Trauma Flashcards
Traumatic aortic injuries are typically caused by __ and happen at __
Traumatic aortic injuries are typically caused by decceleration trauma and happen at the aortic isthmus (where the ductus used to be, just distal to the subclavian takeoff)
Widened mediastinum absolute value
”> 8 cm on CXR”
Basically whenever you have a patient with traumatic aortic injury, they will be . . .
. . . supine
This can make it subtle to detect hemothorax on CXR, so have high suspicion
Tracheal deviation in the setting of suspected aortic dissection
Suggests mediastinal hematoma
Deep sulcus sign
Seen when a patient with pneumothorax is supine
Sulci are deeper than normal and often clear of lung markings
Flail chest
1st rib injury
Another marker of severe trauma
Worrying for aortic or tracheal injury
Lung laceration
“Blush” and active extravasation
Contrast leaking out
Test of choice in suspected bladder rupture
CT cystogram
Normal retrograde urethrogram
Probably exam q’s
When to do a CT cystogram vs retrograde urethrogram?
Multiple pelvic fractures: CT cystogram
Blood at urethral meatus: Retrograde urethrogram
Fracture with more than two pieces
Comminuted
Fx directions
Relationship of fragment pieces
Fractures associated with anterior shoulder dislocations
Sail sign
Fluid pushes a fat pad away from the bone
Indicates joint effusion, which may be associated with a fracture
Recommend that the patient come back in 7-8 days for re-imaging.
Adults: Radial head fracture
Kids: Distal humeral condylar head fracture
Bennett’s fracture
Rolando fracture
Gamekeeper’s thumb
Mallet finger
Boxer’s fracture
Displaced, angulated fx of 5th metacarpal
Colles fracture
Smith’s fracture
Opposite displacement of Colles fracture
Montegga fracture
Galeazzi fracture
Scaphoid fracture
If you aren’t sure, have them come back in 7-10 days
Fat-fluid level in the knee
Should raise concern for some type of fracture, even if you can’t see it
Particularly a tibial pleateau fracture
Segond fracture
This patient needs an MRI!
Whenever we see a fracture at the medial malleolus, there is probably. . .
. . . another fracture at the proximal fibula
So, get another radiograph
Maisonneuve fracture
Jones’ fracture
Hangman’s fracture
Due to severe hyperextension injury
Jefferson fracture
Dens fracture
Pathological fracture
When to order an ankle x-ray, according to the Ottawa ankle rules
- The patient has pain near the malleolus and one of the following:
- Is age 55 or older
- Has tenderness at the edge of the tibia
- Has tenderness at the tip of either maleolus
- Has tenderness at the navicular bone*
- Has tenderness at the cuboid*
- Has tenderness at the 5th metatarsal base*
- Inability to bear weight immediately following injury*
- Inability to walk 4 steps in the ER*
- The starred ones are also an indication for foot x-ray
Fracture descriptors
Diagnosis of an occult (not visible on simple x-ray) hip fracture
MRI is the most sensitive, best option
If not available, CT can also work
Names of major femur fractures
Grading system for femur fractures (with associated treatments)
Artery that supplies the femoral head
Profunda femoral artery
Posterior shoulder dislocation
Inferior shoulder dislocation
