Compartment Syndrome Flashcards
The diagnosis ofcompartment syndromeis primarily a clinical one based on careful history and physical examination
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Compartment pressure greater than 50 mm Hg or within
is considered to be an indication of fasciotomy
F Compartment pressure greater than 30 mm Hg or within
20 to 30 mm Hg of the diastolic blood pressure is considered to be indication for fasciotomy
Fasciotomy in a timely manner is the only management for
compartment syndrome with good outcome expected
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compartment syndrome can occur in any closed space in
the body,even the orbit
T
mostly occurs within fibro-osseous space in the upper
and lower extremities
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most common site is the upper extremities
F most common site is the lower leg, followed by the forearm and hand.
Upper arm compartment syndrome
is rare, with few reported cases.
91% of the patients were men in their thirties why?
being more likely to sustain high-energy injuries, the author suggested that less space for muscle swelling of the muscle after injury led to a higher incidence of acute compartment syndrome in young men
The upper arm consists of two compartments around the
humerus: the anterior and posterior compartments . They are divided by the lateral and medial intermuscular septae
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The musculocutaneous nerve and median nerves run through the posterior compartment
F The musculocutaneous nerve and median nerves run through the anterior compartment
why symptoms of radial or ulnar nerve ischemia are
not compartment specific?
F The ulnar and radial nerves travel in one compartment first, and then pass through the intermuscular septum into
another compartment at the level ofdistal third ofthe arm
The muscles in the volar compartments are
usually divided into superficial and deep groups
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The forearm has three major compartments, and the radius, ulna,
and rigid interosseous membrane constitute the stifffloor ofthe compartments
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The deep volar muscles are usually the most severely affected in forearm compartment syndrome,
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The median nerve runs between the superficial
and deep muscles and ends at the carpal tunnel
T
The ulnar nerve
is the most commonly affected nerve in forearm compartment syndrome.
F The median nerve
is the most commonly affected nerve in forearm compartment syndrome.
The lateral compartment of the forearm include»»>
Brachioradialis muscle
Radial artery
Extensor carpi radialis muscles (ECRP,ECRL)
The AIN and the deepest portion ofthe flexor muscles are severely damaged when compartment syndrome involves the
deep volar compartment
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The dorsal compartment contains the wrist and finger extensors,
and the motor branch of the radial nerve (posterior interosseous
nerve)
T
Course of PIN
ravels obliquely through and into the supinator muscle. then lies in a plane between
the superficial and deep extensor muscles. In the distal forearm, the
PIN lies on the interosseous membrane
The dorsal and lateral forearm compartments along with volar forearm compartment are usually effected together
F also
may develop isolated compartment syndrome
There are at least 10 compartments in the hand divided into five groups: thenar, hypothenar, adductor pollicis, palmar, and dorsal interosseous
T
The thenar, hypothenar, adductor pollicis, and
interosseous compartments contain 5 intrinsic muscles of hand
F The thenar, hypothenar, adductor pollicis, and
interosseous compartments contain 14 intrinsic muscles of hand
compartment syndrome can still occur in the finger.
T Although the finger has no muscle, compartment syndrome can still occur in the finger.
The compartments of the finger are considered to
be bounded by skin, and Cleland and Grayson ligaments
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Inadequate tissue perfusion within the compartment is the foundation, and progressive cell death is the final result of compartment syndrome
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The leak
ofthe cellular membrane, especially the endothelium of a capillary results in increased capillary permeability, causing the intravascular fluid to move into the interstitial space
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Skeletal muscle can tolerate up to 4 hours of
ischemia, and can recover partially after 6 hours, but incurs permanent damage after 8 hours
T
Nerve conduction function is affected after
5 hour of ischemia
F Nerve conduction function is affected after
1 hour of ischemia
peripheral nerves may undergo irreversible
damage after 4 to 6 hours ofischemia
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Volkmann ischemic contracture is used to term the final
result of tissue ischemia following compartment syndrome,
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What is the crush syndrome?
severe local compartment syndrome can also
arise the systemic manifestations, which is called crush syndrome. Rapid return of toxic muscle products into the circulatory system may lead to renal failure, cardiac failure, respiratory failure, and intravascular coagulation
prolonged limb positioning, can lead to compartment syndrom
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High pressure injection injury, drugs
or contrast medium extravasation can lead to compartment syndrom
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