Trauma cont. Flashcards
What are the Retroperitoneal Organs?
SAD PUCKER
- Suprarenal glands
- Aorta
- Duodenum (middle parts)
- Pancreas (except tail)
- Ureters
- Colon (Ascending/Descending)
- Kidneys
- Esophagus
- Rectum
With Hip Rocking, how will a pelvis fracture present?
Mobile pelvis
What is the treatment for a Pelvic Fracture?
Temporary binder or possible Internal Fixation
If there is associated bleeding due to a Pelvic Fracture, what are some (3) treatment options?
Preperitoneal packing
Angiography and Angioembolization
Laparotomy
How may a Ureter Injury present?
Expanding hematoma or there will be extravasation of contrast with a CT
What 2 tests can be obtained for a possible Ureter Injury?
CT IV Delayed
Cystoscopy
Where do Bladder Ruptures usually occur?
Dome of the bladder
What is the main symptom with a Bladder Rupture?
Hematuria
What 2 tests can be obtained to assess for a Bladder injury?
Retrograde Cystography
Cystoscopy
If there is intraperitoneal bleeding with a bladder injury, what is the treatment? Extraperitoneal?
Intraperitoneal – surgery
Extraperitoneal – usually self resolves
What portion of the Urethra is usually injured?
Membranous portion – not protected by prostate
What are 4 signs of a Urethral injury?
- Blood at tip of meatus
- High-riding prostate
- Perineal bruising
- Unable to void
What are 4 signs of a Urethral Injury?
- Blood at tip of meatus
- High-riding prostate
- Perineal bruising
- Unable to void
What test should be done to assess for Urethral Injury?
Retrograde Urethrogram
If the Urethral injury is low grade, what is the treatment?
Transurethral catheter
If the Urethral Injury is high grade, what is the treatment?
Suprapubic catheter placement +/- surgery
If you do not fix a severe Urethral Injury, what is the patient at risk for?
Stenosis of the urethra
What are hard signs that a penetrating trauma caused an arterial injury? (3)
- Pulsatile bleeding
- Absent pulses
- Expanding hematoma
What 2 things may be felt/heard with a severe arterial injury from penetrating trauma?
Palpable thrill
Audible bruit
If a patient is presenting with hard signs of an arterial injury, what is the treatment?
OR immediately
What are the soft signs of an arterial injury from penetrating trauma?
- Bleeding
- Asymmetric pulses
- Non-expanding hematoma
What diagnostic should be obtained if soft signs of an arterial injury are present?
CTA
If there is penetrating trauma but no real signs, how can you assess if there may be an arterial injury?
ABI
How will the leg look with a femur fracture? Femur dislocation?
Fracture = Leg shortened and ER
Displaced = IR
Intracapsular femoral fracture involves the head and neck. It must be fixed with ______ and there is risk of?
Prosthetic
–> AVN of the femoral head
Intertrochanteric femoral fractures are fixed with?
Plates and screws
Subtrochanteric/Diaphyseal femoral fractures are fixed with?
Medullary rods
What symptom will those with a Scaphoid fracture present with?
Pain at the anatomic snuffbox
If a patient is presenting with pain at the anatomic snuffbox, what is the likely diagnosis?
Scaphoid fracture
The scans may be negative with Scaphoid fractures, thus if a patient has pain at the anatomic snuffbox, what is the treatment?
Cast
How will the arm look with an Anterior shoulder dislocation?
Elbow ADDucted
Humerus ER
Elbow adducted and Humerus ER
Anterior shoulder dislocation
What is a possible complication of an Anterior shoulder dislocation?
Axillary nerve compression –> deltoid paresthesia
What can cause a Posterior shoulder dislocation?
Electrical shock/seizure/lightening strike
How will the arm look with a Posterior shoulder dislocation?
Elbow ADDucted
Humerus IR
Elbow adducted and Humerus IR
Posterior shoulder dislocation
How do Scaphoid fractures occur and why are they dangerous?
FOOSH
– watershed area!
With the fracture of the femur or other long bones, what is a possible complication?
Fat Embolism syndrome
3 signs of Fat Embolism Syndrome following a long bone fracture?
Respiratory distress
Confusion
Petechial rash
3 signs of Fat Embolism Syndrome following a long bone fracture?
Respiratory distress
Confusion
Petechial rash