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Fall 2018 Emergency Med > Trauma > Flashcards

Trauma Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

primary survey involves

A 
A	Airway & C-spine protection
B	Breathing & Ventilation
C	Circulation w/ Hemorrhage control
D	Disability/Neurologic status
E	Exposure/Environmental control
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2
Q

how to monitor breathing

A

Inspect for symmetrical chest movements. Auscultate for breath sounds bilaterally. Palpate the trachea for deviation and the chest wall for fractures or emphysema

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3
Q

segment of the rib cage breaks under extreme stress and becomes detached from the rest of the chestwall and moves independently

A

flail chest

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4
Q

where to do a needle decompression

A

2nd ICP MCL

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5
Q

universal blood

A

O-

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6
Q

any hypotensive trauma pt think

A

hemorrhagic shock

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7
Q

GCS EYE

A

4-opens spontaneously
3-opens to speech
2-open to pain
1-none

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8
Q

GCS VERBAL

A 
5-oriented
4-confused
3-inappropriate
2-incomprehensible/mumbling
1-none
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9
Q

GCS MOTOR

A 
6-obeys commands
5-moves to pain
4-moves away from pain 
3-abnormal flexion
2-abnormal extension (decerebrate)
1-none
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10
Q

two parts of an organ accelerate or decelerate at different rates.

A

shear

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11
Q

what vessels can be injured in the scalp?

A

middle meningeal artery or dural sinus

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12
Q

CSF leak
Raccoon Eyes
Battle’s Sign

A

basilar skull fracture

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13
Q

how to tx closed, uncomplicated skull fx

A

Symptomatic management
Observation for 2-3 days
No need for Antibiotics

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14
Q

how to tx basilar skull fx

A

Single dose antibiotic prophylaxis
Do not pack nose or ears to stop CSF leaking (danger of meningitis)
Put patient in semi-sitting position

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15
Q

ICP range

A

10 mm Hg = Normal
>20 mm Hg = Abnormal
>40 mm Hg = Severe

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16
Q

epidural hematoma

A

Blood btw skull & dura

Classic: Tear of middle meningeal artery

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17
Q

subdural hematoma

A

Tears to bridging vessels of cerebral cortex

Rapid surgical evacuation recommended, especially if > 5 mm shift of midline

18
Q

how to dx SAH

A

blood in CSF

19
Q

diffuse axonal injury

A

CT may initially be normal

seen in high velocity impact

20
Q

No gross pathology. Transient LOC. CT Scan is normal

A

concussion

21
Q

Bruising of brain surface underneath a fracture or at under-surface of frontal & temporal lobes, due to shearing forces Seen on CT scan

A

contusion

22
Q

Tearing of brain substance. Seen on CT Scan

A

laceration

23
Q

localized in glial cells, myelin sheaths & intercellular spaces. May cause ICP
**May not be seen initially on CT scan.

A

brain edema

24
Q

severe brain injury GCS score
moderare
mild

A

3-8
9-12
13-15

25
Q

what can you use for severe brain injury with swelling?

A

hyperventilation
hypertonic-preferable
mannitol

26
Q

what should you do with penetrating trauma

A

leave the item in!! get imaging

27
Q

which part of orbit is MC injured?

A

floor

enophthlamos, infraorbital anesthesia, diploplia on upward gaze, stepoff deformity

28
Q

how to control bleeding?

A

pressure!

29
Q

gold standard for detecting source of bleed

A

arteriogram

30
Q

Non accessible injuries or injuries to the vertebral arteries best managed w/

A

anticoag 3 months

31
Q

lesions below ( ) result in paraplegia

A

T1

32
Q

Traumatic flexion & distraction
Most pt’s die of brainstem destruction and apnea or have profound neurologic impairments (ventilator dependent and quadriplegic)
Common cause of death in Shaken baby Syndrome

A

atlanto-occipital dislocation

aka orthopedic decapitation

33
Q

C1 (atlas) fx

A

burst/jefferson
MOI Axial loading
Best seen on open mouth view of C1 & C2 region

34
Q

C1 rotary subluxation

A

Most often seen in children
May occur spontaneously or w/ minor & major trauma
Persistent rotation of the head (torticollis)

35
Q

Hangman fx

A

Posterior elements of C2 (pedicles)
Extension Injury
Anterior dislocation of C2 vertebral body

36
Q

Transverse fractures through vertebral bodies

MOI: MVC crash w/ restraint only by lap belt

A

chance fx

37
Q

Injury to this part of the cord results in bladder and bowel dysfunction as well as decreased sensation & strength to lower extremities

A

T11-L1

38
Q

anterior cord syndrome

A

Complete paralysis below lesion (legs>arms)
Loss of pain & temperature sensation
Preservation of proprioception & vibratory function

39
Q

central cord syndrome

A

Quadriparesis- greater in upper extremities

40
Q

brown sequard

A

Ipsilateral spastic paresis
Loss of proprioception and vibratory sensation
Contralateral loss of pain & temperature sensation

41
Q

neurogenic shock

A

bradycardia
warm skin
nrl urine output

42
Q

hypovolemic shock

A

tachy
cold skin
low urine output

Fall 2018 Emergency Med (6 decks)

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