General Trauma Flashcards

1
Q

what is polytrauma

A

more than one major long bone is injured

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

major complications of poly trauma are

A

SIRS
ARDS
Multi organ dysfunction syndrome
death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what do intramedullary nails increase the risk of

A

fat embolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what cells build new bone

A

osteoblasts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

difference between healing by primary and secondary intention

A

primary - gap is small and new bone can form spontaneously

secondary - large gaps so this need to be filled to allow healing eg ORIF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

describe the types of fractures

A
transverse
oblique
spiral
comminuted
segmental
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

cardinal features of compartment syndrome

A

increased pain on PASSIVE stretch of muscle
severe pain not explained by clinical context
swollen limb
tender to touch

pulses usually present - absent pulses is a LATE sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

treatment of compartement syndrome

A

fasciotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

complication of compartment syndrome

A

ischaemic muscle will necrose resulting in a fibrotic contracture known as Volkmann’s ischaemic contracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

describe what neurapraxia means

A

occurs when the nerve has a temporary conduction defect from compression or stretch and resolve over time with full recovery (can take up to 28 days)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

describe what axonotmesis means

A

sustained compression or stretch of nerve with subsequent distal axonal death - recovery more variable and may take longer or not recover fully

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is neurotmesis

A

complete transection of nerve - needs surgical repair

usually occurs only in a penetrating injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

nerve injury in colles fracture

A

median nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

nerve injury in anterior dislocation of the shoulder

A

axillary nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

nerve injury in humeral shaft fracture

A

radial - wrist drop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

nerve injry in supracondylar fracute of elbow

A

median nerve

17
Q

posterior dislocation of hip can injury which nerve

A

sciatic

18
Q

bumper injury to lateral knee can injure what nerve

A

common peroneal

19
Q

knee dislocation risks injury to what vessel

A

popliteal artery

20
Q

paediatric supracondylar factrure risks injury to what vessel

A

brachial artery

21
Q

should trauma risk injury to what vessle

A

axillary artery

22
Q

how would you asses the vascular status of a limb

A

temperature
colour
pulses
cap refill

if compromised - vascular surgery review

23
Q

signs of excessive skin pressure which could lead to necrosis

A

tenting of the skin

blanching

24
Q

management excessive pressure on the skin

A

reduce fraction as an emergency under analgesia and sedation

25
Q

important complication to the skin in crush or shearing injuries

A

‘degloving’ skin is avulsed from blood supplu

26
Q

signs of fracture non union

A

ongoing pain
ongoing oedema
movement at fracture sign

27
Q

what is the slowest healing bones in body

A

tibia - takes 16 weeks to a year :O

femoral shaft - takes 2-4 months

28
Q

what is a delayed union

A

A delayed union is a fracture that has not healed within the expected time

29
Q

commonest cause of delayed union

A

infection

30
Q

what causes hypertrophic non union

A

excessive motion at fracture site results in large defective callus
infection can also cause

31
Q

causes fo atrophic non union

A

lack of blood supply
chronic disease
infection

32
Q

fractures prone to poor healing are

A

scaophoid
distal clavivle
subtrochanteric femur fracture
jones frature of 5th metatarsal

33
Q

fractures prone to AVN

A

scaphoid
talus
femoral neck

34
Q

management of open fracture

A

IV broad specturm Abx - flucox and gent and met
sterile or antiseptic soaked dressing
surgical managemetn to debride and stabilised either internally or externally

35
Q

what complete tendon tears need surgically repaire

A

quadrices
patellar

as essential for function

some others eg achilles or biceps can be managed conservatively

36
Q

management of septic arthritis

A

joint aspiration
IV antibiotics
surgical washout