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Ellie's Path Processes > Sesh 7.2- Pathology Of Trauma > Flashcards

Sesh 7.2- Pathology Of Trauma Flashcards

1
Q

What are the 4 general effects of trauma?

A
  1. Bleeding
  2. Infection and sepsis
  3. Specific organ/system effects
  4. Multi-organ failure
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2
Q

What is a diffuse axonal injury commonly caused by?

A

A deceleration injury e.g. Head struck in car accident/ with object, causing axons to break

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3
Q

List some complications of head injury.

A
  • Raised intracranial P- will put P on centres controlling resp and cardiac function in brainstem
  • Generalised effects- reduced Glasgow coma score
  • Specific neurological defects
  • Infection- skull fractures or penetrating wounds
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4
Q

If intercostal arteries become damaged in a rib fracture, what can result?

A

Haemothorax

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5
Q

Give 4 types of abdominal trauma

A
  1. Liver laceration
  2. Spleen laceration
  3. Intestinal perforation
  4. Pancreatic injury
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6
Q

What is the main complication associated with pelvis fractures?

A

Severe internal haemmorhage- bp will drop, so need fluid then blood

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7
Q

Give 4 possible complications of long bone fracture.

A
  1. Bleeding
  2. Vascular damage
  3. Nerve damage
  4. Fat embolism
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8
Q

Name 4 types of trauma that can give rise to vascular injury.

A
  1. Stabwounds
  2. Gunshot wounds
  3. Impalement
  4. Plate glass accidents
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9
Q

What are the main complications of crush injuries?

A
  1. Tissue loss- can result in amputation
  2. Fractures- will be v small fragments
  3. Vascular injury
  4. Compartment syndromes- compromises blood supply-ischaemia
  5. Rhabdomyolysis- skel muscle damage–>myoglobin released and affects kidney function
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10
Q

What is the ‘rule of 9’s’ in relation to burns?

A

Used to give estimate of % of body affected, for prognosis and to calc fluid loss etc.
E.g. Head=9%; 1 leg=9%

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11
Q

What are some of the systemic effects of burns?

A
  • Release of cytokines and inflam mediators
  • Fluid loss
  • Reduced myocardial contractility- hypotension and hypoperfusion- ischaemic damage
  • Metabolic rate massively increases
  • Non-specific down-regulation of immune response
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12
Q

Why is aggressive enteral feeding required for burns victims?

A

Their metabolic rate has massively increased, so need to feed to reduce catabolism and maintain GIT integrity.

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13
Q

Why are burns victims susceptible to infection?

A
  • Get non-specific down-regulation of immune response

- Lost part of skin barrier

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14
Q

What are the systemic effects of haemorrhage?

A
  • Hypovolaemic shock

- Reduce CO–> hypoperfusion–> tissue ischaemia/ hypoxia

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15
Q

What is SIRS?

A

Systemic inflammatory response syndrome- the body’s response to infection, inflammation and/or stress (i.e. Trauma).

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16
Q

What are the criteria for SIRS?

A

Must have at least 2 of:

  • temp >38.5 or <36 C
  • HR> 90bpm
  • RR >20 bpm or PaCO2 <32 mmHg
  • WBC >12,000 cells/mm3, <4, 000 cells/mm3 or >10% immature
17
Q

What is the difference between sepsis and SIRS?

A

Sepsis= SIRS + confirmed or suspected infection

18
Q

What is the difference between sepsis and severe sepsis?

A

Severe sepsis= sepsis + 1/ more signs of organ dysfunction

19
Q

What are some of the clinical features of sepsis/ severe sepsis?

A
  • Areas of mottled skin
  • DIC
  • Long cap refill
  • AKI
  • Low urine outputt
  • Acute resp distress syndrome
  • Lactate >2mmol/L
  • Cardiac dysfunction -Tn leak
  • Altered mental status- abn EEG
  • Platelets <100
20
Q

What is acute respiratory distress syndrome?

A

Results from acute lung injury

  • Damage/death of pneumocytes
  • Oedema
  • Neutrophils migrate into alveoli and release proteases
21
Q

What is septic shock?

A

Sepsis plus 1 of:

  • MAP <60 mmHg after adequate fluid resuscitation
  • Need inotropes (e.g. NA) to maintain bp after fluid resuscitation
  • Lactate >4 mmol/L
22
Q

Patients with multi-organ failure/ dysfuction syndrome become ____________ and _______________.

A
  1. Hypometabolic

2. Immunodepressed

23
Q

What are the mechanisms behind MODS?

A
  • Genetics
  • Co-morbidities
  • Treatments e.g. O2 therapy can damage circulation
  • Circulation
  • Inflammatory mediators are key
  • Coagulation system is inappropriately activated
24
Q

How may MODS present?

A
  • AKI- acidosis, uraemia
  • Acute resp distress syndrome- impaired gas exch, increased O2 need
  • Cardiac dysfunction- reduced CO, hypotension
  • Encephalopathy- reduced conscious level
  • GI disturbance- e.g. Paralytic ileus
  • Liver dysfunction- low albumin, jaundice
  • Coagulopathy- DIC
  • Bone marrow suppression

Ellie's Path Processes (6 decks)

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