RS Notes Flashcards
What are the four types of brain bleeds?
Epidural bleed
Subdural bleed
Subarachnoid bleed
Intracerebral hemorrhage
Define Epidural hematoma.
Accumulation of blood between dura mater and the cranium.
Usually associated with a laceration or tear of the middle meningeal artery.
Define Subdural hematoma.
A collection of blood between the dura and the surface of the brain in the subdural space.
This injury usually results from bleeding of the veins in that bridge the subdural space.
Define subarchnoid hematoma.
A collection of blood in the subarachnoid space.
Bleeding into the cerebrospinal fluid.
50% of patients with BLANK hematoma have a transient loss of consciousness, followed by a lucid interval (6-18 hours) in which neurological status returns to normal.
Epidural hematoma.
Signs and symptoms of BLANK hematoma are similar to those of BLANK hematoma and include headache, nausea and vomiting, decreasing level of consciousness, coma, abnormal posturing, paralysis, and, in infants, bulging fontanelles.
These findings are maybe subtle because of the slow development of the hematoma location and chronic phases.
Subdural hematoma.`
Characteristics of BLANK hematoma
sudden and severe HA dizziness neck stiffness unequal pupils vomiting seizures LOC
subarachnoid hematoma
Define intracerebral hematoma
an accumulation of blood or fluid within the tissue of the brain. More than 5 mL
Common causes penetrating trauma, MVC, ICP as a result of compression
Define Virchow’s Triad.
As it is has come to be known today, the triad consists of stasis, vessel damage, and hypercoagulability, and is used to describe the etiology and assess the risk of thrombosis, especially of deep vein thrombosis (DVT.)
S+S of DVT
pain edema warmth erythmea or bluish discoloration tenderness
Risk factors for DVT?
Recent lower extremity trauma recent surgery advanced age recent MI inactivity confinement to bed CHF Cancer previous thrombosis oral contraceptive therapy sickle cell disease obesity
What is Beck’s Triad?
3 D’s
Decreased heart sounds (muffled)
Distended Jugular Veins
Decreased BP
Rule of Nines
A method to estimate burn injury that divides the total body surface area into segments that are multiples of 9%.
Using the rule of nines what is the adult body (or child greater than 9 years old) percentage look like?
Head 9 Upper chest 9 Abdomen 9 Upper Back 9 Lower back 9 L arm 9 R arm 9 Groin 1 L thigh 9 around L calf around 9 R thigh 9 around R calf around 9
What does Nitroglycerin do?
Reduce preload.
NTG dilates arterioles and veins in the periphery (and coronary arteries in high doses). The resultant reduction in preload, and to a lesser extent in after load, decreases the workload of the heart and lowers myocardial oxygen demand. NTG is lipid soluble and is thought to enter the body from the GI tract through the lymphatics rather than the portal blood.
Contraindications for the use of Nitroglycerin?
Hypo tension
Erectile dysfunction drug use
Allergy
Define gestational hypertension
Hypertension that occurs during the latter stages of pregnancy (>20 weeks) without any other features of preeclampsia, and resolves during postpartum period’ recognized by BP greater than 140/90.
Thought to result from rejection of the pregnancy by the immune system and can be an early indication of preeclampsia.
Define preeclampsia
an abnormal disease disease of pregnancy characterized by the onset of acute hypertension associated with proteinuria after the twentieth week of gestation.
Can be mild or severe - diastolic BP >110 mmHg
Define eclampsia
a grave form of pregnancy-induced hypertension, characterized by convulsions, coma, proteinuria and edema.
Most common in patients with severe preeclampsia.
What are the three Blast Injury Phases
Primary - caused by heat of explosion and over pressure wave
Secondary - caused by blast projectiles
Tertiary - caused by personnel displacement and structural collapse.
Brady Volume 2 page 37
List the organs in the abdomen.
Stomach Gallbladder Pancreas Liver Spleen Large intestine Small intestine Colon Bladder R and L Kidney Ovaries - females
Peritoneal Space definition
division of the abdomen cavity containing those organs or portions of organs covered by the peritoneum.
Retro-peritoneal Space definition
division of the abdomen cavity containing those organs posterior to the peritoneal lining.
Which is in the RUQ?
Gallbladder - always under stomach*** R kidney most of the liver some small bowel small portion of the pancreas portion of the ascending and transverse colon
What is in the LUQ
Stomach - Mnemonic eating with R hand guarding full stomach with L hand*** Spleen*** L kidney most of the pancreas portion of the liver small bowel transverse and descending colon
What is in the RLQ?
Appendix*** portions of the urinary bladder small bowel ascending colon rectum female genitalia
What is in the LLQ?
sigmoid colon potions of the urinary bladder small bowel descending colon rectum female genitalia
What are the six rights of drug administration?
Patient Drug Route Time Dose Documentation
Signs of Diabetes?
polydipsia
polyphagia
polyuria
electric shock can cause?
internal damage
v-fib
cardiac irritability
smoldering clothes
What are the four pharmacokinetics are?
absorption
biotransformation
distribution
elimination
Mnemonic A B (no C) D E
define pharmacokinetics
how drugs are moved in and out of the body
what is the primary function of nitro when treating angia?
reduced preload
what kind of shoulder dislocation presents with a patient in the “squared off” position
anterior dislocation
what is the most common age group to experience febrile seizure?
6 months - 6 years
what breathing pattern is associated with DKA?
kussmaul’s
frothy red blood at a wound site my suggest
open pneumothorax
subglottic thermal burns are most likely caused by
superheated steam
hyperresonance in the chest can be caused by?
pneumothorax or emphysema
anesthetics are which?
medications that induce loss of sensation to touch or pain
the buccal route is
between the cheek and the gums
patient has palms turned upwards. if the patient rotates palm facing downward this is called?
pronation?