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shelf surgery > I > Flashcards

I Flashcards

1
Q

fracture midshaft humerus, most likely injured?

A

radial nerve where it passes through radial groove

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2
Q

where would a fracture be that injures brachial artery

A

supracondylar fracture of humerus

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3
Q

signs and symptoms of brachial artery injury

A

pain, pallor, pulselessness, paresthesia and Pressure

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4
Q

signs of compartment syndrome

A

pain pallor pulselessness, paresthesia and pressure

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5
Q

claw hand

A

ulnar nerve damage

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6
Q

common sings of aortic root injury

A

anxiety, tachycardia and HTN

common after MVA and blunt trauma

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7
Q

initial test to rule out aortic injury

A

CXR
look for mediastinal widening
deviation of trachea or NG tube to the right or depression of Left mainstem bronchus

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8
Q

Left ventricular aneurysm is complication of what if it happens

A

transmural MI

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9
Q

CXR findings of pulmonary contusion

A

opacities from hemorrhage in lung segments

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10
Q

CXR findings of traumatic diaphragmatic rupture

A

herniations of abdominal contents into thorax

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11
Q

non healing wound for years. suspect what

A

malignancy with SCC– marjolin ulcer

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12
Q

GSW to abdomen indications for exploratory lapoarotomy

A

hemodynamically unstable
evidence peritonitis
evisceration of organs

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13
Q

after blunt trauma to abdomen with pain referring to shoulder

A

peritonitis and irritaiton of diaphragm– kehr sign

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14
Q

what part of bladder is damaged in blunt abdominal injury and why

A

dome of the bladder because it is the only part covered by peritoneum

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15
Q

causes of intestinal ileus

A

exaggerated intestinal reaction after surgery, retroperitoneal hemorrhage (vertebral fractures

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16
Q

symptoms paralytic ileus

A

failure to pass stool or flatus, abdominal distention, nausea and or vomiting, distended abdomen with tympany and decreased or absent bowel sounds

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17
Q

abdominal XR findings in patients with paralytic ileus

A

air fluid levels and distended gas filled loops of both small and large intestines

18
Q

presentation of acute colonic pseudoobstruction

A

nausea, abdominal pain, abdominal distention, tympanic bowel sounds and hyperactive bowel sounds

19
Q

signs of hypovolemic shock

A

hypotension, tachycardia, flat neck veins, confusion and cold extremities

20
Q

major thoracic trauma with tachypnea and paradoxicacl thoracic wall movements that correct with positive pressure mechanical ventilation

A

flail achest

when there are multiple fractured ribs in two or more locations

21
Q

early steps in managing flail chest

A

pain control and supplemental ozygen

22
Q

signs of tracheobronchial injury

A

hemoptysis, penumomediastinum

air leak even after chest tube placement

23
Q

sings of ischemic colitis

A

post surgery hae dull abdominal pain in area overlying ischemia with bloody diarrhea

24
Q

CT ischemic colitis

A

thickening of bowel wall

25
Q

radiation proctitis signs and symptoms

A

diarrhea, rectal bleeding, tenesmus and incontinence

26
Q

acute pancreatitis with past history of gall stones

next step?

A

cholecystectomy after acute pancreatitis heals

27
Q

do you need a CT to perform laparascopic appendectomy

A

no

if have clinical suspiciion and findings consistent with it

28
Q

burn patient with significant scarring in esophagus

next step?

A

intubate immediately

29
Q

ruptured aortic aneurysm

A

urgent surgery

30
Q

what causes syringomyelia

A

CSF drainage from central canal of spinal cord is disrupted

31
Q

signs syringomyelina

A

decreased strength and decreased pain and tem in cap like distribution
normal light touch, vibration and proprioception

32
Q

how to confirm an esophageal rupture

A

water soluble contrast esophagography

33
Q

fat embolism

A

in fractures of long bones

severe resp distress, petechial rash, subconjunctival hemorrhage, tachycardia, tachypnea, and fever

34
Q

confirmation of fat embolism Dx

A

fat droplets in urine or presence of intra-arterial fat globules on fundoscopy

35
Q

Tx fat emoblism

A

respiratory support

36
Q

meniscal tear vs ACL

A

ACL won’t be able to bear weight immediately after

37
Q

compartment syndrome findings on PE

A

excrutiating pain with passive motion, does not respond to narcotics

38
Q

most critical prognostic indicator for compartment syndrome

A

time to fasciotomy

39
Q

persistent pneumothorax despite chest tube placement and penumomediastinum and has subcutaneous emphysema

A

tracheobronchial rupture

40
Q

what is subcutaneous emphysema

A

palpable crepitus below the skin

41
Q

prefereed way to establish airway in frauma

A

orotracheal

42
Q

preferred surgical cricothyroidotomy in children

A

needle cricothyroidotomy

shelf surgery (7 decks)

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