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A - Hippo Vids > Trauma and US > Flashcards

Trauma and US Flashcards

1
Q

What is a normal FHR?

A

120-160

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2
Q

Central cord Injury - what mechanism?

What is the resulting injury?

A

Hyper extension —> Extra Credit

Sensory deficits loss in UE > LE

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3
Q

Pt w/signs and symptoms of basilar skull fracture but negative CT, do what? Why?

A

Emergent Neurosurg consult —> CT is NOT 100% diagnostic

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4
Q

Everything distal to what structure defines anterior urethral injury?

What kind of injury?

A

Urogenital diaphragm

Straddle injury

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5
Q

Where do you place the probe 1st for US FAST exam?

A

RUQ view —> Longitudinal at Anterior axillary line

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6
Q

Posterior urethral injury occurs in what setting?

What else can occur with this injury?

A

Pelvic fracture

Bladder rupture

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7
Q

Widened mediastinum on PA/supine is what?

Upright?

A

8cm

6cm

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8
Q

Anterior cord syndrome what mechanism of injury?

Causes what?

A

Flexion injury —> Free Agent

B/l motor paralysis, loss of pain/temp
2pt tactile and vibration INTACT

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9
Q

Where to start the FAST exam in blunt trauma?

Penetrating trauma?

A

RUQ (Morrison’s pouch)

Cardiac window —> r/o Tamponade

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10
Q

Teardrop fracture can happen in what setting?

What structure will be injured?

A

Diving into a pool

Anterior spinal artery

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11
Q

Aortic dissection what findings on CXR?

A

Widened mediastinum

Obscured aortic knob

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12
Q

What is the NEXUS criteria?

A 
CPAIN —> Cervical midline TTP, Pain-distracting, AMS, Intox, Neuro deficit
No midline C spine tenderness
No EtOH
Normal alertness
No FND
No distracting injury
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13
Q

Where do you perform the pericardial incision?

Relative to phrenic nerve?

A

5th ICS

Vertical, parallel, anterior to phrenic n.

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14
Q

Bike handlebar injury #1 MC?

A

Duodenum

Then pancreas

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15
Q

What is the MC injury in GSW?

Stab wound?

A

Small bowel

Lover

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16
Q

Diaphragmatic injuries occur MC d/t what?
Occur where?

Symptoms?

Dx how?

A

Blunt trauma
T4-T10 (nipple - navel)

sob, cp, abd pain

Laparoscopy w/sx repair, No imaging is sensitive enough

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17
Q

What are the UNSTABLE C-spine fractures?

A 
Jefferson Bit Off A Hangman’s Tit
Jefferson
B/l facet dislocation
Odontoid (2, 3)
Atlanta-occipital/axial dislocation
Hangman
Teardrop
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18
Q

Patient that has b/l facet dislocation had what mechanism of injury?

A

Hyperflexion

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19
Q

What is a Jones fracture?

A

Fracture w/in 1.5cm of 5th metatarsal tuberosity w/out extension distal to 4th-5th intermetatarsal articulation

20
Q

What is pathognomonic for diaphragmatic injury?

What test to do?

A

Coiled NG tube in chest

Laparoscopy

21
Q

Pt with a open book pelvic fracture, treat how?

A

Apply pelvic binder at level of greater trochanter

22
Q

What is a posterior urethral injury?

A

Proximal to diaphragm, due to Pelvic fractures

All the Ps!!!

23
Q

Describe a Teardrop fracture, where is it?

D/t what kind of injury?

Can cause what syndrome?

A

C5 wedge shaped fracture at base of vertebral body

Extreme flexion and axial load, MC d/t diving injury

Anterior cord syndrome

24
Q

How is the oculovestibular reflex tested?

With intact cortex and brain stem, what are the results?

A

Irrigate ear canal w/cold water

Nystagmus away from irrigated ear, slow part towards ear

COWS - cold opposite, warm same

25
Q

When is Nimodipine contraindicated in SAH?

A

When the SAH is d/t trauma

Given in spontaneous SAH to prevent vasospasm

26
Q

What delta pressure indicates compartment syndrome?

A

< 30

27
Q

What is the management of a Jones fracture?

A

Non weight bearing LL cast/splint for 6-8 weeks w/ortho fu

28
Q

What mandibular fracture is the only kind that does NOT require Abx?

Why?

A

Condylar

It is the only one that is CLOSED

29
Q

What muscles does the median nerve control?

A

Meat LOAF

Lumbricals in digits 1+2, Opponens pollicis, Abductor pollicis breves, Flexor pollicis brevis

30
Q

Pt with Brain injury and they give you Vitals look for WHAT?!!??!

A

Cushing Reflex - HTN, bradycardia, irregular respirations

31
Q

Pt w/foreign body in eye that gets a corneal rust ring, what is next step in management?

A

CT orbit

32
Q

DVT US study always performed how? With what probe?

A

Transverse plane, Linear probe or Curvelinear in fat people

33
Q

The common femoral vein divides into what?

What can occur?

A

Superficial and deep femoral vein

Duplication of venous system (1/3 of pts)

34
Q

How do you decipher a pericardial effusion from pleural effusion on US?

A

Pleural effusion will not extend past the descending aorta on PSLX

Pericardial effusion will EXTEND anterior to the descending aorta

35
Q

What are the 2 main landmarks in the perihepatic window?

What else?

A

Glisson’s capsule of liver and Gerota’s fascia

Perinephric fat

36
Q

What is the earliest finding of IUP?

Seen when?

Embryo seen when?

A

Yolk sac

5-6 weeks

6+ weeks

37
Q

When is cardiac activity seen in relation to CRL?

A

> 5mm CRL

38
Q

What size makes the diagnosis of AAA?

Over 90% of them are what?

What size indicates high chance of rupture?

A

> 3cm

Infarenal

> 5cm

39
Q

Describe the flow of urine from out of the kidney

A

medullary pyramids —> minor calyces —> major calyces —> renal pelvis —> ureter —> bladder

40
Q

What is normal optic sheath nerve diameter?

If it is elevated, what can it indicate?

A

< 5 mm

Increased ICP

41
Q

How to tell posterior vitreous detachment from retinal detachment?

A

Turn gain all the way down, PVD will disappear

42
Q

What is McConnell’s sign?

What else will you see in the echo with this sign?

What view to see?

A

Norm/hypokinesis of apical segment of RV free wall WITH hypo or akinesia of the remaining free wall of the RV

Dilated RV

Apical 4CH

43
Q

What is the D sign?

What view?

Indicates what?

A

LV appears as a “D” due to bowing of RV on the intraventricular septum

PSSA

PE, pulm HTN, ARDS, basically right heart strain

44
Q

Jefferson fracture is also called what?

Seen in what kind of injury?

Xray will show what?

A

C1 burst

Axial loading, football spear

Lateral masses are misaligned

45
Q

What is a Chance fracture?

Occurs where?

Need to eval for what else?

A

Flexion-distraction injury

Transverse fx through ant/mid/post columns assoc w/use of a lap belt

Bowel injury

A - Hippo Vids (2 decks)

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