Trauma & MOI Flashcards
Relationship between venous return and cardiac output
Frank-Starling mechanism/Starling law of the heart
In the context of shock, calcium channel blockers interfere with ___
Vasoconstriction
___ interfere with normal sympathetic response and prevent the heart from pumping harder or faster, which can alter the body’s response to shock
Beta blockers
Anaerobic, toxin-producing bacterium that leads to the development of gangrene
Clostridium perfringens
Dead tissue caused by interruption or cessation of blood supply
Gangrene
2 types of gangrene
Wet & dry
Consensus formula for burn patient fluid resuscitation
2-4 mL x body weight (kg) x TBSA burned
“How many dimes make a dollar” tests function of the ___ in a head trauma patient
Parietal lobe
Speech is processed in the ___ lobe
Temporal
“Seeing stars” or flashes of light upon head trauma indicates possible injury to the ___ lobe
Occipital
Rapidly touching finger to thumb (or any rapid, repetitive motion) tests for dysfunction of the ___
Cerebellum
TBI patients requiring assisted ventilation should be ventilated to maintain an ETCO2 of:
35-40 mmHg
Hyperventilation causes cerebral ___
Vasoconstriction
Patients presenting with S&S of cerebral herniation should be ventilated to maintain en ETCO2 of:
30-35 mmHg
A pt with a crushing injury should be administered ___ prior to removing the crushing object.
High flow O2 & albuterol neb
If a crushing syndrome PT shows signs of EKG changes consistent with hyperkalemia, administer ___ to stabilize the myocardium
Calcium
___ is an increase in core body temperature due to inadequate thermolysis
Heat illness
A PT with dry, hot, possibly sweaty skin, and absent muscle cramping, may be experiencing:
Heat stroke
Muscle cramps paired with pale, cool, moist skin and mild confusion should be considered evidence of:
Heat exhaustion
3 factors contributing to heat cramps
Salt depletion, dehydration, muscle fatigue
___ is contraindicated in PTs with confirmed exercise associated hyponatremia
Administration of hypotonic/isotonic fluids or LR
Destruction of muscle tissue leading to release of K+ and myoglobin
Rhabdomyolysis
Emergency diagnosis of heat stroke typically depends on findings of:
Elevated CBT & AMS
A burn produced by touching a hot object
Contact burn
A form of necrosis that results from the transformation of tissue into a liquid viscous mass (pus)
Liquefaction necrosis
Surrounding structures & accessories of an organ
Adnexa
Le Fort III fracture that involves a fracture of all of the midfacial bones, which separates the entire midface from the cranium
Craniofacial disjunction
Principle mass of a tooth, made up of material much denser than bone
Dentin
Paralysis of gaze or lack of coordination between movements of the two eyes
Dysconjugate gaze
misalignment of the teeth
malocclusion
Inflammation of the mediastinum
Mediastinitis
3rd cranial nerve; innervates the muscles that cause motion of the eyeballs and upper eyelids
Occulomotor nerve
movement of both eyes in unison
sympathetic eye movement
Joint between the posterior condyle and the temporal bone
temperomandibular joint
Traumatic separation of the trachea from the larynx
tracheal transection
Clinical course that usually begins within hours of exposure to radiation
acute radiation syndrome
Cell death typically caused by ischemia or infarction
coagulation necrosis
Formula used to calculate infusion of LR based on body weight
Consensus formula
Surgical cut through a burn to minimize effects of compartment syndrome
escharotomy
“Burn shock”
hypovolemic shock
Detailed version of the “rule of 9’s” chart that accounts for growth
Lund-Browder chart
above the glottic opening
supraglottic
Reddened area surrounding a full thickness burn
zone of coagulation
area least effected by a thermal burn injury where there is increased blood flow
zone of hyperemia
Area surrounding the zone of coagulation that has decreased blood flow and inflammation; may undergo necrosis
zone of stasis
connective tissue within the cavity of a tooth
pulp
Condition that occurs with flexion injuries or fractures, resulting in displacement of bonny fractures into the anterior portion of the spinal cord
anterior cord syndrome
Symptoms of anterior cord syndrome
paralysis below the level of insult; loss of pain, temperature, and touch perception
compensatory physiologic response that occurs in an effort to shunt blood to the brain; manifests clinically as HTN
Autoregulation
The brain’s ability to regulate the diameter of vessels in the brain in response to a wide range of MAPs
autoregulation
Irregular pattern, rate, and depth of respirations with intermittent periods of apnea; results from increased ICP
biot respirations
area of the brain between the spinal cord and cerebrum
brainstem
Condition associate with penetrating trauma; characterized baby hemisection of the cord and complete damage to all spinal tracts on the effected side
Brown-Séquard syndrome
Deep, rapid respirations similar to Kussmaul but without the acetone breath odor; commonly seen after brainstem injury
Central neurogenic hyperventilation
area of the brain involved in fine and gross muscle coordination
cerebellum
Brain injury caused by jarring, does not cause structural damage or permanent neuromuscular impairment
cerebral concussion
focal brain injury in which brain tissue is bruised and damaged in a defined area
cerebral contusion
largest portion of the cerebrum
cerebral cortex
Pressure inside cerebral arteries
cerebral perfusion pressure
gradually increasing rate and depth of respirations followed by a gradual decrease with intermittent period of apnea
Cheyne-Stokes respirations
HTN, bradycardia, and irregular respirations associated with increased ICP
Cushing triad
Abnormal posture of the limbs presenting with extension & rotation of the arms and pointing of the toes
decerebrate posturing
Posturing that indicates increased ICP
Decerebrate posturing
Posturing that indicates decreased ICP
