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ATLS > Chapter 8- MSK Trauma > Flashcards

Chapter 8- MSK Trauma Flashcards

1
Q

patients with long bone fractures above and below the diaphragm increase the liklihood of what

A

associated internal torso injuries

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2
Q

severe crush injuries cause the release of ____ which may precipitate in the renal tubules and result in renal failure

A

myoglobin

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3
Q

an uncommon but lethal complication of long bone fractures that can lead to pulmonary failure and impaired cerebral perfrusion

A

fat embolism

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4
Q

what can help decrease bleeding with fractures

A 
appropriate splinting (enhances tamponade effect of the muscle) 
if fracture is open- sterile pressure dressing
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5
Q

what type of vehicle collision can result in a lateral compression fracture

A

side impact in a vehicle collision

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6
Q

when safety belts are worn too high what type fracture can occur when in a MVA

A

fractures of the lumbar spine (burst or compression)

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7
Q

how will an anterior hip dislocation present

A

flexed, ABducted, externally rotated

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8
Q

how will a posterior hip dislocation present

A

flexed, adducted, internally rotated

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9
Q

what type of ankle dislocation is most common and how does it present

A

lateral. externally rotated, prominent medial malleolus

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10
Q

how are knees dislocated

A

anteroposterior

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11
Q

how will a dislocated knee present

A

loss of normal contour, extended

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12
Q

what is the most common cause of rhabomyolysis

A

muscular trauma

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13
Q

myoglobin produces dark ____ usrine that tests positive for ____

A

amber, hemoglobin

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14
Q

what can rhabdo lead to

A

metabolic acidosis, hyperkalemia, hypocalcemia, DIC

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15
Q

management of rhabdo

A

early and aggressive IV fluid therapy

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16
Q

what should UOP be maintained at until myoglobin is cleared

A

100 mL/hour

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17
Q

what is the only way to determine communication b/w an open wound and a joint

A

surgically explore and debride

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18
Q

all patient with open fractures should be treated with ______ as soon as possible

A

intravenous antibiotics

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19
Q

abx to be given to all patients with open fractures

A

1st generation cephalosporins (cephalexin, cefazolin)

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20
Q

more severe open injuries should also be treated with what

A

aminoglycosides or other gram negative appropriate abx

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21
Q

muscle does not tolerate a lack of arterial blood flow for longer than ___ hours

A

6

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22
Q

when is limb reimplantation usually performed

A

with an injury of an isolated extremity

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23
Q

how to take care of amputated parkts

A

washed thorough in isotonic solution (ringer’s lactate), wrapped in sterile gauze that has been soaked in aqueous penicillin (100,000 units in 50 mL of Ringer’s lactate) then wrapped in sterile tow, plastic in bag and put on crushed ice (don’t freeze it)

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24
Q

common areas for compartment syndrome

A

lower leg, forearm, foot, hand, gluteal region, thigh

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25
Q

risks for compartment syndrome

A 
tibia/ forearm fractures
injuries immobilized in tight dressing/ casts
severe crush injury to muscle
localized external pressure to extremity
burns
excessive exercise
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26
Q

what is “delta-P”

A

diastolic blood pressure- compartment pressure (if 30 or less may have compartment syndrome)

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27
Q

inability to abduct the index and little finger can indicate damage to what nerve most likely due to an injury where?

A

ulnar, elbow

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28
Q

this nerve allow for extension of the thumb, finger metacarpophalangeal extension

A

radial nerve

29
Q

radial nerve provides sensation to where?

A

first dorsal web sapce

30
Q

what may cause injury to the rdial nerve

A

distal humeral shaft injury, anterior shoulder dislocation

31
Q

the axillary nerve innervates what muscle

32
Q

sensation of the lateral shoulder is from what nerve?

33
Q

what can cause injury to the axillary nerve

A

anterior shoulder dislocation

proximal humerus fracture

34
Q

knee extension is controlled by the ____ nerve, which also sense the anterior knee

35
Q

what can injure the femoral nerve

A

pubic rami fractures

36
Q

what nerve controls hip adduction and provides sensation for the medial thigh?

37
Q

what can cause injury to the obturator nerve

A

obturator ring fracture

38
Q

this nerve controls toe flexion and provides sensation for the sole of the foot

A

posterior tibial

39
Q

what can cause injury to the posterior tibial nerve

A

knee dislocation

40
Q

this nerve allows for ankle eversion and provides sensation for the lateral dorsum of the foot

A

superficial peroneal

41
Q

what can cause injury to the superficial peroneal nerve?

A

fibular neck fracture, knee dislocation

42
Q

this nerve allows for ankle/toe dorsiflexion and sensation to the dorsal first to second toe webspace

A

deep peroneal

43
Q

what can cause damage to the deep peroneal nerve

A

fibular neck fracture, compartment syndrome

44
Q

this nerve allows for plantar dorsiflexion and allows sensation of the foot.

A

sciatic nerve

45
Q

what can injury the sciatic nerve

A

posterior hip dislocation

46
Q

this nerve allows for hip abduction and sensation to the upper buttocks

A

superior gluteal

47
Q

what can cause superior gluteal nerve damage

A

acetabular fracture

48
Q

this nerve allows for gluteus maximus hip extension and provides sensation to the lower buttock

A

inferior gluteal nerve

49
Q

what can cause injury to the inferior gluteal nerve

A

acetabular fracture

50
Q

in a _____ a patient usually cannot use the muscle or experience decreased function because of pain in the affected extremity.

A

contusions

51
Q

elbow flexion tests what nerve?

A

musculocutaneous (C5 and C6)

52
Q

what does power grip fo the hands and dorsiflexion of the writ test what nerve?

A

radial nerve (C6)

53
Q

flexion of the fingers tests what nerve

A

median and ulnar (C7 and C8)

54
Q

finger add and abduction tests what nerve

A

ulnar (C8 and T1)

55
Q

dorsiflexion of the great toe and ankle tests what nerve?

A

deep peroneal L5

56
Q

plantar dorsiflexion test what nerve

A

posterior tibial (S1)

57
Q

How do you test C5 sensation?

A

lateral aspect of upper arm (axillary nerve)

58
Q

how do you test C6 sensation

A

palmar aspect of the thumb and index finger (median nerve)

59
Q

How do you test C7 sensation

A

palmar aspect of long finger

60
Q

how do you test C8 sensation

A

palmar aspect of the little finger (ulnar nerve)

61
Q

how do you test T1 sensation

A

medial aspet of forearm

62
Q

how do you test L3 sensation

A

medial aspect of thigh

63
Q

how do you test L4 sensation

A

medial aspect of lower leg (medial malleolus)

64
Q

HOw do you test L5 sensation

A

dorsum of the foot b/w the first and second toes (common peroneal)

65
Q

how do you test S1 sensation

A

Lateral aspect of the foot

66
Q

how do you realign a deformed humerus

A

grasp elbow and manually apply distal traction

67
Q

how do you realign a forearm

A

apply distal traction through the wrist while holding the elbow and applying counter traction

68
Q

how do you realign a femur

A

apply traction though the ankle (only if fibula and tibia not fracture)

69
Q

how to realign a tibia

A

apply distal traction at the ankle and counter traction just above the knee (no fracture to femur)

ATLS (6 decks)

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