trauma and burns

Question 1

What are thermal burns due to?

Answer 1

Heat
fire
scoldings
flash
direct contact with hot object

Question 2

Which is thr most powerful UV rays?
a)UVA
b) UVB
c) UVC

Answer 2

a

Question 3

Through what mechanism does radiation burn occur?

Answer 3

contact with radioactive sources found in commercial and industrial settings

Question 4

What are the three types of rays that a patient could be exposed to with radiation burn?

Answer 4

alpha, beta, gamma

Question 5

what is the most dangerous ray a patient can be exposed to? alpha, beta or gamma?

Answer 5

gamma

Question 6

In chemical burns, there is potential for acid or alkali exposure. Which exposure is most severe?

Answer 6

alkali exposure

Question 7

What is the result in the body when exposed to acid?

Answer 7

produces coagulation necrosis by denaturing proteins, forming eschar which limits the penetration of the acid

Question 8

what is the result in the body of exposure to alkali?

Answer 8

liquifaction necrosis involves denaturing of proteins which does NOT limit tissue penetration.
more severe injury

Question 9

parkland formula

Answer 9

4cc x kg x %TBSA burned
fluid administered over 24 hours
1/2 over 8 hours,2nd half over remaining 16 hours

Question 10

Rule of 9s - what are the percentages of parts of body?

Answer 10

head I clouding neck- 4.5% front. 4.5% back
chest - 9% front and 9% back
and abdomen- 9% front and 9% back
upper back - 9% front 9% back
lower back- 9% front and 9% back
upper limb (1)-4.5% front, 4.5% back
lower limb (1)- 9% front and 9% back
genitalia - 1%

Question 11

What are the 3 classifications of burns

Answer 11

superficial burn
partial thickness burn
full thickness burn

Question 12

there are 3 categories of burns. what are the requirements for a MAJOR burn?

Answer 12

25% BSA
Involvement of hands, feet, face, perineum
electrical or inhalation injury

Question 13

what are the four categories of shock?

Answer 13

hypovolemic
distributive
obstructive
cardiogenic

Question 14

causes of hypovolemic shock?

Answer 14

hemorrhage
fluid loss
third spacing of fluid

Question 15

causes of distributive shock

Answer 15

sepsis,neurogenic causes,anaphylaxis, adrenal crisis

Question 16

what are some causes of obstructive shock

Answer 16

pulmonary embolism
tension pneumothorax
cardiac tamponade

Question 17

what are some causes of cardiogenic shock

Answer 17

myocardial infarction, arrhythmia, valvular defects, cardiomyopathy

Question 18

a hypotensive patient in shock may have a reduction in one of 2 things

Answer 18

reduction in stroke volume (low output state )
reduction in systemic vascular resistance (vasodilatory state)

Question 19

what is the trauma triad of death

Answer 19

hypothermia
metabolic acidosis
coagulopathy

Question 20

equation for MAP

Answer 20

MAP= DBP + 1/3 (SBP - DBP)

Question 21

Why are burn patients prone to hypothermia after being cooled?

Answer 21

The skin aids in thermoregulation, and so they lose ability to thermoregulate due to damage to the skin

Question 22

What is the significance of vomiting within 10 mins after radiation exposure?

Answer 22

they will not survive

Question 23

Those with radiation exposure who exhibit vomiting within 1 hour have _______radiation exposure and a ____% to _____% survival

Answer 23

severe
30
80

Question 24

how long do you cool a burn for?

Answer 24

15-20min,

Question 25

the burn wound has 3 zones/ degrees of injury. what are they?

Answer 25

zone of coagulation
zone of stasis
zone of hyperemia

Question 26

You are caring for a patient who was involved in a MVI. You notice a clear fluid coming from the ear, as well as ecchymosis behind the ear. What type of skull injury to you suspect?

Answer 26

basilar skull fracture

Question 27

what is the definition of primary brain injury?

Answer 27

the injury to the brain and it’s associated structures that results immediately from impact to head

Question 28

what are the processes that occur in a secondary brain injury ?

Answer 28

cerebral edema, intracranial hemorrhage, increased ICP, cerebral ischemia, hypoxia, hypoglycemia, hypotension
Also decrease in ATP, and switch to anaerobic metabolism

Question 29

The normal CPP in an adult is 60mmHg. A _______ drop in CPP ______ the chances of death in patient eith brain injury

Answer 29

single

doubles

Question 30

Why does BP go up and HR go down in brain injury?

Answer 30

when brain injured, body’s autoregulatory mechanism shunts more blood to brain, increasing systemic arterial BP and reflex bradycardia.

Question 31

what is myocardial contusion?

Answer 31

-may be minor or asymptomatic
-tachycardia may be present
– sone pts develop conduction abnormalities and/or arrhythmias

Question 32

true or false: ventricular rupture is a form of blunt cardiac injury, and is usually asymptomatic

Answer 32

false! it is usually rapidly fatal.

Question 33

true or false: valve disruption is a form of blunt cardiac injury and my cause heart murmur and manifestations of heart failure

Answer 33

true

Question 34

what is becks triad?

Answer 34

hypotension
jugular vein distention
muffled heart sounds

Question 35

what pathology is becks triad associated with?

Answer 35

acute cardiac tamponade

Question 36

true or false: pericardial effusion is a slow build up of fluid so pericardium can stretch co accommodate fluid, whereas cardiac tamponadr is a sudden accumulation of fluid in the pericardium and it doesn’t have time to stretch

Answer 36

true

Question 37

symptoms of pericardial effusion include:

Answer 37

chest pain
shortness of breathe
compression of nearby structures

Question 38

causes of cardiac tamponade include:

Answer 38

chest trauma - stab wound
ruptured aorta
future of ventricle adapter myocardial infarction

Question 39

what is pulsus paradoxus

Answer 39

exaggerated drop in a patients blood pressure by more than 10mmHg during INSPIRATION