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True Learn Studying 2021 > Trauma Surgery Review > Flashcards

Trauma Surgery Review Flashcards

1
Q

What is a grade I pancreatic injury

A

small hematoma/superficial laceration without duct injury

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2
Q

small hematoma/superficial laceration without duct injury of the pancreas…give grade of injury

A

grade I

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3
Q

What is a grade II pancreatic injury

A

large hematoma/large laceration without duct injury

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4
Q

Grade of following injury: pancreas with large hematoma/laceration without duct injury

A

grade II

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5
Q

Grade III pancreatic injury

A

distal pancreatic laceration/hematoma with duct injury

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6
Q

Grade IV pancreatic injury

A

proximal pancreatic hematoma/laceration with duct injury

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7
Q

Grade V pancreatic injury

A

major disruption of pancreatic parenchyma at head of pancreas

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8
Q

how do you expose a tracheal injury, if its in the distal third of the trachea

A

right posterolateral thoracotomy

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9
Q

how would you expose an injury to the proximal two thirds of the trachea

A

cervical incision

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10
Q

GCS scores for eye opening

A

1 - no eye opening
2- eye opening to painful stimuli
3 - eye opening to voice
4 - spontaneous eye opening

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11
Q

GCS score for verbal

A 
1 - no sound
2 - no words, sound only
3 - non-coherent words
4 - disoriented conversation
5 - normal conversation
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12
Q

GCS score for motor

A

1 - no movement
2 - decerebrate posturing (arms straight out)
3 - decorticate posturing (arms close to chest)
4 - withdrawal from painful stimuli
5 - localization to painful stimuli
6 - follows commands

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13
Q

stress multiplier for TEE in elective surgery

A

1-1.2

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14
Q

stress multiplier for TEE in multiple fractures

A

1.1-1.3

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15
Q

stress multipler of TEE for severe infection

A

1.2-1.6

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16
Q

stress multiplier for TEE in burns

A

1.5-2.1

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17
Q

baseline energy requirement

A

25-30 kcal/kg of ideal body weight

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18
Q

Physiology for hypotension in tension pneumothorax

A

decreased venous return = decreased CO and hypotension

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19
Q

when do you explore a Zone III hematoma in trauma surgery

A

penetrating injury causing a zone III hematoma is always explored

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20
Q

when do you not explore a Zone III hematoma in trauma surgery

A

a blunt injury leading to the hematoma should not be explored…instead you do pelvic packing, fix the bones, and IR to embolize what is bleeding

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21
Q

How do you calculate a delta pressure in an extremity?

A

Diastolic pressure - compartment pressure

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22
Q

What delta pressure would prompt you to consider a fasciotomy?

A

Delta pressure < 20-30 mmHg

23
Q

In what ligament is the splenic artery suspended?

A

splenorenal ligament

24
Q

postsplenectomy hematology picture

A
  • howell jolly bodies, erythroblasts, heinz bodies
  • leukocytosis
  • thrombocytosis
25
Q

how much splenic tissue do you need to keep immunocompetence?

26
Q

four compartments of the lower leg?

A

anterior
lateral
superficial posterior
deep posterior

27
Q

how do you perform 4 compartment fasciotomy?

A
  • lateral incision: 15-18 cm incision 1 cm posterior to fibular head down to superior of Lateral Malleolus
  • anterior incision 15-18 cm incision 3-4 finger breaths posterior to medial edge of tibia
28
Q

What compartments are decompressed with a medial incision in a four compartment fasciotomy?

A

Superficial posterior

Deep posterior

29
Q

Which compartments are decompressed with a lateral incision in a four compartment fasciotomy?

A

Anterior

Lateral

30
Q

what causes upper airway damage in burn injuries?

A

heat from inhaled air

31
Q

what causes distal airway damage in burn victims?

A

inhaled toxins

32
Q

Cattell-Braasch maneuver

A

Right colon mobilized and rotated medially

33
Q

Maddox maneuver

A

left colon mobilized and rotated medially

34
Q

Best way to evaluate for rectal injury in stable patient? After noticing blood at anus

A

CT scan with rectal contrast

35
Q

Why should you be worried about lateral compression pelvic fractures?

A
  • 25% of them are associated with major arterial blood loss
36
Q

Indication for surgical evacuation for Epidural Hematoma?

A

> 1.5 cm in thickness or midline shift > 5 mm

37
Q

Indication for surgical evacuation for Subdural Hematoma

A

> 1 cm in thickness or > 5 mm midline shift

38
Q

Indication for surgical evacuation for Intraparenchymal hemorrhage

A

large clot causing > 5 mm of midline shift

39
Q

Indication for non-operative management of a fracture?

A
  • non-displaced
  • incomplete fracture
  • impacted fractures in elderly patients or those with osteopenia
40
Q

first line treatment for sub glottis stenosis?

A

serial dilations

41
Q

how would you approach a left subclavian artery injury

A
  • left anterior thoracotomy in 3rd intercostal space (proximal control)
  • transverse incision superior to clavicle for distal control
42
Q

which burns tend to need skin/graft coverage?

A
  • deep 2nd degree
  • 3rd degree
  • 4th degree
43
Q

why do deep 2nd degree burns tend to need graft coverage?

A
  • burn reaches dermal appendages, which prevent repithelialization
44
Q

when can you primarily close a GI injury?

A
  • less than a cm in size

- minimal contamination

45
Q

when is it indicated to do a perimortem cesarean section?

A
  • fetus is greater than 24 weeks old

- mother lost pulses within 4 minutes

46
Q

how do you repair a tracheal injury?

A

in one layer with absorbable suture and strap muscle to buttress

47
Q

left-sided medial visceral rotation eponym

A

Mattox maneuver

48
Q

right-sided medial visceral rotation eponym

A

Cattell-Braasch Maneuver

49
Q

right renal artery goes posterior or anterior to IVC?

50
Q

Fall down stairs with motor and sensation deficits in upper extremities, lower extremities are normal

A

Central cord syndrome

51
Q

Bilateral loss of motor, pain and temperature…further down intact vibration and proprioception

A

Anterior cord syndrome

52
Q

Loss of motor vibration and proprioception on one side with loss of pain and temperature on the other side

A

Brown-sequard syndrome

  • lesion on ipsilateral side of motor loss
53
Q

Loss of only proprioception and vibration

A

Posterior cord syndrome

True Learn Studying 2021 (27 decks)

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