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MSK > Regional Adult Trauma > Flashcards

Regional Adult Trauma Flashcards

1
Q

How do you clinically clear a c spine?

A 
No LOC
GCS 15, no alcohol intoxication
No head injury/chest trauma
No neuro symptoms
No midline tenderness
No pain
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2
Q

How to treat c spine injury?

A

Stable - firm cervical collar

Unstable - Halo vest (external fixator)

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3
Q

Indications for thoracolumbar surgery

A

Neuro deficits

Unstable - lig damage, displacement

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4
Q

Spinal shock

A

Physiologic response to injury with complete loss of sensation and motor function and loss of reflexes below point of injury, absent bulbocavernous reflex (contraction of anal sphincter)
Resolves in 24 hours

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5
Q

What signals end of spinal shock?

A

Return of bulbocavernous reflex (contraction of anal sphincter)

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6
Q

Neurogenic shock

A

After temporary shutdown of sympathetic chain = hypotension and bradycardia
Resolves in 24-48 hours
Priapism

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7
Q

Treatment of neurogenic shock

A

IV fluids

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8
Q

Complete spinal cord injury

A

No sensory or motor below level of injury

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9
Q

Define level of injury

A

Most distal spinal level with partial function (dermatomal sensation, myotomal movement)

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10
Q

Incomplete spinal cord injury

A

Some function below level of injury
Sacral sparing
Greater the function = faster the recovery

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11
Q

Central cord syndrome

A

Incomplete cord injury due to hyperextension injury in c-spine with OA
Paralysis of arms more than legs, loss of movement, pain and temperature
Can feel position, vibration and touch
Sacral sparing

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12
Q

Anterior cord syndrome

A

Incomplete cord injury
Loss of motor function , coarse touch, pain and temperature
Proprioception, vibration sense and light touch are preserved (dorsal columns)

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13
Q

Posterior cord syndrome

A

Incomplete cord injury

Loss of dorsal column function = loss of proprioception, vibration and light touch

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14
Q

Brown-Sequard syndrome

A

Incomplete cord injury
Hemisection of cord from penetrating injury = ipsilateral paralysis with loss of dorsal column function (proprioception, vibration, light touch) AND contralateral loss of pain, temperature and deep touch
Due to spinothalamic tract crossing

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15
Q

Lateral compression fracture (pelvis)

A 
Side impact (RTA), hemipelvis displaced medially
Sacral compression fracture or SI joint disruption
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16
Q

Vertical shear fracture (pelvis)

A

Axial force on hemipelvis (fall from height/deceleration)
Displaced superiorly
Shorter leg on affected side
Lumbosacral plexus damage

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17
Q

Anteroposterior compression injury

A

Pubic symphysis disturbed = open book fracture

Substantial bleeding = pelvic binder

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18
Q

Signs of bladder/urethral injury

A

Blood at urethral meatus

Urethrography, CT, call urologists

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19
Q

Fractures of which acetabulur wall associated with dislocation?

A

Posterior acetabular wall

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20
Q

Treatment of humeral neck fracture

A 
Conservative sling (minimally displaced)
Displaced may improve with time
Consistently displaced = reduce and fix
21
Q

How does anterior shoulder dislocation happen?

A

External rotation force
Fall onto back of shoulder
Seizure

22
Q

Bankart lesion

A

Due to anterior shoulder dislocation
Anterior glenoid labrum tear where biceps attaches (SLAP)
Bankart repair

23
Q

What nerve/artery can be damaged in shoulder dislocation?

A 
Axillary nerve (regimental badge area)
Axillary artery
24
Q

Signs of anterior dislocation

A

Loss of symmetry/roundness
Arm held in adduction
Loss of sensation in regimental badge area (axillary nerve damage)

25
Q

Sign of ACJ dislocation

A

Step at ACJ

26
Q

Cause of posterior shoulder dislocation

A

Posterior forced on adducted and IR arm

Need lateral xray

27
Q

Signs of posterior humeral head dislocation

A

Head palpable posteriorly

Lightbulb sign

28
Q

What is vulnerable to injury in humeral shaft fracture?

A

Radial nerve in spiral groove = wrist drop and loss of sensation in 1st dorsal web space

29
Q

Supracondylar fractures usually occur in:

A

Kids

30
Q

Signs of radial head/neck fracture

A

Fat pad sign on lateral xray

31
Q

Nightstick fracture

A

Fracture of ulna on its own after direct blow

Make sure there is no Monteggia injury (also dislocated radial head)

32
Q

Monteggia

A

MUS - Ulna fractured superiorly

Radial head dislocation

33
Q

Galeazzi

A

GRI - radius fractured inferiorly

Dislocation of ulna at DRUJ

34
Q

Colles fracture

A

Extra-articular fracture of distal radius
Dorsal displacement
Due to FOOSH onto extended wrist
Conservative or ORIF

35
Q

Smith’s fracture

A

Volarly displaced distal radius after fall onto flexed wrist

Unstable = ORIF

36
Q

Barton’s fracture

A

Intra-articular fracture of distal radius = carpal bones sublux
ORIF

37
Q

Cause of scaphoid injury

A

FOOSH

38
Q

Signs of scaphoid injury

A

Pain in anatomical snuffbox

Pain on compressing thumb metacarpal

39
Q

Investigation and treatment of scaphoid injury

A

4 views on xray (AP, lateral, 2 oblique)
Can show up 2 weeks later
Splint/cast/fix

40
Q

Complications of scaphoid fracture

A

Non-union

AVN of proximal pole

41
Q

Peri-lunate dislocation

A 
High energy, hyperdorsiflexion
Loss of alignment of capitate and lunate
Associated scaphoid fracture, median nerve injury
Split cup sign
Emergency reduction
42
Q

Mallett finger

A

Avulsion of extensor tendon from insertion onto distal phalanx
Due to forced flexion of DIP
Pain, drooped DIP, inability to extend
treat with mallett splint

43
Q

Boxer’s fracture

A

Fracture of 5th metacarpal

44
Q

Management of hip fractures

A

Surgery within 24 hours - replacement in intracapsular, fixation in extracapsular
Early mobilisation

45
Q

Branches of profunda femoris

A

Medial and lateral circumflex arteries

46
Q

Knee dislocation

A

Surgical emergency

Reduce, NV assessment

47
Q

Predispose to patella dislocation:

A

Female
Laxity
Genu valgum
Femoral neck anteversion

48
Q

What criteria used to identify ankle fracture?

A

Ottawa

49
Q

Lisfranc fracture

A

Midfoot

TMT joints

MSK (10 decks)

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