Trauma + Paeds

Question 1

what does the term triple immobilisation mean?

Answer 1

Collars, block, tape, spinal board

Question 2

what are the NICE guidelines for CT of the cervical spine?

Answer 2

• GCS <13 or intubated
• abnormal or inadequate radiographs
• polytrauma
• clinical suspicion + patient is:
  a. >65 years
  b. dangerous mechanism
  c. focal neurological deficit

Question 3

which spinal cord syndrome affects the upper limbs more than the lower limbs?

Answer 3

Central cord syndrome

Question 4

in what direction to IV discs usually prolapse?

Answer 4

Posterolateral

Question 5

the joints formed by intervertebral discs are an example of what kind of joint?

Answer 5

secondary cartilaginous joint

Question 6

what is an example of a primary cartilaginous joint?

Answer 6

epihphyseal cartilage of growing bone

Question 7

which vertebrae have a bifid spinous process?

Answer 7

Cervical vertebrae

Question 8

which vertebrae have a transversarium foramen?

Answer 8

Cervical vertebrae

Question 9

what structures travel within the trasversarium foramen?

Answer 9

Vertebral artery + vein
Sympathetic plexus

Question 10

what spinal level does the ankle reflex test?

Answer 10

S1/2

Question 11

what spinal level does the knee reflex test?

Answer 11

L3/4

Question 12

what spinal level does the triceps reflex test?

Answer 12

C7/8

Question 13

what spinal level does the biceps reflex test?

Answer 13

C5/6

Question 14

what is the defining feature of a thoracic vertebrae?

Answer 14

Prescence of facets on sides of the bodies for articulation with heads of ribs + facets on transerve processes

Question 15

broad laminae are a feature of what vertebra?

Answer 15

Lumbar

Question 16

lamina connect which structures

Answer 16

spinous processes + transverse processes

Question 17

what is the lethal triad in trauma patients?

Answer 17

Metabolic acidosis (lactic acidosis)
Hypothermia
Coagulopathy

Question 18

what classification is used for pelvic fractures?

Answer 18

Young and burgess

Question 19

young and burgess classifies pelvic fractures based on what?

Answer 19

Mechanism of injury

Question 20

in a haemodynamically unstable patient with a pelvic fracture despite resuscitation what are the next steps?

Answer 20

Ex-Fix Pelvis/Pelvic Binder
Pre-peritoneal packing
Angiography

Question 21

Blood stained urine in a patient with a pelvic fracture mandates what investigation?

Answer 21

retrograde cystogram via catheter or retrograde urethrogram if unable to pass catheter

Question 22

how much saline should be used to irrigate open fractures?

Answer 22

3L of saline for each successive gustilo type:

I - 3L
II - 6L
III - 9L

Question 23

definitive management of open fractures depends on what 4 criteria of injury?

Answer 23

Fracture
Soft tissue damage
neurovascular compromise
contamination

Question 24

Why must septic arthritis be managed urgently?

Answer 24

• Risk of septic shock
• Chondrolytic effect of pus
• OSteonecrosis of femoral head

Question 25

how quickly can articular cartilage be damaged by infection/pus?

Answer 25

8 hours

Question 26

what approach should be used in open washout of the paediatric hip?

Answer 26

Anterior