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Patient Care > Trauma 2 > Flashcards

Trauma 2 Flashcards

1
Q

Abdominal Cavity Borders

A

Superior: Diaphragm
Inferior: Pelvis
Posterior: Lumbar spine
Anterior: Muscular Abdominal Wall

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2
Q

Peritoneum

A

Lines abdominal cavity
Double-walled structure
Separates abdominal cavity into two parts

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3
Q

Peritoneal Cavity

A

True abdominal cavity

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4
Q

Contents of Peritoneal Cavity

A

Liver
Spleen
Stomach
Small intestine
Colon
Gallbladder
Female reproductive organs

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5
Q

Solid Organs

A

Liver
Spleen
Pancreas
Kidneys
Ovaries

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6
Q

Hollow Organs

A

Stomach
Intestines
Gallbladder and bile ducts
Ureters
Urinary bladder
Uterus and fallopian tubes

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7
Q

Major abdominal blood vessels

A

Aorta
IVC
SVC

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8
Q

Liver

A

Largest organ in abdominal cavity
Commonly injured from penetrating trauma
Referred right posterior shoulder pain

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9
Q

Spleen

A

Upper left quadrant
Injured from blunt trauma
Rich blood supply

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10
Q

Kehr’s Sign

A

LUQ pain radiates to left shoulder
Sign of splenic injury

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11
Q

Retroperitoneal Cavity

A

Space behind true abdominal cavity
Risk of concealed exsanguinating hemorrhage with no early symptoms

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12
Q

Contents of retroperitoneal cavity

A

Abdominal aorta
IVC
Most of duodenum
Pancreas
Kidneys
Ureters
Ascending and descending colon

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13
Q

Cullen Sign

A

Hemorrhagic discolouration of umbilical area due to intraperitoneal hemorrhage

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14
Q

Grey Turners Sign

A

Bruising of one or both flanks indicative of retroperitoneal hemorrhage
Pancreatitis

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15
Q

Axial Skeleton

A

Central axis of the body
Skull, vertebral column, bony thorax

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16
Q

Appendicular skeleton

A

Limbs

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17
Q

Pectoral girdle

A

Bones that attach upper limbs to axial skeleton

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18
Q

Pelvic Girdle

A

Paired bones of the pelvis that attach lower limbs to axial skeleton and sacrum

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19
Q

Critical Factors of Falls

A

Height
Surface
Follow path of energy through body

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20
Q

S/Sx Pelvic Injury

A

Tenderness over pubis upon palpation of one plane, SI joint tenderness, hemiparesis, pelvic ecchymosis, hematuria

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21
Q

Risk of Pelvic injury

A

Internal bleeding, bladder/genital trauma
up to 2000mL blood loss

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22
Q

Diaphysis

A

Long, narrow shaft
Dense, compact bone

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23
Q

Metaphysis

A

Head of bone
Between epiphysis and diaphysis

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24
Q

Medullary canal

A

Contains marrow

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25
Q

Periosteum

A

Outer fibrous covering
Allows for increase in diameter
Vascular
Nerves

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26
Q

Epiphysis

A

Articulated, widened end
Allows bone to lengthen, hyaline cartilage
Cancellous bone with red blood marrow
Weakest point in child’s bone

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27
Q

Open Fracture

A

Wound extends from body surface to fracture site
Produced by bones or object causing fracture
Infection risk
Bone end not necessarily visible

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28
Q

Direct Fracture

A

Break occurs at point of impact

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29
Q

Indirect fracture

A

Force transmitted along bone
Injury occurs at some point distant to point of impact

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30
Q

Twisting Fracture

A

Distal limb remains fixed
Proximal part rotates
Shearing, fracturing occur

31
Q

Avulsion Fracture

A

Muscle and tendon unit with attached fragment of bone ripped off bone shaft

32
Q

Stress Fracture

A

Feet secondary to prolonged running or walking

33
Q

Pathological Fracture

A

Fracture with minimal force

34
Q

Transverse Fracture

A

Cuts shaft at right angle to long axis
Often direct injury

35
Q

Greenstick Fracture

A

Pliable bone splinters on one side without complete break
In children

36
Q

Spiral or twisting fracture

A

Fx coils through bone like spring
Occurs with torsion

37
Q

Oblique fracture

A

Angle to long axis of shaft

38
Q

Comminuted fracture

A

Bone broken into 3+ pieces

39
Q

Impacted fracture

A

Bone ends jammed together
Occurs with compression
No loss of function

40
Q

Don Juan Syndrome

A

Fall onto feet
Bilateral heel fractures
Compression fractures of vertebrae
Bilateral Colles’ fractures