decorticate posturing
Area of skin supplied by a specific sensory spinal nerve
dermatome
Potentially life-threatening injury that presents clinically with massive, uninhibited, uncompensated cardiovasular response
autonomic dysreflexia/hyperreflexia
A PT with SBP >200 and DBP > 130, with cool, pale extremities is likely experiencing:
autonomic dysreflexia syndrome
Spinal cord injury without radiographic abnormalities can occur in children because:
their vertebrae lie flatter on top of each other
___ is an increae in MAP to maintain cerebral blood flow
autoregulation
___ involved stretching, shearing, or tearing of the neuronal extensions
diffuse axonal injury
A PT with possible SCI should be given what kind of medication to prevent secondary injury caused by movement caused by acute agitation
short-acting, reversible sedative
The ___ spinal nerve tract carries information regarding pain and temperature
lateral spinothalamic
As the body ages, the intervertebral discs:
lose water content and become thinner
PTs with diaphragmatic breathing without intercostal muscle use has mostl likely experienced a spinal injury above the level of:
T2
Crescent shaped fold that divides the cerebrum into left and right hemispheres
falx cerebelli
Type of skull fracture most common following high-energy direct trauma to a small surface are with a blunt object
depressed fracture
Type of intracranial hemorrhage most likely to be cause by a penetrating head injury:
intracerebral hematoma
First step in any neurological assessment
Determining the PTs level of consciousness
Portion of the brainstem responsible for maintenance of consciousness
reticular activating system
___ is observed when the toes move upward in response to stimulation of the sole of the foot
positive Babinski reflex
The ___ lobe controls the body’s ability to perceive limb movement
parietal
A subdural hematoma is classified as acute if clinical signs & symptoms develop:
within 48 hours following the injury
Subdural hematoma is classified as subacute when signs & symptoms develop:
between 2-14 days following injury
___ is characterized by motor function loss on the same side, and below the level of cord injury
Brown-Séquard syndrome
Needle thoracentesis should be performed in this location:
Superior to the 3rd rib in the intercostal space at the midclavicular line
Immediate treatment for an open pneumothorax involves:
converting it to a closed pneumothrax (chest seal)
Suspect a pericardial tamponade when a PT has hypotension, JVD, and:
normal breath sounds
Traumatic injuries to the aorta are MOST commonly the result of:
shearing forces
___ is a result of chest wall impact during the critical period of cardiac repolarization
Commotio Cordis
Becuase the diaphragm is protected by the liver, most diaphragmatic injuries occur on the ___ side
left
A massive hemothorax is characterized by:
more than 1,500 mL of blood within the pleural space
PTs with suspected tracheal tear should be managed with what airway technique?
The least invasive possible
In a pericardial tamponade, blood collects between the ___ and ___
visceral and parietal pericardium
Generalized abdominal pain following rupture of a hollow organ would be most suggestive of:
diffue peritoneal contamination
Anatomically, the abdominal cavity extends from the:
diaphragm to the pelvis
Membranous tissue that acts as the attachment point for various abdominal organs
messentary
Fractures of the lower rib cage should make you MOST suspicious of injuries to the:
liver or spleen
Most abdominal injuries involve:
blunt trauma
When bloos is released into the peritoneal cavity, nonspecific signs such as ___ may occur
tachycardia & hypotension
Fournier gangrene is a potential complication associated with:
scrotal lacerations
Immediate pain from the heel to the calf and a sudden inability for plantar flexion is MOST indicative of:
Achille tendon rupture
Typically the first complaint in a PT who is developing compartment syndrome:
Disproportionate pain
6 P’s of musculoskeletal injury assessment:
Pain, Pallor, Parasthesias, paralysis, pulselessness, Pressure
“Silver Fork” fracture
Colles fracture
Bilateral closed femur fractures can result in internal blood loss of up to: ___ mL
3,000
___ fracture occurs at an angle across the bone and is typically caused by direct or twisting force
Oblique
Pain and tenderness in the anatomic snuffbox is a classic finding in fractures of the ___ bone
scaphoid
___ fractures are generally caused by low-energy trauma an are typically not associated with deformity
Nondisplaced
Blood loss in a unilateral closed femur fracture may exceed ___ before enough pressure develops to tampnade the bleeding
1,000 mL
Wrist drop following a midshaft humeral fracture should raise suspicion of ___
radial nerve injury
Bleeding disorder in which clotting does not occur or occurs insufficiently
Hemophilia
Trauma triad of death
Hypothermia, coagulopathy, and acidosis
Black and blue mark caused by disruption to the small vessels in the dermis
Ecchymosis
Collection of blood beneath the skin
Hematoma
___ occurs because of prolonged compressive forces that impaired muscle metabolism
Crush syndrome
Injury resulting from a piercing object
Puncture wound
Avulsion involving the complete or partial loss of a body part
Amputation
Normal ICP range
5-15 mmHg
Normal MAP range
85-95 mmHg
Normal CPP range , determined by normal MAP and ICP
70-90 mmHg
Excessive fluid in the pericardial sac
Cardiac tamponade
Classic combination of physical findings in 10-40% of patients with cardiac tamponade
Beck’s triad
Signs include muffled heart tones, hypotension, and JVD
Beck’s triad
Hypotension and distended neck veins in the presence of normal lung sounds indicates:
Cardiac tamponade
Hypotension and distended neck veins in the presence of absent or diminished lung sounds indicate:
Pneumothorax
Pathologic condition characterized by restricted cardiac contraction, falling CO, and shock
Cardiac tamponade
