trauma Flashcards
how does the ARRT define trauma?
a serious injury or shock to the body, often requiring modifications that may include variations in positioning, minimal movement of the body part, and so on…
types of trauma
blunt
penetrating
explosive
thermal forces
It is (good/poor) practice to accept lower quality images because of patient condition or difficulty of procedure
poor
displacement of a bone that is no longer in contact with its normal articulation
dislocation
occurs when a bone is partially pulled or pushed out of place in relation to its normal alignment
sublaxation
a wrenching or twisting of a joint resulting in a tearing or rupturing of associated soft tissues without dislocation
sprain
a bruise type of injury. Can sometimes be associated with a bony injury
contusion
a disruption of bone caused by a force applied either directly to the bone, or transmitted along the shaft of the bone
fracture
how the fragmented ends of the bone make contact with each other. There are three terms to describe this relationship; what are they?
apposition
anatomic, lock of apposition (distraction), bayonet apposition
type of apposition where the fractured ends of the bone align anatomically making contact with each other
anatomic apposition
type of apposition where the ends of the fragmented bone are aligned, but pulled apart with a gap between them
lack of apposition (distraction)
type of apposition where the bone fragments are displaced and overlapping each other so that the shafts of the bone are in contact with each other
bayonet apposition
__________ describes the loss of alignment of the fracture and the direction of angulation caused by this misalignment. there are three types; what are they?
angulation
apex angulation, varus deformity, valgus deformity
The apex of the angulation is __________ in relation to the distal ends of the fractured bone
opposite
angulation which describes the angle or direction of the fragment such as a medial or lateral apex in which the point of the angle points medially or laterally
apex angulation
angulation which describes when apex is pointing away from the midline of the body and the distal ends of the fractured bone are angled towards the midline of the body
varus deformity
angulation which describes when apex is pointing to the midline of the body and the distal ends of the fractured bone are angled away from the midline
valgus deformity
fracture in which the bone does not break through the skin
simple fracture (closed)
a fracture in which a portion of the bone breaks through the skin. This is typically the fragmented end
compound fracture
fracture does not completely transverse the bone. More common in __________ patients who still have more _____________
incomplete fracture (partial); pediatric, flexible bone tissue
two types of incomplete/partial fracture
torus “buckle,” greenstick
a buckle of the outer portion of the bone (the cortex) with localized expansion of the cortex with little to no displacement or complete break in the cortex
torus or “buckle” fracture
this fracture is on one side of the bone only with the cortex of the affected side of the bone broken and the cortex on the other side bent
greenstick fracture
the bone is broken into two separate pieces. There is a complete fracture that includes the cross section of the bone
complete fracture
three types of complete fractures
transverse, oblique, spiral
the fracture is nearly at a right angle to the long axis of the bone
transverse fracture
the fracture crosses the long axis of the bone at an oblique angle
oblique fracture
the bone has been twisted and the fracture spirals around the long axis of the bone
spiral fracture
the bone is splintered and/or crushed at the site of the fracture resulting in two or more pieces
comminuted fracture
three types of comminuted fracture
segmental, butterfly, splintered
two fracture lines that create three distinct sections of bone with the middle section being fractured at both ends
segmented fracture
a fracture with two pieces on each side of a main wedge-shaped piece
butterfly fracture
can be caused by direct trauma in which a fracture is created with thin sharp fragments
splintered fracture
severe stress to a tendon or ligament which causes it to pull away a section of bone
avulsion fracture
caused by blunt trauma to the orbit, maxilla, or zygoma which causes fracturing to the orbital floor and lateral orbital margins
blowout fracture
a compression type injury in which a vertebral body collapses or is compressed
compression fracture
compression fractures are typically seen radiographically in the _____________ aspect of the vertebral bodies forming a ______________
