Trauma: spine and upper limb Flashcards
how can spinal cord or roots be damaged from trauma
contusion, compression, stretch, laceration, vascular disruption and oedema
what is urgent after spinal injury
ATLS primary survey and protection of spine
what is a complete spinal cord injury
no sensory or voluntary motor function below level of injury
how is the level of injury determined in spinal cord injury
dermatomal sensation and myotomal muscle contraction
what is incomplete spinal cord injury
some neurologic function distal to injury eg sacral sparing
what is spinal shock
physiological response to injury resulting in loss of sensation and motor function below injury
how long does spinal shock usually last
24 hours
what is bulbocavernous reflex
reflex contraction of anal sphincter and penis (absent in shock)
what is neurogenic shock
secondary to shutdown of symp outflow T1–> L2
where do neurogenic shock injuries usually occur
cervical or thoracic region
what are symptoms of neurogenic shock
hypotension, bradycardia, priapism (boner)
how do you treat shock from spinal trauma
IV fluid, immobilisation, traction, surgery
why are humeral neck fractures displaced medially
pec major
how do you get humeral neck fractures
FOOSH and osteoporotic bone
what treatment is needed for displaced humeral neck fractures and then communited
internal fixation, TSR
what is a risk of a displaced humeral neck fracture
stiffness and chronic pain
how do you get anterior glenohumeral dislocations
external rotational force on back of shoulder from trauma
what are symptoms of glenohumeral dislocations
loss of symmetry and roundness, loss of sensation in badge area (axillary nerve)
what investigations are needed in glenohumeral dislocations
X ray and neruovascular assessment
how do you treat glenohumeral dislocations (ant and post)
ant: MUA, if fractured ORIF
post: reduction and sling
what are acromioclavicular joint injuries
acromion of scapula and clavicle: sprain, suluxation (acriomioclavicular ligament)
what ligament is injured in an acromioclavicular joint dislocation
coracoclavicular
what nerve can be damaged in humeral shaft fracture and what would a symptom be
radial nerve, wrist drop and loss of sensation in dorsal web
how do you get a olecranon fracture and where is it
fall onto pointed elbow with contracted biceps
how do you treat olecranon fractures
ORIF and wiring
how do you get ulnar shaft fractures and how are they usually treated
direct blow (often self defence), conservative or ORIF if v unstable
what is a monteggia fracture
fracture of ulnar with radial dislocation at elbow (under the eggy elbow)
what is a galezzia fracture
fracture of radius with ulnar dislocation at radioulnar joint (Get wRecked Uhuh)
what investigation is done for a monteggia fracture
elbow x ray
what investigation is done for a gallezia fracture
wrist x ray
what is a colles fracture
extra articular fracture of distal radius - FOOSD
what are risks of colles fracture
medial nerve compression –> carpal tunnel, rupture of extensor pollicus longus
how do you treat colles fracture
splint or ORIF
what is smiths fracture and how do you get it
displaced extraarticular distal radius from falling onto flexed wrist
what is a bartons frature
intra-articular distal radius
what is a classic symptom of a scaphoid injury (ly Annie)
tenderness in anatomical snuff box and pain in thumb
what is mallet finger
avulsion of extensor tendon by forced flexion of DIPJ
how do you get and treat mallet finger
sport injury - mallet splint
how are 3rd 4th and 5th metacarpal fractures commonly acquired
punching