41
Q

Blood Loss Fractures

A

Tib/fib: 500
Femur: 1000-1200
Pelvis: 2000

42
Q

Sprains

A

Stretching, tearing of ligaments surrounding joint
Occur when joint is twisted beyond normal range of motion
No typical deformity

43
Q

Grades of Sprain

A

I: Minor + incomplete, stable
II: significant but incomplete, intact but unstable
III: complete tear, unstable

44
Q

Strains

A

Tearing, stretching of musculotendonous unit
Spasm, pain on movement
No deformity, swelling
Pain on active movement

45
Q

6 P’s of MSK assessment

A

Pain
Pallor
Pulselessness
Paresthesias
Paralysis
Polar/Pressure

46
Q

MOA Acetaminophen

A

Activation of descending serotonergic inhibitory pathways in CNS
More antipyretic

47
Q

Side effects acetaminophen

A

Very safe
Number one cause of hepatic toxicity

48
Q

Pts good for acetaminophen

A

Mild to moderate pain
Severe pain co-administered with stronger analgesic

49
Q

Pts not good for acetaminophen

A

Hepatic dysfunction
Drinking alcohol
Taken large doses recently

50
Q

Ibuprofen MOA

A

Inhibits free arachidonic acid conversion to prostaglandins and thromboxane A2s

Reduce pain, inflammation and platelet aggregation

51
Q

Side effects Ibuprofen

A

Ability to form clots
Bronchoconstriction/worsening asthma
Irritates stomach wall lining
Renal toxicity in high doses

52
Q

Ibuprofen good pts

A

Mild to moderate
Severe pain with stronger analgesic

53
Q

Ibuprofen not good pts

A

Inability to clot, renal failure, asthma/autoimmune symptoms

54
Q

Ketorolac MOA

A

NSAID similar to ibuprofen

55
Q

Side effects ketorolac

A

Bronchoconstriction
Impaired clotting
Compounded with NSAID use

56
Q

Good ketorolac pts

A

Unable to tolerate oral meds
Mild to moderate pain
Severe pain with stronger analgesic

57
Q

Precautions Morphine

A

Resp depression
Hypotension
N/v
Dizziness, mental clouding, sedation
Pruritis fro histamine release
Bradycardia

58
Q

MoA Morphine

A

Binds opioid receptors
Inhibits ascending pain pathways
Alters perception of and response to pain
Produces generalized CNS depression

59
Q

Good morphine pts

A

Moderate to severe pain
Cardiac ischemia
Going through pre/post reperfusion

60
Q

Bad morphine pts

A

High tolerance to morphine
Weak BP
Depressed resp drive

61
Q

Wooden chest

A

Rapid administration of large doses of fentanyl cause skeletal and thoracic muscle rigidity

62
Q

Fentanyl

A

Synthetic opioid binding to Mu
Works on CNS
Concentration greater than morphine
Less BP effect

63
Q

1st Degree Burn

A

Affects epidermis
Redness w/o blistering

64
Q

2nd Degree Burn

A

Burn into dermis
May go into glands and hair follicles
Redness + blistering

65
Q

3rd degree burn

A

Entire epidermis and dermis, pale and leathery

66
Q

Minor Burns

A

2nd degree <15% or <10% ped
3rd degree <2% not involving eyes, ears, face, hands, perineum, feet

67
Q

Moderate Burns

A

2nd degree 15-20% or 10-20 child
3rd degree 2-10%

68
Q

Major Burns

A

2nd degree >25% or 20% peds
3rd degree >10%
Hands, face, eyes, ears, feet, perineum
Inhalation
electrical
Associated injuries
Poor risk pts

69
Q

Parkland formula

A

4ml/kg/%bsa in first 24 hrs
1/2 in first 8
1/2 in next 16
urine output 30-50ml/hr

70
Q

AC Current

A

Muscular tetany
Locked on
May paralyze rest muscles
VF arrest

71
Q

Direct Current

A

Unidirectional flow of electrons
Pts thrown
aSystole

72
Q

Rhabdomyolysis

A

Breakdown of striated muscle tissue
Direct damage
Metabolic Causes
Drugs and Toxin

CK >1000

73
Q

Complications of rhabdo

A

myoglobin causes tubular obstruction
HyperK
Phosphate binds to calcium
DIC

Patient Care (11 decks)

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