chapter 12 trauma Flashcards
1
Q
Trauma is the most common cause of death for ages____ to ___
A
1 -44 yrs old
2
Q
Before a trauma victim is transported , what 3 actions must take place to avoid displacing fractures
A
- Establish a clear airway
- Control acute bleeding
- immobilize the patient
3
Q
The primary hospitals in the trauma system are ______
A
Level 1 trauma centers
4
Q
What are key elements of a level 1 trauma center
A
- 24 hr. coverage by general surgeons
2. other specialty care includes: ortho, neuro, anesthesiology etc
5
Q
____ are the most common trauma facility serving as a community trauma center
A
level 2
6
Q
Does a level 2 trauma hospital provide cardiac surgery, hemodialysis or microvascular surgery
A
no, only level 1
7
Q
___ Trauma Center is capable of providing total care for every aspect of injury – from prevention through rehabilitation.
A
level 1 trauma center
8
Q
is able to initiate definitive care for all injured patients.
A
level 2 trauama center
9
Q
_____ Trauma Center has developed transfer agreements for patients requiring more comprehensive care at a Level I or Level II Trauma Center
A
level 3 trauma center
10
Q
What is the primary means of evaluating skeletal trauma
A
conventional radiography
11
Q
Dual or sharp pain in the posterior neck is a primary manifestation of _____
A
Whiplash injury
12
Q
____ fractures are the most frequent type of injury involving a vertebral body
A
compression fracture
13
Q
fracture of 2nd cervical vertebra
Arch
AKA: _____
A
hangman’s fracture
aka traumatic spondylosis
14
Q
a non-medical term describing a range of injuries to the neck caused by or related to a sudden distortion of the neck associated with extension.
A
whiplash
15
Q
Define Hangman’s fracture
Aka:_____
A
*** aka: traumatic spondlyosis
fracture of arch of second vertebral body
associated with anterior subluxation of c2-3
16
Q
Hangman’s fracture is associated with _____.
A
subluxation of C2-3
17
Q
vertebral arch Burst fracture of the C1
A
Jefferson’s fracture
18
Q
what is the jefferson’s fracture
A
vertebral arch burst of C1
19
Q
The spine is vizualized as 2 columns
1.
2.
A
- Anterior = vertebral body and intervertebral disk
2. posterior column = posterior elements ) spinous process and lamina
20
Q
If just one column of the spine is fractured , it is considered
A
stable
21
Q
If both columns of the spine are fractured it is considered
A
unstable
22
Q
what are the 3 classifications of cerebral cranial fractures
A
- Linear
- Depressed
- Basilar
23
Q
straight, sharply defined, nonbranching lines describe which type of fracture
A
Linear fracture
24
Q
Define linear fracture
A
Straight,
sharply defined
non-branching lines of the skull
25
curvelinear density in which the fracture edges overlap describes which fracture
depressed fracture
26
define depressed fracture
Skull fracture that is depressed inward
27
fracture of bones of the base of the skull that can involve the occipital bone, sphenoid, ethmoid or temporal bones.
Basilar skull fracture
* radiographic sign: air fluid level in sphenoid sinus or clouding of mastoid air cells
28
Which pathology is present when air fluid level is seen in a sphenoid sinus or clouding of mastoid air cells are seen
Basilar skull fracture
29
Which radiographic exam is crucial when there is a suspected basilar fracture
x-table skull
30
Damage to the brain that results from accerleration and rapid deceleration of the head is known as
closed head injury
| aka: traumatic brain injury ( TBI )
31
Brief loss of unconsciousness which results in headache, vomiting and vertigo
Concussion
32
Define concussion
Brief loss of conciousness due to a blow to the head
Can cause headache, vomiting and vertigo
33
bruising of brain parachyma
contussion
| - more dangerous than a concussion
34
define contussion
bruising of brain parachyma
35
contusion formed on the side of the head where the trauma occurs
coup lesion
36
define coup lesion
contussion formed on the side of the head where the trauma occured
37
contussion formed on oppisite side of the skull of trauma
contrecoup lesion
38
____ are characterized by neuron damage, edema and pinpoint puncture or depressions
contussion
| bruising the brain parachyma
39
Persistence of loss of consciousness for more than 24 hrs.
coma
40
define coma
loss of consciousness for more than 24 hs.
