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Major Clinical Sciences (Big 4) > Surgery > Flashcards

Surgery Flashcards

1
Q

What are the ABCs of Trauma Evaluation?

A

Airway
Breathing
Circulation

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2
Q

Characteristics of a patient with a PROTECTED airway

A

Awake and conscious

Normal tone of voice

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3
Q

Characteristics of a patient with an UNPROTECTED airway

A

Coma (GCS < 8)
Expanding hematoma or emphysema in neck
Noisy breathing/Difficulty breathing

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4
Q

Methods for establishing an airway in the field

A

Intubation

Cricothyroidotomy

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5
Q

Methods for establishing an airway in the Emergency Department

A

Rapid induction
Intubation
Pulse oximetry monitoring

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6
Q

Routes for intubation

A

Oral tube
Nasal tube (via bronchoscopy)
Cricothyroidotomy
Tracheostomy

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7
Q

Minimum age of patient to do cricothyroidotomy?

A

12 years old

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8
Q

Why is cricothyroidotomy not performed in children?

A

Small cricoid cartilage

Possible airway collapse

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9
Q

In the Trauma Setting:
For VENTILATION check ______________
For OXYGENATION check ______________

A

Breath Sounds

Pulse Oximetry

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10
Q

What is hypoxia?

A

Condition of low oxygen in body cells and tissues

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11
Q

Causes of hypoxia in the setting of trauma?

A

Hemorrhage/Blood loss
Collapsed airway
Lung parenchymal injury
Decreased ventilatory drive (neurologic)

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12
Q

What is shock?

A

Condition of low blood perfusion to body tissues and organs, resulting in multiple organ failure

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13
Q

Most common types of shock in the setting of trauma?

A

Hypovolemic Shock

Obstructive Shock

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14
Q

Clinical criteria of Shock

A

SBP < 90 mmHg
HR > 100
Urine Output < 0.5 ml/kg/hr

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15
Q

Causes of hypovolemic shock in the setting of trauma

A 
Hemorrhage
Burns
Massive diarrhea
Peritonitis
Pancreatitis
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16
Q

Causes of obstructive shock in the setting of trauma

A

Tension pneumothorax

Cardiac tamponade

17
Q

Recommended fluid resuscitation in traumatic hypovolemic shock

A

Establish 2 IV lines - large bore (Gauge 16 for Adults)

IV Plain Lactated Ringer’s solution

18
Q

How to administer blood products for resuscitation in traumatic hypovolemic shock?

A

Typically in 1:1:1 ratio of pRBC, PC, and FFP

19
Q

Clinical signs of a cranial base hemorrhage

A

Raccoon’s Eyes sign
Battle sign
Rhinorrhea
Otorrhea

20
Q

Clinical findings in a patient with tension pneumothorax

A

Decreased breath sounds on affected side
Deviated trachea (not midline)
Dyspnea

21
Q

What is the classic triad of cardiac tamponade?

A

BECK’S TRIAD
Low blood pressure
Distended neck veins
Muffled heart sounds

22
Q

Treatment for a patient with tension pneumothorax

A

Pleural cavity decompression

Subsequent insertion of chest tube

23
Q

Therapeutic procedures for a patient with cardiac tamponade?

A

Pericardiocentesis
Subxiphoid pericardial window
Thoracotomy

24
Q

Minimum MAP for a patient with uncontrolled hemorrhage to maintain cerebral perfusion

A

60 mmHg

25
Q

In the setting of trauma, identify the purpose of:

  1. Primary Survey
  2. Secondary Survey
A
  1. Stabilize the patient

2. Determine the etiology of the patient’s condition

26
Q

A period of unconsciousness, followed by a lucid interval (return to normal functioning), with a subsequent return of unconsciousness, with fixed eye dilation and development of hemiparesis is the classic clinical picture of a patient with: _________________

A

Acute Epidural Hematoma

27
Q

Classic CT scan finding in a patient with Acute Epidural Hematoma

A

Lens-shaped, convex hematoma

28
Q

Classic CT scan finding in a patient with Acute Subdural Hematoma

A

Crescent-shaped hematoma

29
Q

3 components of neurologic damage caused by trauma

A
  1. Initial blow
  2. Hematoma expansion
  3. Cerebral edema
30
Q

How is cerebral perfusion pressure calculated?

A

Mean arterial pressure - intracranial pressure

31
Q

Non-surgical measures to decrease intracranial pressure?

A

Head elevation
Hyperventilation
Avoidance of fluid overload
Diuretics

32
Q

TRUE or FALSE

Uncontrolled cerebral hemorrhage often leads to hypovolemic shock

A

FALSE
The limited volume within the skull, along with autoregulation of cerebral vasculature, limits the amount of hemorrhage and thus, does not usually lead to hypovolemic shock

33
Q

Classic CT scan finding of Diffuse Axonal Injury

A

Punctate hemorrhages

Loss of gray-white matter differentiation

Major Clinical Sciences (Big 4) (3 decks)

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