anterior, wedge-like appearance
most common in pediatric patients. It’s a fracture at the growth plate of a bone. One of the most common fracture sites in children
epiphyseal fracture
fracture lines radiate outwards from the focal point of trauma in a “star-like” pattern most commonly seen in the patella
stellate fracture
ankle joint fracture involving both the medial and lateral malleoli as well as the posterior lip of the distal tibia
tri-malleolar fracture
a fracture in which one segment is driven into the other such as the shaft of a bone being driven into the distal end of the bone such as a Buckle Fracture
impacted fracture
fracture of the distal phalanx caused by being struck by a ball. Frequently an avulsion fracture at the base of the distal phalanx is seen with this injury
baseball (mallet) fracture
usually seen in the distal part of the fifth metacarpal caused by punching. It is best visualized on the lateral image
boxer fracture
a wrist fracture in which the distal fragment is displaced posteriorly. May be caused by a forward fall
colles fracture
a wrist fracture in which the distal fragment is displaced anteriorly. May be caused by a backward fall
Smith’s fracture
a bilateral fracture traversing the pars interarticularis of cervical vertebrae 2 (C2) with an associated traumatic subluxation of C2 on cervical vertebrae 3 (C3)
Hangman fracture
______________ is the second most common fracture of the C2 vertebrae following a fracture of the ______________
Hangman fracture; odontoid process
Colles fracture is a wrist fracture in which the distal fragment is displaced ___________; what direction for fall?
posteriorly, forward fall
Smith’s fracture is a wrist fracture in which the distal fragment is displaced ________; what direction for fall?
anteriorly, backward fall
intra-articular fracture of the radial styloid process
Hutchinson (Chauffer) fracture
a fracture to the proximal half of the ulna with an associated radial head dislocation
Monteggia (mon-tej-ah) fracture
a complete fracture to the distal fibula with accompanying major damage to the joint and associated soft tissues (ligaments etc.) and often seen with fracturing to the medial malleolus and/or distal tibia
Pott’s fracture
reduction in which the pieces of bone are put back into alignment manually. This is non surgical and is often used in conjunction with x-ray or fluoroscopy
closed reduction
this type of reduction is a surgical procedure. The fracture may or may not be aligned prior to incision. When the site is exposed, plates, screws, rods, or other hardware is used to keep the fractured pieces in alignment until new bone growth can take place
open reduction
open reduction surgery is often referred to as __________
ORIF (open reduction/internal fixation)
what does ORIF stand for?
open reduction/internal fixation
3 key principles in trauma radiography
- 2 projections must be attained at 90 degree planes from each other (orthogonal views)
- included the entire structure or trauma area on the IR
- Maintain patient, public, and healthcare worker(s) safety
what are orthogonal views?
2 projections must be attained at 90 degree planes from each other
Danelius-Miller can be seen in…
trauma, during surgery, post surgery
SID Danelius-Miller
40 inches
for a Danelius-Miller, place IR against _______________________; then rotate IR so that it is parallel with the __________
patient’s side and 1” above iliac crest; femoral neck
how do you place IR parallel to femoral neck in a Danelius-Miller?
abduct bottom of IR 15-20 degrees away from body
for a Danelius-Miller, ask patient if they can rotate affected leg __________, but do not force
15 degrees internally
CR centering for Danelius Miller
femoral neck
inlet view is also called _____________
Lilienfeld Method
outlet view is called __________
Taylor Method
trans-thoracic shoulder SID
40 inches
for trans-thoracic shoulder, raise unaffected arm and place affected shoulder ______________
against the IR
CR centering for trans-thoracic shoulder
surgical neck of affected shoulder
respiration for trans-thoracic shoulder
Suspend on respiration or use a breathing technique
respiration for trans-humerus shoulder
Suspend on respiration or use a breathing technique
for trans-humerus shoulder, raise unaffected arm and place affected shoulder (against IR/away from IR)
against IR
CR centering for trans-thoracic humerus
Center mid-shaft of the affected to the midline of the IR
trauma C spine views
cross table lateral, swimmer’s
trauma C-Spine SID
60-72 inches
oblique C-spine method
CR 45 degrees to the patient
This could be a self defense injury to the arm
Monteggia fracture