41
collection of blood
what are the 4 types
hematoma
- 4 types:
1. epidural
2. subdural
3. Subarachnoid
4. intracerebral
42
# define hematoma
exam to diagnose
collection of blood
CT scan
43
what are the 4 types of hematomas
1. epidural
2. subdural
3. Subarachnoid
4. intracerebral
44
____ hematoma results from a torn artery with blood pulling between the skull and dura matter
epidural hematoma
45
___ follows blunt trauma. It is positioned between the dura matter and the arachnoid meningeal layers
subdural hematoma
46
___ oocurs at the vertex. It accumulates between the arachnoid layer and the pia matter
subarachnoid hematoma
47
this hematoma results from trauma and non traumatic causes
intracerebral hematoma
48
Discontinuity of bone caused by mechanical forces applied to the bone or transmitted along the line of a bone
fracture
49
# define fracture
exam to dx
discontinuity of bone caused by mechanical forces applied to the bone or transmitted directly along the line of a bone
- xray
50
during trauma x-rays, why are 2 projections needed at 90 degrees apart from each other
to determine fracture alignment
51
when is a fracture considered to be in " good alignment"
1. when there is no angulation of displacement in both frontal and lateral projection
52
define delayed union
term for when a fracture does not heal within a usual time
53
term for when a fracture does not heal within a usual time
delayed union
54
fracture that heals in a faulty position which affects the function and cosmetic appearance
malunion
55
define malunion fracture
fracture that heals in a faulty position which affects the function and cosmetic appearance of the part
56
fracture in which healing does not occur and fragments do not join
nonunion fracture
*most serious form*
57
define nonunion fracture
fracture in which healing does not occur and fragments do not join
58
fracture in which the bone has penetrated the skin
open fracture
| aka compound fracture
59
another word for compound fracture is ___
define
open fracture
Fracture that penetrates the skin ( requires surgical intervention to clean out bacteria that may enter through the broken skin)
60
Fracture in which it does NOT penetrate the skin
closed fracture
| aka : simple fracture
61
define closed fracture
fracture in which the bone does not penetrate the skin
62
list the fractures that are classified according to the mechanics of stress that produce the break
1. Torsion ( twisting)
2. Transverse
3. Linear
4. Spiral
63
when one fractured bone is jammed into another fragment it is known as
impacted fracture
64
define impacted fracture
when one fractured bone is jammed into another fracture
65
List the fractures as classified according to their location
1. intertrochanteric
2. Transcervical
3. Supracondylar
4. Transcondylar
66
why do fracture do not fit into a specific classification ?
because they are often mixed fractures
67
What is the choice of treatment for closed and non-displaced fractures
splinting, casting or both
68
reduction in which anesthetic is given for pain and then a splint or cast is applied
closed reduction
69
reduction is required when orthopedic hardware is needed to maintain fracture reduction
open reduction
aka ORIF
Open reduction internal fixation
70
What does ORIF stand for
open reduction internal fixation
71
Fracture in which the bone is splintered or crushed
Communited fracture
72
Fracture in which the bone has separated into 2 fragments
complete non communicated fracture
73
# Define Complete non communicated fracture
list examples:
fracture in which the bone has separated into 2 fragments
1. Spiral/ Oblique
2. Transverse
3. Pathologic
74
fracture that results from a rotary type of injury that twist the bone apart
- common in shafts of bones
Spiral / oblique fracture
Classificaiton of complete, noncomminuted fracture
75
Ragged along a fracture line
which type of classification is it
transverse fracture
classification of complete, non comminuted fracture
76
transverse fracture that occurs in abnormal bone that is weakened by disease
Pathologic fracture
classification of complete, non comminuted fracture
77
fracture in which a fragment of bone is pulled away from the bone
Classifcation
avulsion fracture
- occurs around joints
Traumatic
78
define avulsion fracture
fracture in which a fragment of bone is pulled away from the bone
- occurs around joints
79
fracture in which cortex breaks on one side without separation or breaking on the opposite side
greenstick fracture
- type of incomplete fractures
80
define greenstick fracture
fracture in which cortex of a bone breaks on one side with out breaking on the other side
- type of incomplete fracture
81
aka buckle fracture
