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Y2 Revision > Trauma - CORTEXT > Flashcards

Trauma - CORTEXT Flashcards

1
Q

true or false: when spinal shock occurs, loss of motor function and sensation occurs above the level of the injury

A

false

occurs below the level of the injury

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2
Q

what normal body reflex is absent in spinal shock?

A

bulbocavernosus reflex

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3
Q

describe complete spinal cord injury

A

no sensory or voluntary motor function below the level of injury

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4
Q

describe incomplete spinal cord injury

A

some neurologic function present distal to the level of injury

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5
Q

true or false: the presence of sacral spinal cord sparing in spinal cord injury suggests a better prognosis

A

true

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6
Q

in which age groups are pelvic fractures more common?

A

young patients (high energy trauma)

old patients (osteoporosis)

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7
Q

name the bones that form the pelvic ring

A

sacrum
ilium
ischium
pubic bones

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8
Q

how is the pelvic ring like a polo mint?

A

if it breaks in one place, it will also break in another

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9
Q

what happens in a lateral compression fracture of the pelvis?

A

one half of the pelvis is displaced medially

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10
Q

what happens in a vertical shear fracture of the pelvis?

A

one half of the pelvis is displaced superiorly

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11
Q

what happens in an anteroposterior compression injury of the pelvis?

A

disruption of the pubic symphysis

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12
Q

what neurovascular structures are at risk in pelvic fractures?

A

branches of the internal iliac artery
venous plexus
lumbosacral plexus

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13
Q

true or false: a PR exam is mandatory in pelvic fractures

A

true

to assess sacral nerve root function and to check for blood

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14
Q

what is the most common mechanism of injury in proximal humerus fractures?

A

low energy osteoporotic injury due to FOOSH

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15
Q

what does FOOSH stand for?

A

fall onto out stretched hand

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16
Q

which part of the proximal humerus is most commonly fractured?

A

the surgical neck

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17
Q

in which direction does the humeral shaft usually displace in proximal humerus fractures and why?

A

medially

due to the pull of pectoralis major

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18
Q

what is the mainstay of treatment for proximal humerus fractures?

A

sling immobilisation

internal fixation if there is recurrent displacement

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19
Q

which direction of shoulder dislocation is most common?

A

anterior

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20
Q

what is a Bankart lesion?

A

anterior shoulder dislocation that causes detachment of the glenoid labrum and capsule

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21
Q

what is a hill-sachs lesion?

A

posterior humeral head impacts the anterior glenoid

causes an impaction fracture of the posterior humeral head

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22
Q

which nerve is at risk in shoulder dislocation?

A

axillary nerve

nerves of the brachial plexus

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23
Q

what is the characteristic sign on an x-ray of a posterior shoulder dislocation?

A

lightbulb sign

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24
Q

what is the principle sign of axillary nerve injury?

A

loss of sensation in a badge-patch area

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25
Q

what is the mainstay of treatment for anterior shoulder dislocation?

A

closed reduction under sedation

sling for two to three weeks

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26
Q

describe the relationship between risk of recurrent shoulder dislocation and the age of the patient

A

under 20 = 80%

over 30 = 20%

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27
Q

what is involved in Bankart repair?

A

reattach the torn labrum and the capsule via arthroscopy or open repair

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28
Q

how do injuries of the ACJ usually occur?

A

fall onto the point of the shoulder

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29
Q

in subluxation of the ACJ, what is usually ruptured?

A

the acromioclavicular ligaments

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30
Q

in dislocation of the ACJ, what is usually ruptured?

A

the coracoclavicular ligaments

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31
Q

up to how many degrees of angulation is accepted in a humeral shaft fracture and why?

A

30

the mobility of the shoulder and elbow joint aid union

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32
Q

which nerve is susceptible to injury in humeral shaft fractures?

A

radial nerve

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33
Q

what pathology can be caused by damage to the radial nerve?

A

wrist drop

loss of sensation in the first dorsal web space

34
Q

how are intra articular fractures usually treated?

A

open reduction, internal fixation (ORIF)

35
Q

describe the usual mechanism of injury in olecranon fractures

A

fall onto point of the elbow

contraction of the triceps

36
Q

which direction of elbow dislocation is most common?

A

posterior

37
Q

the forearm acts as a ring due to the ligaments around the radio-ulnar joints, what does this mean for fractures?

A

if one bone fractures, there is usually a fracture in the other bone too

38
Q

what is a nightstick fracture?

