Trauma Flashcards
Universal blood donor.
O-negative.
Proportion of PRBCs, FFP, platelets to be transfused in unstable trauma patients
1:1:1
Calcium levels in massive transfusion.
Can be decreased due to citrate binding with calcium.
Lactate level below this indicate adequate resuscitation.
2.5
Physiologic changes in class I hemodynamic shock.
None.
Blood volume loss in class I hemodynamic shock.
Up to 15%
Blood volume loss in class II hemodynamic shock.
15-30%
Increased or decreased systemic vascular resistance in hypovolemic shock.
Increased SVR.
Treatment of neurogenic shock.
Dobutamine or dopamine.
Femur fractures may be converted from ex-fix to IMN in this time period.
3 weeks
Tibia fracture should be converted from ex-fix to IMN in this time period.
10 days
Most common cause of death in pregnancy.
Trauma.
Place all pregnant patients at more than 20 weeks gestation in this period.
Left lateral decubitus.
Why pregnant women placed in left lateral decubitus.
Prevent vena cava compression by gravid uterus.
Intracompartmental pressure within ____ mm Hg of diastatolic pressure indicates compartment syndrome.
30 mmHg
Complications of antivenom administration after snakebite.
- anaphylaxis
2. serum sickness
Duration of treatment of indomethacin for HO ppx.
6 weeks.
IMN bending stiffness related to this function of radius.
Radius cubed (r^3).
IMN torsional stiffness related to this function of radius.
Radius to the fourth power (r^4).
First motor function to return after radial nerve palsy after humerus shaft fx (2).
- Brachioradialis
2. ECRL
Last motor function to return after radial nerve palsy after humerus shaft fx (2).
- EIP
2. EPL
Most common direction of elbow dislocation.
Posterolateral.
Synostosis after BBFA ORIF associated with this.
Single excision.
Galeazzi fx.
Distal third radius fracture with radioulnar dislocation.
Unreducible DRUJ most likely due to this.
Interposition of extensor carpi ulnaris tendon.
Stages of perilunate instability.
- Scapholunate dissociation
- Lunocapitate disruption
- Lunotriquetral disruption
- Lunate dislocation
Differentiates APC2 and APC3 pelvic ring injuries.
APC2 – Posterior sarcoiliac ligaments intact
APC3 – Posterior sacroiliac ligaments disrupted. Complete disruption of SI joint.
Denis sacral fracture zone I.
Lateral to foramen.
Denis sacral fracture zone II.
Through foramen.
Denis sacral fracture zone III.
Medial to foramen.
This pelvic radiograph allows optimal visualization for S1 neural foramen.
Pelvic outlet.
Most common simple acetabular fracture.
Posterior wall.
Most common associated acetabular fracture.
Associated both column.
Axial pelvis CT, this type of acetabular fracture has vertical line.
Transverse or T-type.
Axial pelvis CT, this type of acetabular fracture has horizontal line.
Column fracture.
Posterior wall tab fx ORIF approach.
Kocher.
Transverse tab fx ORIF approach.
Kocher.
Anterior column tab fx ORIF approach.
Ilioinguinal.
Associated both column tab fx ORIF approach.
Ilioinguinal.
This starting point in piriformis entry nails is associated with risk of iatrogenic comminution.
Anterior.
Higher femoral fracture union rate – ream or unreamed nails?
Reamed.
Medial or lateral meniscal tears more common with lateral tibial plateau fractures?
Lateral.
Medial or lateral meniscal tears with medial tibial plateau fracture (Schatzker IV)?
Medial.
In general lateral or medial meniscal pathology more common with tibial plateau fx?
Lateral.
Bone substitute with highest compressive strength.
Calcium phosphate.
Calcium phosphate or autogenous iliac graft with lower rate of subsidence?
Calcium phosphate.
Keep external fixation wires or pins this far from joint to avoid septic knee/
15mm
BMP used for tibial nonunions.
BMP-7.
BMP used as adjuvant for type III open tibia fractures acutely.
BMP-2.
Common malreduction of proximal third tibia shaft fractures.
Valgus and procurvatum (apex anterior).
Use of VAC does or does not change the risk of infection in open tibia fractures?
Does not.
Patchy subchondral radiolucency of talar dome.
Hawkins sign.
Hawkins sign indicates this.
Good blood flow. AVN unlikely.
This type of malunion is most common after talar neck fracture.
Varus due to medial comminution.
Medial or lateral subtalar dislocation more common?
Medial.
If medial subtalar dislocation is irreducible, what is blocking reduction?
Extensor digitorum brevis
If lateral subtalar dislocation is irreducible, what is blocking reduction?
Posterior tibial tendon
Best calcaneus ORIF outcomes in these patients.
Young female nonsmokers with nonlabor jobs.
Eponym of C1 burst fracture.
Jefferson.
Indication for operative treatment of C1 fracture.
Combined lateral mass displacement greater than or equal to 7mm
If atlanto-dens inverval is greater than 3mm.
Transverse ligament injury.
If altanto-dens interval is greater than 5mm.
Both transverse and alar ligaments injured.
Operative treatment of C1 fx w/ incompetent transverse ligament.
C1-2 or occiput-C2 fusion.
Operative treatment of C1 fx w/ transverse ligament intact.
Halo.
Risk factors for nonunion in type II odontoid fractures (5)..
- displacement >5mm
- angulation >10 deg
- posterior displacement
- age >40 yrs
- delayed treatment
Tx of type I odontoid fx.
Rigid cervical orthosis.
Tx of type III odontoid fx.
Halo.
Hangman’s fracture.
Traumatic spondylolisthesis of C2. Bilateral C2 pars fractures.
How many pins for halo traction in adult?
4
Torque to pins for halo traction in adult?
6-8 inch-lb
How many pins for halo traction in children?
8-10
Torque to pins for halo traction in children?
2 inch-lb
Indications for non-operative management of burst fractures.
- kyphosis less than 30 deg
- no neurologic def
- canal compromise less than 50%
- less than 50% loss of body height
Physeal bridge resection with fat interposition used to treat these types of growth arrest.
2cm growth remaining, less than 50% physeal involvement.
Completion of physeal arrest and contralateral epiphysiodesis used to treat this type of growth arrest.
Arrest involving more than 50% of physis.
Cubitus varus malunion consequences.
Cosmetic not functional.
Overgrowth after femur fracture is common in this pediatric age group.
< 10 years old
Incidence of growth arrest after distal femur physeal injury.
30-50%
Tearing of this artery in pediatric tibial tubercle fractures may cause compartment syndrome.
Anterior tibial recurrent artery.
Eponym for SH III fractures of distal tibia.
Tillaux fx.
Salter-Harris type of triplane distal tibia fractures.
SH-IV.
This portion of the distal tibia physis closes last.
Anterolateral.
For triplane fractures, the Thurston-Holland metaphyseal fragment is usually located here.
Posterolateral.