trauma

Question 1

Inferior orbital wall fracture

Answer 1

he inferior rectus muscle or orbital tissue can become entrapped within the fracture, resulting in tethering and restriction of gaze and diplopia

inferior rectus:
It depresses, adducts, and helps extort (rotate laterally) the eye.

Question 2

ottawa ankle rules

Answer 2

• inability to walk 4 stems at time of injury
• inability to walk 4 steps in the ED
• tendernwss over the lateral malleolus
• tenderness over the medical malleoulus

Question 3

ruptured globe injury

Answer 3

• avoid tono pen
• get tenus, start ABX, consult optho, get visual acuity
• A ruptured globe presents with enophthalmos (posterior displacement), not proptosis, as vitreous humor leaks out of the eye

Question 4

retrobulbar hematoma

Answer 4

Traumatic proptosis with impaired extraocular movements

Sequelae include optic nerve ischemia and secondary visual impairment

Question 5

tension Pneumo needle placement?

Answer 5

second intercostal space midaxillary line

Question 6

orbital blow out fractures are common a fracture to the maxillary sinus or ethmoid sinus

Answer 6

• epistaxis
• subq emphysema
• fracture through the max could get the second branch of the trigeminal nerve and cause ipsilateral infraorbital region
• if the inferior rectus muscle gets trapped within the fracture of the inferior wall then the patient will be unable to look up causing diplopia with upward gaze
• NO PROPTOSIS

Question 7

hyphema = collection of blood

Answer 7

you will see a fluid level/meniscus in the anterior chamber

Question 8

hypopion

Answer 8

collection of purulent material

Question 9

keratitis

Answer 9

corneal inflammation

Question 10

iritis

Answer 10

inflammation of the iris

Question 11

central cord syndrome what to do first?

Answer 11

iv steroids then a cervical MRI

Question 12

L5 nerve root?

Answer 12

compression of a L4-5 disc would result in compression of L5 i think this is wrong, it exits under

• doral specte of the foot sensation
• dorsiflexion

Question 13

hip disclocation what type of rotation?

Answer 13

internal rotation

Question 14

fall, right leg is abducted and externally rotated, what kind of fracture?

Answer 14

femoral neck fracuture

Question 15

worrried about the popliteal artery and ahave a fracture

Answer 15

this is an emergency, dont wait for the OR, do an immediate reduction in the ED

Question 16

describe the rule of 9’s

Answer 16

go ahead dscribe it!