A

fracture of the ulnar shaft

39
Q

how is a diaphyseal fracture of both forearm bones treated?

A

ORIF with plates and screws

IM nail if very unstable

40
Q

what is ORIF?

A

open reduction and internal fixation

41
Q

describe a monteggia fracture

A

fracture of the ulna

dislocation of the radial head at the elbow

42
Q

describe a galeazzi fracture

A

fracture of the radius

dislocation of the ulnar at the distal radioulnar joint

43
Q

what is the usual mechanism of injury in distal radial fractures?

A

FOOSH

44
Q

describe a colles fracture

A

extra articular fracture of the distal radius (within an inch of the articular surface), with dorsal displacement

45
Q

which nerve can be damaged in colles fractures?

A

median nerve

46
Q

describe a smith’s fracture

A

extra-articular fracture of the distal radius with volar displacement

47
Q

what treatment should be done for all smith’s fractures?

A

ORIF with plate and screws

48
Q

describe a barton’s fracture

A

intra articular fracture of the distal radius where carpal bones sublux

49
Q

what is another name for a dorsal barton’s fratcure?

A

intra articular colles fracture

50
Q

what is another name for a volar barton’s fracture?

A

intra articular smith’s fracture

51
Q

name two clinical signs of a scaphoid fracture

A

tender anatomical snuffbox

pain on compressing the thumb metacarpal

52
Q

how many x-ray views are taken of a suspected scaphoid fracture?

A

four

AP, lateral and two oblique views

53
Q

how are undisplaced scaphoid fractures usually treated?

A

plaster cast for six to twelve weeks

54
Q

how do fractures of the fifth metacarpal usually occur?

A

punching injury

hence why they are called boxer’s fractures

55
Q

how many degrees of angulation can be tolerated in a boxer’s fracture?

A

up to 45

56
Q

what is the most common cause of hip fractures in the elderly?

A

osteoporosis

57
Q

true or false: the majority of hip fractures occur in males

A

false

58
Q

true or false: nearly all patients with hip fractures have surgery

A

true

59
Q

what are the two broad categories of hip fractures?

A

intracapsular

extracapsular

60
Q

what is the blood supply to the head of the femur?

A

branch of the obturator artery

61
Q

what is the blood supply to the neck of the femur?

A

femoral circumflex artery

62
Q

true or false: the arterial supply of the femoral head is more at risk of disruption in extracapsular fractures

A

false

63
Q

describe the position of an intracapsular hip fracture

A

above the trochanteric line

64
Q

what is the mainstay of treatment for intracapsular hip fractures?

A

hemiarthroplasty

THR

65
Q

true or false: extracapsular hip fractures can be repaired with internal fixation

A

true

if there is a high union rate and low risk of AVN

66
Q

which type of embolism can occur with femoral shaft fractures?

A

fat embolism

67
Q

which type of splint is recommended for femoral shaft fractures?

A

Thomas splint

68
Q

true or false: a knee injury is a surgical emergency

A

true

due to high risk of neurovascular injury

69
Q

which direction do the vast majority of patellar dislocations occur in?

A

lateral

70
Q

true or false: patellar dislocation is more common in females

A

true

71
Q

are proximal tibia fractures intra or extra articular?

A

intra

72
Q

which nerve could be damaged in proximal tibia fractures?

A

common fibular nerve

73
Q

which fracture is the most common cause of compartment syndrome after trauma?

A

tibial shaft fracture

74
Q

what is the extent of displacement and angulation acceptable for conservative management of tibial shaft fractures?

A

up to 50% displacement and 5% angulation

75
Q

what is the most common method for surgical stabilisation of tibial shaft fractures?

A

IM nail

76
Q

what is another name for a distal tibia fracture?

A

pilon fracture

77
Q

how are pilon fractures generally treated?

A

ORIF

78
Q

what is the most common mechanism of injury in ankle fractures?

A

inversion injury

79
Q

name the lateral ankle ligaments

A

anterior talofibular
posterior talofibular
calcaneofibular

80
Q

what is another name for a midfoot fracture?

A

lisfranc fracture

81
Q

describe a lisfranc fracture

A

fracture of the base of the 2nd metatarsal with/without dislocation of other metatarsals at the TMJ’s

82
Q

which tendon is involved in an avulsion fracture of the 5th metatarsal?

A

peroneus brevis

Y2 Revision (95 decks)

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