Musculoskeletal

Question 1

Compartment syndrome

Answer 1

Condition in which increased tissue perfusion within a limited space compromise the circulation and function of the contents within that space.
Happens in the fascia: Skin, Fascia, Muscle, Bone.

Caused by long bone fractures, hemorrhage, edema, contrictive casts.

Should be suspected in any unconscious pt with a swollen limb.

Question 2

Compartment syndrome S/S

Answer 2

Severe ischemic pain (can hardly feel toes)
Tensely swollen
Skin perfusion, arterial pulses until blood supply cut off.
Paresthesia
Passive stretch of muscle is painful
Progressive loss of sensory/motor function
Repeated exams are required to check for developing compartment syndrome.

Question 3

Diagnostics and management of compartment syndrome

Answer 3

Striker tonometer to assess compartment pressure.
Normal: 0-8
Intracompartmental pressure >30 = comaprtment syndrome and a need for fasciotomy.
Delta pressure is the perfusion pressure of the compartment. It is the difference between the diastolic blood pressure (DBP) and the intracompartmental pressure (ICP)
Delta pressure=DBP-ICP
Deltra pressure <30= fasciotomy.