injuries Flashcards
hematoma
extravasation of blood out of vessels into the surrounding tissues
nerve compression syndromes
and innervation of the hand
carpal tunnel:median
cubital tunnel syndrome- ulnar
palmar surface : 3.5 ulnar +1.5 median
dorsum: look at image (all 3 nerves)
rhabdomyolysis and crush syndrome
crush syndrome: shock and kindey failure A LOCALISED CRUSH INJURY BUT WITH SYSTEMIC MANIFESTATIONS
these waste products accumulate to a toxic level and, should the limb be released, the waste products are released into the circulatory system and pumped to the heart which can cause cardiac arrest and IMMEDIATE DEATH!
damage to muscles and release of mygolbin which is tolix to the kidney so can cause kidney failure
as muscle cells die they take in sodium and ca2+ (now the pump is no longer working) so na is just coming in as it pleases dragging water with it - leads to oedema of the muscles. as we said the dying cells release k leading to hyperkalemia (heart issues)
substances release:
k, thromboplastin (clots) , myoglobin, phospahte (as we have high amount in the cell)
SCALP
Skin dense CT tissue aponeurosis loose areolar ct periosteum
types of skull/brain injures based on location
epidural
subdural
intracranial
subarachnoid
whats more dangerous relatively pancreatitis or appendicitis?
pancreatitis
which organ is most affcted in abdo blunt injuries
spleen
deleayed rupture of spleen
> 48 h from injury thought to be caused by a expanding subcapsular hemotoma which ruptures the cpsule
emergency laprotmy indications
in the case of peritonitis e.g after abdo trauma you go from xiphoid to pubic tubercle
kehr sign
example of referred pain,
irritation of the diapgharagm by blood or other contents (hemoperitoneum) causes shoulder pain
if it occurs on left side its classic of ruptured spleen
kehr sign
example of referred pain,
irritation of the diapgharagm by blood or other contents (hemoperitoneum) causes shoulder pain
if it occurs on left side its classic of ruptured spleen
dpl
what can you look for that makes it a postive result
CI
was once the gld standarsd for abdo trauma but now we have advanced tech like FAST SCAN
- Can indentify blood
- can identify a diapghragm injury
- blood
- wbc
-bacteria
-amylase
-br
-intetsinal contetns (poo, food)
Ci-previous abdominal surgery : due to adhesions
dpl
what can you look for that makes it a postive result
CI
was once the gld standarsd for abdo trauma but now we have advanced tech like FAST SCAN
- Can indentify blood
- can identify a diapghragm injury
- blood
- wbc
-bacteria
-amylase
-br
-intetsinal contetns (poo, food)
Ci-previous abdominal surgery : due to adhesions
haemobiliia
bleeding into biliary tree, is a sign of extensive liver hematoma
haemobiliia
bleeding into biliary tree, is a sign of extensive liver hematoma
hich rgans are retropertionael
SAD PUCKER
which parts of duodenum are retro
2nd and 3rd
which parts of duodenum are retro
2nd and 3rd
why is there high mortality in pancreatic injuries
caustic nature of enzymes
MASSIVE WIDEPREAD INFLAMMATION
why is there high mortality in pancreatic injuries
caustic nature of enzymes
MASSIVE WIDEPREAD INFLAMMATION
WHY MAY signs of duodenal injuies be delayed
due to their part retroperitoneal location
WHY MAY signs of duodenal injuies be delayed
due to their part retroperitoneal location
what is the most commonmechanism of small intestine trauma
PENETREATING
most common mechanism for pancreatic trauma
crushing of the body pancreas with a ridgid structure like steering while between the spine
most common mechanism for pancreatic trauma
crushing of the body pancreas with a ridgid structure like steering while between the spine
WHAT score do we use for splenic injuries
AAST
5 GRADES
grade 1 - s.c hemotoa <10%, parenchme laceration <1
- s.c hemaotoma 10-50% , parenchymall laceration 1-3
- s.c hematoma >50%, parenchymal laceration >3
- splenic vascualr injury , active bleeding but confined within capsule
- splenic vascular injury. SHATTERED SPLEEN , active bleeding extending beyond the spleen into periotneum
