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Vascular Surgery > Chap 155-160 Vascular Trauma > Flashcards

Chap 155-160 Vascular Trauma Flashcards

1
Q

What is the equation for impact kinetic energy?

A

IKE= 1/2mass x velocity squared

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2
Q

What kind of injuries can occur from a blast injury?

A

direct blast pressure
penetrating fragments
collision with objects
thermal injury

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3
Q

What are principles of management for non compressible truncal haemorrhage?

A 
minimize delay to OR
permissive hypotension
balancced resuscitation
procoagulant adjuncts (tranexamic acid)
damage control surgery/shunts
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4
Q

Most common injured abdo vessels?

A

IVC
aorta
SMA
Portal

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5
Q

What are the zones of the carotid? And how do you obtain control of each zone?

A

Zone I
Below the cricoid cartilage—proximal control obtained in the chest
Zone II
b/w the cricoid cartilage and the angle of the mandible—proximal and distal control obtained in the neck
most commonly injured
zone III
above the angle of the mandible—distal control difficult to obtain

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6
Q

In what time period should you attempt revascularization if neurological defects?

A

within 24 hours

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7
Q

What is treatment for BCVI?

A

heparin

can consider warfarin

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8
Q

What is treatment for BCVI?

A

heparin

can consider warfarin

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9
Q

What is classification of aortic injury?

A

grade I intimal tear
grade II intramural hematoma
grade III PSA
Grade IV rupture

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10
Q

What are mechanisms of blunt aortic trauma?

A

stretching
sudden BP elevation
osseous pinching
water-hammer effect

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11
Q

What injuries would you consider initial management of blunt AI in grade I?

A 
cardiac RF
head injury
pulmonary injury
coagulopathy
severe abdo injury
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12
Q

What injuries would you consider initial management of blunt AI in grade I?

A 
cardiac RF
head injury
pulmonary injury
coagulopathy
severe abdo injury
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13
Q

What are the zones of the abdomen?

A

zone 1 aortic hiatus to sacral promontory

zone 2 L and R kidney, paracolic gutter and renal vessels

Zone 3 pelvic retroperitoneum and iliacs

zone 4 liver

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14
Q

When should RPB be explored?

A

penetrating unless stable and non-expanding
paraduodenal (rule out duodenal injury)
root of mesentery with ischemic bowel

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15
Q

When to do damage control?

A

coagulopathic
hypothermic
BE >15 mmol
signif bowel edema

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16
Q

At what pressure is abdo compartment syndrome suspected?

A

> 20mmHg with organ dysfunction

20-30 consider decopression

17
Q

What are RF for ACS?

A 
Massive blood transfusion
Vascular injury
Prolonged hypotension, aortic cross clamping
Damage control procudreus
Tight closure of abdo wall.
18
Q

What are the zones of the SMA?

A 
Zone 1
b/w aortic origin and inferior pancreaticoduodenal artery
zone2
b/w inf pancduo and middle colic artery
zone 3
distal to middle colic artery
zone 4
segmental intestinal branches
19
Q

What zones of the SMA can be ligated with limited ischemia?

A

3 and 4

20
Q

What veins does the IVC receive?

A 
lumbar
right gonadal
renal
right adrenal
hepatic
phrenic
21
Q

What veins does the IVC receive?

A 
lumbar
right gonadal
renal
right adrenal
hepatic
phrenic
22
Q

What is hepatic vascular isolation clamp order?

A

clamp infradiaphragmatic aorta, suprahepatic IVC,
infrahepatic IVC above renals
and portal triad

23
Q

What is the portal vein formed by?

A

confluence of SMV and splenic vein

24
Q

What are had signs?

A

Absent distal pulses
Palpable thrill or audible bruit
Actively expanding hemotoma
Active pulsatile bleeding

25
Q

What are soft signs?

A

Diminished pulses
History of significant hemorrhage
Neurologic defecit
Proximity of wound to named vessel

26
Q

What are soft signs?

A

Diminished pulses
History of significant hemorrhage
Neurologic defecit
Proximity of wound to named vessel

27
Q

For bypass in LE injury, was conduit do you use?

A

Take vein form non injured side to preserve collateral venous drainage as vein injury rate is high

28
Q

What are features of the MESS score?

A

type of injury
degree of limb schema
hemodynamic instability
age

29
Q

What score correlates with primary amp?

A

> /= 7

30
Q

What is treatment for frostbite?

A

Local, intr-arterial CDT,
close observation,
limb rewarming,
wound care

31
Q

What are the segments of the vertebral artery?

A

V1 readily accessible
V2 within bony foramen of cervical canal
V3 exit foramen and enter skull
V4 intracranial

32
Q

What is the grading scale for blunt cerebrovascular injury?

A

grade I, luminal irreg or disection 25% of lumen
Grade III PSA
Grade IV occlusion
Grade V transection

33
Q

Who should be screened for BCVI?

A

GCS

Vascular Surgery (53 decks)

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