4.2 - TRAUMA Flashcards Preview

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Flashcards in 4.2 - TRAUMA Deck (54):
1

leading cause of death in children and young adults

trauma

2

3 neurosurgical areas

traumatic brain injury
spinal cord injury
peripheral nerve injury

3

open fractures require

Debridement and scalp repair

4

indications for craniotomy

depression > cranial thickness
intracranial hematoma
frontal sinus involvement

5

craniotomy CI in skull fractures like?

dural venous sinus

6

fracture of the temporal bone leading to extravasation of the blood behind the ear

battles sign

7

raccoon eyes
anosmia
rhinorhea results from what fracture?

anterior skull base

8

a drop of fluid into an absorbent tissue. result shows red spot in the middle and surrounding layer

halo test

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if halo test is indeterminate, what test to order?

beta-2 transferrrin testing

10

common tx for CSF leaks

elevate head for several days
lumbar drain

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tx for facial nerver palsies

steroids

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most common type of TBI

closed head injury

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patients with a documented CHI and evidence of intracranial hemorrhage and depressed skull fracture should receive

17mg/kg phenytoin LD
300-400mg/d phenytoin

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peptic ulcers occuring in patients w head injury

cushings ulcers

15

moderate head injury

gcs 9-12

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risk in a patient: headache, dizziness, no loss of consciousness

low risk. can be discharged w/o CT

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risk in a patient: depressed consciousness, changing neuro exam..

high risk. CT and then admit

18

temporary neuronal dysfunction following nonpenetrating head trauma

concussion

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grade concussion based on the colorado grading system
1, px with amnesia
2, lost consciousness

grade2
grade 3

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refers to when brain is more susceptible to minor head trauma in the first 1-2 weeks after concussion

second impact syndrome

21

bruise of the brain, impact causes breakage of small vessels; appear bright on CT

contussion

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contussion occuring in the opposite site of i9njury

contrecoup injury

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two main subtypes of penetrating (CHI)

missile (bullets)
non missile (knife)

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types of intracranial hematomas

epidural
subdural (acute and chronic)
intraparenchymal

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stage wherein EDH subclinically expands

lucid interval (patient is awake)

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EDh rarely occurs in

posterior fossa

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conservative management for EDH when all criteria is met

clot volume

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results from venous bleeding, typically from bridging vein from cerebral cortex to dural sinus

subdural hematoma

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higher risk population to have SDH d/t brain atrophy

elderly and alcoholic

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tor F: SDH cross the midline

F, no d/t falx

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indication for craniotomy in SDH

thickness >1cm
midline shift >5mm
gcs drop of 2pts

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at 2-3 weeks CT scan reading of SDH

hypodense

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hyperdense up to ?

3 days

34

small bleeds that expands the collection

acute - on -chronic SDH

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placed in order to prevent reaccumulation of blood

subdural/subgalcal drains

36

isolated hematomas/ intraparenchymal hemorrhage are d/t?

hypertensive hemorrhage
AV mal

37

indication for craniotomy with IPH

1. clot volume >50cm
2. clot volume >20cm with neuro deterioration (gcs6-8)
3. midline shift >5mm, basal cistern compression

38

violation of the vessel wall intima

dissection

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intradural dissection may present w

SAH

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angiographic abnormality in dissection

string sign

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surgical options for dissection

vessel ligation and bypass grafting

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presents with pulsatile proptosis, , retroorbital pain, loss of normal eye movement

carotid cavernous fistula

43

tx for ccfs

balloon occlusion

44

causes of vertebrobasilar dissection

- sudden rotation of the neck
- chiropractic manipulation
- direct blow to the neck

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Rule of spence

7mm or greater

46

Ondontoid type? Tip only

1

47

C2 is broken

Hangmans fracture

48

Failure of anterior column

Compression fravture

49

Failure of anterior and middle column

Burst fracture

50

Middle and posterior failure

Chance

51

All columns

Fracture-dislocation

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Least severe. Pn injury

Neuropraxia

53

Most severe

Neurotmesis

54

Brachial plexus types

Erb palsy
Klumpke palsy