Minor Treatment Flashcards
There are many ways to reduce an anterior shoulder. What are a few?
- External rotation, if goes all the all supinate and bring arm to front and flex shoulder.
- Go slow, hold pts arm, flex extend elbow to ensure relaxed (Byran showed me) - Traction/Counter Traction
- Cunningham technique: involves massaging the biceps muscle in the mid humerus, with the patient’s affected arm adducted, and the elbow flexed, while the physician massages the biceps. At the same time the patient is told to move the shoulder superiorly (up), and posteriorly (back) to allow the humeral head to relocate back into the glenoid fossae
- Stimson Technique
- Scapular manipulation
- Kocher’s method: arm bent 90 degrees, externally rotate until resistance, move humerus anteriorly and internally rotate back to starting position
Dont need to sedate the cooperative pts.
what are 4 signs of flexor tenosynovitis?
- swollen circumferential swelling
- Finger in flexion
- Pain on passive extension/flexion
- Pain on palpation along tendon
In a fight bite, what organism are we worried about?
Eikenella.
What is the organism that we worry about in Cat bites?
Pasteurella
What are the components of the Eye exam?
VVEEPP, fundoscopy, slit lamp
Visual acuity (chart, fingers, motion, light perception) Visual fields External examination EOM Pupillary evaluation (absolute and relative) Pressure determination (IOP) Slit Lamp - Lids/ Lashes - Conjunctiva/sclera - Cornea (+/- floures stain) - Anterior chamber - Iris - Lens Fundoscopic Exam
What is seen in CRAO - central retinal arterial occulsion?
General pallor of retina and cherry red spot (which is the macula).
- The cherry red spot is seen because the macula receives its blood supply from the choroid, supplied by the posterior ciliary arteries, while the surrounding retina is pale due to retinal artery infarction.
DDX painless vision loss
Retinal detachment TIA Amurosis fugax Vitreous hemorrage CRVO CRAO Temporal arteritis (HA) Optic neuritis (would expect pain)
DDX acute painful vision loss
Acute angle closure glucoma Uveitis Keratitis Optic neuritis Temporal arteritis
What does cells and flare in the anterior chamber suggest on slit lamp exam?
Caused by intraocular inflammation
- Uveitis (includes the iris, ciliary body, and choroid)
- Iritis
Flare is hazziness caused by protein, cells are cells.
How do you treat acid or alkali to the eye?
Copious irrigation until pH paper is neutral and pt is asymptomatic
For eye burns which is worse, acid or alkali?
Alkali
- causes a liquefactive necrosis of the cornea and goes through the corneal layers. Only treatment is irrigation
What is the treatment for orbital compartment syndrome?
Lateral canthotomy.
worry about retrobulbar hematoma in trauma and can spontaneously occur in AC patients
What are the most common bacterial causes of conjunctivitis?
Haemophilus influenza
Staph aureus
Strep Pneumo
What are the Ottawa ankle rules?
Get Ankle xrays if tenderness in malleolar region and any:
- Tender on posterior aspect of lateral or medial malleolus up 6 cm
- Inability to weight bear immediately AND in the ED
What are the Ottawa Foot rules?
Get Foot xrays if pain in mid-foot and any of:
- Tender on navicular or base of 5th MT
- Inability to weight bear immediately AND in the ED
