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Disciplines (Emergency) > Trauma > Flashcards

Trauma Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

Cushing’s reflex

A

**Signs of ICP

  1. HTN
  2. bradycardia
  3. Irregular respiratory pattern
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2
Q

Most important factor for neuro assessment in head trauma

A

level of consciousness

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3
Q

Most common cause of traumatic brain injury?

A

motor vehicle collision

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4
Q

Best treatment for decreasing ICP?

A

mannitol (osmotic diuretic)

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5
Q

What are key findings on a blowout fracture exam?

A
  • enopthalmos
  • Limited upward gaze
  • Diplopia with upward gazev
  • Loss of sensation below the orbit
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6
Q

What should you do with a patient with a blowout fracture?

A
  • Emergent referral for ENT surgery
  • Antibiotics (ex. amoxicillin-clauvulanate, levofloxicin)
  • Tetanus prophylaxis
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7
Q

What should you look for on xray for a possible blow out fracture?

A

Tear drop sign on Water’s view*

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8
Q

What is the first and second most commonly fractured facial bones?

A
  1. Nose

2. Mandible

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9
Q

Central Cord Syndrome

A
  • Hyperextension injury
  • Arm weakness
  • Bladder dysfunction
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10
Q

Anterior cord syndrome

A
  • Complete motor paralysis and loss of pain and temperature sensation distal to lesion
  • Preserved light touch, motion, vibration, and proprioception
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11
Q

Brown-Sequard

A
  • one-sided cord injury
  • Same side: loss of voluntary motor
  • Opposite side: loss of temperature and pain sensation
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12
Q

Spinal injuries fro most severe to least severe

A
  1. Flexion teardrop
  2. Extension teardrop
  3. Hangman’s
  4. Jefferson
  5. Clay shoveler’s
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13
Q

Flexion Teardrop: MOI

A
  • Diving injury

- Sudden forceful flexion

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14
Q

Jefferson Fracture: MOI

A

C1 burst fracture

-Vertical compressive force

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15
Q

Hangman’s Fracture: MOI

A

C2 pedicle fracture

-Hyperextension injury

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16
Q

Clay shoveler’s Fracture

A

Avulsion fracture of spinous process fo C6-T1

-Flexion injury

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17
Q

Where is the most common location of a wedge or compression fracture?

A

L1, then L2, then T12

unlikely to have neurologic effects

18
Q

Chance Fracture

A
  • bone splits horizontally through spinous process, laminae, pedicles, vertebral body
  • “owl eyes”**
  • associated with intra-abdominal injuries
19
Q

Spinal Trauma: treatment

A
  1. Inline immobiliation/stabilization
  2. Sellick’s Maneuver for intubation
  3. 4 person log roll for emesis
20
Q

Which of the zones of neck trauma need angiography?

A

Zone 1 - below the cricoid cartilage

Zone 2 - above the angle of the mandible

21
Q

Is a pneumothorax seen best on expiratory or inspiratory view?

A

expiratory

22
Q

Flail chest

A

3 ribs, each broken in two places

  • inward motion during inspiration
  • outward during expiration
23
Q

Most common cause of hypoxia in flail chest

A

lung contusion

24
Q

How is pulmonary contusion diagnosed?

A

pulmonary opacity seen within 6 hours of blunt trauma

25
Q

What will pneumothorax look like on US?

A

barcode

26
Q

What is normal lung look like on US?

A

seashore sign

27
Q

Where is a chest tube placed for a pneumothorax?

A

5th intercostal space
Above the rib (to avoid neurovascular bundle)
midaxillary line

28
Q

Hamman’s crunch

A

crunching sound heard over the heart during systole

if subcutaneous emphysema in neck (be suspicious)

29
Q

Beck’s triad

A

Cardiac tamponade

  1. JVD
  2. muffled heart sounds
  3. Hypotension
30
Q

Cardiac tamponade: classic signs

A
  • Beck’s Triad
  • pulsus paradoxus
  • Kussmaul sign - neck veins pop out with taking a breath
  • Electrical alternans
  • shortened QRS
31
Q

What fracture is most significantly associated with myocardial contusion

A

sternum fracture

32
Q

Traumatic rupture of aorta most commonly involves what?

A

aortic isthmus (between left subclavian and ligamentous arteriosum)

33
Q

What is the most common complaint of someone with traumatic rupture of the aorta?

A

retrosternal or interscapular pain made worse when BP increases

34
Q

What is the key finding for traumatic rupture of the aorta?

A

Difference in pulse amplitude between UE and LE

35
Q

Aorta rupture CXR findings

A
  1. Mediastinal widening
  2. Esophagus deviation to the right***
  3. Blurring aortic knob
  4. Tracheal deviation to the right
  5. Left pleural effusion
36
Q

Most common organ injured in penetrating trauma is _____

A

liver

37
Q

Most common organ injured in blunt trauma is _____

A

spleen

38
Q

What type of injury should you assume if patient has trauma and is hypotensive?

A

Abdominal injury

39
Q

Kehr’s Sign

A

Left shoulder pain classically associated with splenic rupture

40
Q

Best radiographic study for abdominal trauma?

A

CT

41
Q

What is the name for the most posterior portion on the right side between the liver and the kidney?

A

Morrison’s Pouch

Disciplines (Emergency) (5 decks)

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