

Rule of spence

A

7mm or greater

46
Q

Ondontoid type? Tip only

47
Q

C2 is broken

A

Hangmans fracture

48
Q

Failure of anterior column

A

Compression fravture

49
Q

Failure of anterior and middle column

A

Burst fracture

50
Q

Middle and posterior failure

51
Q

All columns

A

Fracture-dislocation

52
Q

Least severe. Pn injury

A

Neuropraxia

53
Q

Most severe

A

Neurotmesis

54
Q

Brachial plexus types

A

Erb palsy

Klumpke palsy

Surgery (18 decks)

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