General Trauma

Question 1

What are the two types of bone healing and when do they occour?

Answer 1

Primary bone healing = fracture gap less than 1mm

Secondary bone healing = all other fractrures

Question 2

How does primary bone healing occour?

Answer 2

New bone produced by osteoblasts bridges the gap

Question 3

What are the steps involved in secondary bone healing?

Answer 3

1. inflammation
2. Soft callus
3. Hard callus
4. Remodeling

Question 4

How long after the injury is a soft callus formed ?

Answer 4

2/3 weeks

Question 5

How long does a hard callus take to appear?

Answer 5

6-12 weeks

Question 6

What are the 5 typical fracture paterns?

Answer 6

Transverse fractures

Oblique fractures

Spiral fractures

Comminuted fractures

Segmental fractures

Question 7

Describe this fracture

Answer 7

Oblique extra articalur fracture of the middle third of the fibula with a displacement of 100%

Question 8

What causes damage in compartment syndrome?

Answer 8

Increased pressure resulting in compression and ischeamia of the muscle.

Question 9

What are the two cardinal clinical signs of compartment syndrome?

Answer 9

Increased pain on passive stretching of involved muscle

Unusually severe pain

Question 10

How do you treat compartment syndrome?

Answer 10

removal of tight bandages

Emergancy fasciotomies

Question 11

What is prophylaxis should be given to all patients with major lower limb fractures?

Answer 11

Low Molecular Weight Heparin for DVT

Question 12

What are the most common causes of Spetic arthritis?

Answer 12

Straphylococcus aureus

Heamophilus influenzae:- kids

Neisseria gonorrhoea:- Young adults

Eshcerichia coli- Elderly and PWID

Question 13

How do you treat Septic arthritis?

Answer 13

Aspirate joint

Indentify causitive organism

Antibiotics plus surgical washout ( if necesary)

Question 14

What is spinal shock?

Answer 14

Physiological response to injury with complete loss of sensation and motor function and loss of reflexes below the level of the injury for 24hrs

Question 15

What is the bulbocavernous reflex?

Answer 15

relex contraction of the anal sphincter with either a squeeze of the glans penis or tapping on the mons pubis.

Question 16

How do you know when spinal shock is over?

Answer 16

The bulbocavernous reflex returns

Question 17

What is Neurogenic Shock?

Answer 17

Shock occouring from temporary shutdown of sympathetic outflow

Question 18

What is a complete spinal cord injury?

Answer 18

No sensory or voluntary motor function below the level of the injury

Question 19

What is an incomplete spinal injury?

Answer 19

Preservation of some neurological function distal to the level of injury

Question 20

What makes up the pelvic ring?

Answer 20

Sacrum, ilium, ischium and pubic bone

Question 21

What is the name of the socket of the hip joint?

Answer 21

Acetabulum

Question 22

How do you teat humeral neck fractures?

Answer 22

Usually with a sling

Question 23

What is more common: anterior or posterior shoulder disocations?

Answer 23

Anterior

Question 24

Why do most anterior shoulder dislocations happen?

Answer 24

detachment of the anterior glenoid labrum

Question 25

What must you be aware of in anterior shouder dislocations?

Answer 25

Injury to axillary nerve

Question 26

What is the sign of axillary nerve injury?

Answer 26

Loss of sensation in the regimentlal badge area

Question 27

What is the treatment for dislocated shoulders?

Answer 27

Closed reduction under sedation or anaestheic

Neurovascular assement

sling for 2-3 weeks

Question 28

Which nerve is pariculary at risk in humeral shaft fractures?

Answer 28

Radial nerve in the spinal groove

Question 29

What symptoms would suggest a radial nerve injury?

Answer 29

Wrist drop and loss of sensation in the firs dorsal web space

Question 30

What is the usual treatment plan for humeral shaft fractures?

Answer 30

Functional humeral brace

Question 31

What is the managment plan for a dislocated finger?

Answer 31

reduce with or without local anasthetic

Splint for 3 weeks

Question 32

What must you be weary of in knee dislocations?

Answer 32

Poplieal artery injury

common fibular nerve injury