Trauma Facts

Question 1

volume of circulating blood in adult and child

Answer 1

adult (70 kg male) = ~ 5 L

child 75 mL/kg

Question 2

Class I shock (% blood loss and pathologic findings)

Answer 2

< 15%, mental status = anxious, all others normal

Question 3

Class II shock (% blood loss and pathologic findings)

Answer 3

15-30%, HR>100, UOP sightly decreased (20-30 mL/hr) (BP is still normal but pulse pressure narrowed)

Question 4

Class III shock (% blood loss and pathologic findings)

Answer 4

30-40%, HR>120, now BP is decreased, confused, UOP 5-15 mL/hr

Question 5

Class IV shock (% blood loss and pathologic findings)

Answer 5

> 40% (2L), HR > 140, aneuric, lethargic

Question 6

Class of shock table

Answer 6

Question 7

During the repair process of an unstable fracture, the expression of major collagen types during fracture callus formation can best be characterized by

Answer 7

type II collagen early, followed by type I collagen.

Question 8

At what time after fracture is there a maximal vascular response (blood flow rate) at the fracture site maximized?

Answer 8

2 weeks

Question 9

Ebb phase of systemic metabolic response to trauma

Answer 9

cardiovascular instability, alterations in circulating blood volume, impairment in oxygen transport, and heightened autonomic activity

Question 10

Flow phase of systemic metabolic response to trauma

Answer 10

Hyperdynamic circulatory changes, fever, glucose intolerance (gluconeogenesis), and muscle wasting

Question 11

During fracture healing, which of the following tissues tolerates the greatest strain before failure?

Answer 11

granulation tissue

Question 12

serologic tests that are required by the American Association of Tissue Banks (AATB) for musculoskeletal tissue allografts (4)

Answer 12

Hep B

Hep C

HIV

syphillis

Question 13

releative resorption rates of bone graft substitutes

Answer 13

calcium sulfate > tricalcium phosphate > hydroxyapatite

Question 14

shelf life for frozen allograft

Answer 14

one year for fresh frozen stored at -20 degrees C
five years for fresh frozen stored at -70 degrees C
indefinite for freeze-dried

Question 15

levels of energy (percentage over normal) associated amputations:

• Syme
• BKA
• Vascular BKA
• bilateral BKA
• AKA
• vascular AKA

Answer 15

Syme = 15%
BKA = 25% (average)
Vascular BKA = 40%
bilateral BKA = 40%
AKA = 70%
vascular AKA = 100%

Question 16

kids daily Ca intake

Answer 16

1-3 yo = 500 mg/d

4-8 yo = 800 mg/d

9-18 yo = 1000-1500 mg/d

Question 17

talus blood supply

Answer 17

posterior tibial artery

• via artery of tarsal canal (most important and main supply)

supplies most of talar body
only remaining supply with a talar neck fracture

• via calcaneal braches

supplies posterior talus

anterior tibial artery

• suplies head and neck

perforating peroneal arteries via artery of tarsal sinus

• suplies head and neck

Question 18

most common condyle for Hoffa fx

Answer 18

lateral

Question 19

most common complication TALAR NECK FX

Answer 19

arthritis (2nd is AVN)

Question 20

most common complication femoral neck fx

Answer 20

AVN (non-union 2nd)

Question 21

tibia and BMP #

Answer 21

BMP2 (type III open fx)

significantly fewer invasive interventions (e.g., bone-grafting and nail exchange), significantly faster fracture-healing than did the control patients, increased healing (union) rates, fewer hardware failures, fewer infections, and faster wound-healing (83% compared with 65% had wound-healing at six weeks)

BMP 7 (OP1) for nonunion

Clinical and radiographic outcomes were statistically indistinguishable at 9 months between BMP7 vs autograft following treatment and OP-1 avoided donor site morbidity.

Question 22

SIRS

Answer 22

Heart rate > 90 beats/min
WBC count <4000 cells/mm³ OR >12,000 cells/mm³
Respiratory rate > 20 or PaCO2 < 32mm (4.3kPa)
Temperature less than 36 degrees or greater than 38 degrees

– 2 or more

Question 23

main artery to the body of the talus

Answer 23

artery of the tarsal canal, which is a branch of the posterior tibial artery

Question 24

subtalar dislocation blocks to reduction

Answer 24

Medial dislocations (65%) - extensor digitorum brevis

Lateral - posterior tibialis tendon

Question 25

AA, cox, prostaglandins pathway

Answer 25

know COX mediates AA to PG-G2