| - is a greenstick fracture in which the cortex bulges outward producing a slight iregularity
Torus fracture
| type of incomplete fracture
82
define torus fracture
aka buckle fracture
Greenstick fracture in which the cortex bulges outward
83
fractures that involve the ends of long bones of a child
growth plate fracture
84
define growth plate fractures
fracture that involve the ends of long bones of a child
85
fracture that occurs as a result of abnormal degree of repitive trauma
stress fracture
86
define stress fracture
fracture that occurs from an abnormal degree of repitive trauma
87
maximal strain on a bone from unaccustomed activity
fatigue fracture
88
define fatigue fracture
maximal strain on a bone from unaccustomed activity
89
Fracture that has clinical signs but no radiological evidence , 10 day follow up will show bone reabsorption or displacement at the fracture site
occult fracture
90
define occult fracture
Fracture that has clinical signs but no radiological evidence , 10 day follow up will show bone reabsorption or displacement at the fracture site
91
fracture of the distal radius
what is the radiographic appearance
colle's fracture
radiographic appearance= dinner fork
92
define colle's fracture
fracture of distal radius
radiographic appearance= dinner fork
93
A colle's fracture with displacement of fragment towards the palmer aspect of hand
Smith's fracture
94
Fracture of the 5th metacarpal as a result of blow to or with the hand
Boxer's fracture
95
Define boxer's fracture
Fracture of the 5th metacarpal as a result of blow to or with the hand
96
fracture and dislocation of the 1st metacarpal joint
Bennett fracture
97
what is a Pott fracture
fracture to both malleoli with dislocation of the ankle joint
98
fracture to both malleoli with dislocation of the ankle joint
Pott's fracture
99
what is a trimalleolar fracture
fracture of the medial and posterior malleoi of tibia
and
lateral malleolus of fibula
100
Severe ankle sprain with fracture of proximal third of fibula
maisonneuvre fracture
101
Term for fractures of facial bones
visceral cranial fractures
102
what does the tripod fracture consists of
1. Frontal bone
2. Temporal bone
3. Maxillary bone
103
what is the most common site of fracture of the mandible
the angle
104
horizontal fracture of the maxilla that results in a freely movable jaw
Le fort I
105
pyramidal mandible fracture that results in a triangular separation of the maxilla
Le Fort II
106
Transverse mandible fracture that is the most serious as is extends across the orbits
Le Fort III
107
Direct blow to the front of the orbit that transfers the force to the orbital walls and the floor
Blow out fracture (occurs on the orbital floor)
108
what is the thinnest and weakest point of the orbit
Orbital floor
109
The most frequently fractured facial bone
nasal bones
110
what is the nasal septum composed of
1. vomer
| 2. perpendicular plate of the ethmoid bone
111
injury to a joint in which bone is out of its joint and not in contact with its normal articulation
dislocation
112
define dislocation
joint dislocation results bone is out of its joint and not in contact with its normal articulation
113
partial dislocation often occurring with fracture
subluxation
114
define subluxation
partial dislocation often occurring with fracture
115
what are the common sites for dislocation
1. Shoulder
2. Hip
3. acromioclavicular joints
116
shoulder dislocations most commonly dislocate _____
anteriorly
| = humeral head located below the glenoid fossa and the coracoid process
117
compression fracture of the humeral head
hill-sachs deformity
118
Hip dislocations- femoral head is most commonly displaced
posteriorly in which it lies against the sciatic notch
119
acromioclavivular joint separation are most commonly seen in ____
children
120
term associated with physical form of child abuse
AKA: ______
battered child syndrome
aka
non accidental trauma
121
what are the physical signs of child abuse
1. Burns
2. Bruises
3. Fractures
all in various stages of healing
122
severe type of physical abuse that affects the child head and neck
shaken baby syndrome
123
bone death from insufficient blood supply
avascular necrosis
124
common form of avascular necrosis affecting the femoral head
* classification ___
Legg-Calve Perthes disease
* Traumatic
* x-ray
125
Free air trapped in the plueral space and compresses lung tissue
pnuemothroax
126
Incomplete expansion of the lung as a result of partial or total collapse
Classification??
atelectasis
Traumatic
It is not a disease but a sign of an abnormal process
127
air collection of the peritoneal cavity
pneumoperitoneum
radiographic appearance= foot ball sign
128
radiographic appearance of foot ball sign
pnuemoperitoneum
