Trauma + Paeds Flashcards
what does the term triple immobilisation mean?
Collars, block, tape, spinal board
what are the NICE guidelines for CT of the cervical spine?
- GCS <13 or intubated
- abnormal or inadequate radiographs
- polytrauma
- clinical suspicion + patient is:
a. >65 years
b. dangerous mechanism
c. focal neurological deficit
which spinal cord syndrome affects the upper limbs more than the lower limbs?
Central cord syndrome
in what direction to IV discs usually prolapse?
Posterolateral
the joints formed by intervertebral discs are an example of what kind of joint?
secondary cartilaginous joint
what is an example of a primary cartilaginous joint?
epihphyseal cartilage of growing bone
which vertebrae have a bifid spinous process?
Cervical vertebrae
which vertebrae have a transversarium foramen?
Cervical vertebrae
what structures travel within the trasversarium foramen?
Vertebral artery + vein
Sympathetic plexus
what spinal level does the ankle reflex test?
S1/2
what spinal level does the knee reflex test?
L3/4
what spinal level does the triceps reflex test?
C7/8
what spinal level does the biceps reflex test?
C5/6
what is the defining feature of a thoracic vertebrae?
Prescence of facets on sides of the bodies for articulation with heads of ribs + facets on transerve processes
broad laminae are a feature of what vertebra?
Lumbar
lamina connect which structures
spinous processes + transverse processes
what is the lethal triad in trauma patients?
Metabolic acidosis (lactic acidosis)
Hypothermia
Coagulopathy
what classification is used for pelvic fractures?
Young and burgess
young and burgess classifies pelvic fractures based on what?
Mechanism of injury
in a haemodynamically unstable patient with a pelvic fracture despite resuscitation what are the next steps?
Ex-Fix Pelvis/Pelvic Binder
Pre-peritoneal packing
Angiography
Blood stained urine in a patient with a pelvic fracture mandates what investigation?
retrograde cystogram via catheter or retrograde urethrogram if unable to pass catheter
how much saline should be used to irrigate open fractures?
3L of saline for each successive gustilo type:
I - 3L
II - 6L
III - 9L
definitive management of open fractures depends on what 4 criteria of injury?
Fracture
Soft tissue damage
neurovascular compromise
contamination
Why must septic arthritis be managed urgently?
- Risk of septic shock
- Chondrolytic effect of pus
- OSteonecrosis of femoral head
how quickly can articular cartilage be damaged by infection/pus?
8 hours
what approach should be used in open washout of the paediatric hip?
Anterior
