Ortho Flashcards
What are the five unstable C-spine fractures?
atlantoaxial dislocation
Jeffersons fracture (C1 burst)
Hangmans fracture (bilateral pedicle C2)
Type 2 or 3 odontoid process
Tear drop fracture
Bilateral facet joint dislocation
What is Spinal shock and what are the features?
neurological injury to spinal cord and period of confusion where overestimates injury
Features:
Areflexia
Flacid paralysis
What is neurogenic shock and what are the features
distributive shock due to lack of sympathetic tone
Features:
Bradycardia
Hypotension
Warm skin
Poikilothermia
Above what level does neurogenic shock occur?
T6
What is the management of neurogenic shock?
Supportive care - analgesia, immobilise injuries, anti emetics
MAP 85-90 with hartmans when norad
normoxia, normothermia, normoglycaemia
IDC, pressure areas, VTE prophylaxis
What are findings and diagnosis
bilateral facet joint dislocation
anterior displacement of c4/c5 with no fracture
narrowing of vertebral foramen
What are the three lines to follow when looking at c spine x ray?
What other sign is important
The anterior longitudinal line runs along the anterior surface of the vertebral bodies.
The posterior longitudinal line runs along the posterior surface of the vertebral bodies.
The spinolaminar line runs along the anterior edge of the spinous processes (at the junction of the spinous process and the laminae).
NB - prevertebral soft tissue swelling
name the contraindications to biers block
allergy to anaesthetic
BP <200
cuff wont fit eg obese
methaglobulinaemia
uncooperative patient
raynaud/PVD/lymphoedema
What are the indications for closed reduction of distal radial fracture?
neurovascualr compromise
extra articular
less than 5mm radial shortening
dorsal angulation under 5 degress or within 20 degress of contralateral distal radius
less than 2mm articualar step off
describe fracture
Extraarticular distal radius #
25% posterior displacement
45o dorsal angulation
Minimally displaced ulna styloid
What is a normal retropharyngeal space
What is a normal retropharyngeal space
describe abnormality
comminuted fracture Rt femur
Intertrochanteric fracture
Spiral fracture of proximal femoral shaft with shortening and displacement
(one mark for description – displacement/angulation
