Trauma Facts Flashcards
volume of circulating blood in adult and child
adult (70 kg male) = ~ 5 L
child 75 mL/kg
Class I shock (% blood loss and pathologic findings)
< 15%, mental status = anxious, all others normal
Class II shock (% blood loss and pathologic findings)
15-30%, HR>100, UOP sightly decreased (20-30 mL/hr) (BP is still normal but pulse pressure narrowed)
Class III shock (% blood loss and pathologic findings)
30-40%, HR>120, now BP is decreased, confused, UOP 5-15 mL/hr
Class IV shock (% blood loss and pathologic findings)
> 40% (2L), HR > 140, aneuric, lethargic
Class of shock table
During the repair process of an unstable fracture, the expression of major collagen types during fracture callus formation can best be characterized by
type II collagen early, followed by type I collagen.
At what time after fracture is there a maximal vascular response (blood flow rate) at the fracture site maximized?
2 weeks
Ebb phase of systemic metabolic response to trauma
cardiovascular instability, alterations in circulating blood volume, impairment in oxygen transport, and heightened autonomic activity
Flow phase of systemic metabolic response to trauma
Hyperdynamic circulatory changes, fever, glucose intolerance (gluconeogenesis), and muscle wasting
During fracture healing, which of the following tissues tolerates the greatest strain before failure?
granulation tissue
serologic tests that are required by the American Association of Tissue Banks (AATB) for musculoskeletal tissue allografts (4)
Hep B
Hep C
HIV
syphillis
releative resorption rates of bone graft substitutes
calcium sulfate > tricalcium phosphate > hydroxyapatite
shelf life for frozen allograft
one year for fresh frozen stored at -20 degrees C
five years for fresh frozen stored at -70 degrees C
indefinite for freeze-dried
levels of energy (percentage over normal) associated amputations:
- Syme
- BKA
- Vascular BKA
- bilateral BKA
- AKA
- vascular AKA
Syme = 15%
BKA = 25% (average)
Vascular BKA = 40%
bilateral BKA = 40%
AKA = 70%
vascular AKA = 100%
kids daily Ca intake
1-3 yo = 500 mg/d
4-8 yo = 800 mg/d
9-18 yo = 1000-1500 mg/d
talus blood supply
posterior tibial artery
- via artery of tarsal canal (most important and main supply)
supplies most of talar body
only remaining supply with a talar neck fracture
- via calcaneal braches
supplies posterior talus
anterior tibial artery
- suplies head and neck
perforating peroneal arteries via artery of tarsal sinus
- suplies head and neck
most common condyle for Hoffa fx
lateral
most common complication TALAR NECK FX
arthritis (2nd is AVN)
most common complication femoral neck fx
AVN (non-union 2nd)
tibia and BMP #
BMP2 (type III open fx)
significantly fewer invasive interventions (e.g., bone-grafting and nail exchange), significantly faster fracture-healing than did the control patients, increased healing (union) rates, fewer hardware failures, fewer infections, and faster wound-healing (83% compared with 65% had wound-healing at six weeks)
BMP 7 (OP1) for nonunion
Clinical and radiographic outcomes were statistically indistinguishable at 9 months between BMP7 vs autograft following treatment and OP-1 avoided donor site morbidity.
SIRS
Heart rate > 90 beats/min
WBC count <4000 cells/mm³ OR >12,000 cells/mm³
Respiratory rate > 20 or PaCO2 < 32mm (4.3kPa)
Temperature less than 36 degrees or greater than 38 degrees
– 2 or more
main artery to the body of the talus
artery of the tarsal canal, which is a branch of the posterior tibial artery
subtalar dislocation blocks to reduction
Medial dislocations (65%) - extensor digitorum brevis
Lateral - posterior tibialis tendon
