Trauma Imaging

Question 1

when can you treat a pneumothorax conservatively

Answer 1

when air space is less than 2 cm

Question 2

how can you tell a pnuemonia

Answer 2

as will be less white than pleural effusion

has branching white lines- air bronchograms

Question 3

what is the main indication for an abdominal x ray

Answer 3

obstruction

Question 4

how can you tell if a small bowel is obstructed

Answer 4

if it is wider than 2cm

Question 5

what can be seen in a pneumoperitoneum on abdo x ray

Answer 5

pockets of gas

double wall sign bowel

Question 6

what is a torus fracture

Answer 6

when periosteum remains intact (happens in children)

Question 7

what is a greenstick fracture

Answer 7

when only one side is broken (happens in children)

Question 8

what is an avulsion fracture

Answer 8

fracture where ligament/ tendon attaches

happens commonly in ankle/ knee

Question 9

what is the treatment for a # at the anatomical neck of the humerus

Answer 9

replacement of the humeral head

Question 10

what is the treatment for a # at the surgical neck of the humerus

Answer 10

collar and cuff

Question 11

what fat pad is normal in the elbow

Answer 11

anterior

Question 12

what fat pads suggest a radial head fracture/ a supracondylar fracture

Answer 12

enlarged anterior fat pad (anterior sail sign)

presence of any posterior fat pad

Question 13

what are the features of a colles fracture

Answer 13

common in elderly 
FOOSH
dorsal angulation 
distal radius #
extra articular 
ulnar styloid can be avulsed 
dinner fork deformity

Question 14

what are the features of a smiths fracture

Answer 14

of distal radius
volar angulation
shortening of bones
need manipulation

Question 15

what is the blood supply to the scaphoid

Answer 15

palmar and carpal branches of the radial artery

Question 16

what is the risk in scaphoid #

Answer 16

AVN

Question 17

what are the types of NOF #

Answer 17

intracapsular (within joint capsule)

extracapulsar (intertrochanteric, subtrochanteric)

Question 18

which type of NOF # is at risk of AVN

Answer 18

intracapsular

Question 19

what is the treatment for a intracapsular NOF #

Answer 19

femoral head replacement (hemiarthroplasty)

Question 20

what is the blood supply to the head of femur

Answer 20

femoral artery -> medial and lateral circumflex arteries

Question 21

what is the treatment for an extracapsular NOF #

Answer 21

dynamic hip screw

Question 22

what is seen in a trimalleolar #

Answer 22

# of distal fibula, medial and lateral malleoli of tibia
tibio-talar joint dislocation

Question 23

what GCS do you usually intubate someone

Answer 23

8

Question 24

which investigation should you do first in trauma

Answer 24

always follow ABCDE

e.g. if breathless do a CXR to look for pneumothorax ect

Question 25

is low BP an early or late sign of haemorrhage

Answer 25

late, tachycardia early

Question 26

what is the treatment for a splenic laceration

Answer 26

Splenectomy (loose immune function so need lifelong penicillin, done only in grade 5 injury- involve the hilum of the spleen), splenic artery embolisation, conservative Tx (bed rest)

Question 27

what is the blood supply to the spleen

Answer 27

coeliac trunk- splenic artery (dual supply)

Question 28

what are the branches of the coeliac trunk

Answer 28

common hepatic
left gastric
splenic artery

Question 29

why might a vertebral wedge # look extra white

Answer 29

has been compressed