General Trauma Flashcards

(36 cards)

1
Q

what is polytrauma

A

more than one major long bone is injured

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2
Q

major complications of poly trauma are

A

SIRS
ARDS
Multi organ dysfunction syndrome
death

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3
Q

what do intramedullary nails increase the risk of

A

fat embolism

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4
Q

what cells build new bone

A

osteoblasts

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5
Q

difference between healing by primary and secondary intention

A

primary - gap is small and new bone can form spontaneously

secondary - large gaps so this need to be filled to allow healing eg ORIF

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6
Q

describe the types of fractures

A
transverse
oblique
spiral
comminuted
segmental
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7
Q

cardinal features of compartment syndrome

A

increased pain on PASSIVE stretch of muscle
severe pain not explained by clinical context
swollen limb
tender to touch

pulses usually present - absent pulses is a LATE sign

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8
Q

treatment of compartement syndrome

A

fasciotomy

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9
Q

complication of compartment syndrome

A

ischaemic muscle will necrose resulting in a fibrotic contracture known as Volkmann’s ischaemic contracture

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10
Q

describe what neurapraxia means

A

occurs when the nerve has a temporary conduction defect from compression or stretch and resolve over time with full recovery (can take up to 28 days)

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11
Q

describe what axonotmesis means

A

sustained compression or stretch of nerve with subsequent distal axonal death - recovery more variable and may take longer or not recover fully

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12
Q

what is neurotmesis

A

complete transection of nerve - needs surgical repair

usually occurs only in a penetrating injury

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13
Q

nerve injury in colles fracture

A

median nerve

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14
Q

nerve injury in anterior dislocation of the shoulder

A

axillary nerve

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15
Q

nerve injury in humeral shaft fracture

A

radial - wrist drop

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16
Q

nerve injry in supracondylar fracute of elbow

17
Q

posterior dislocation of hip can injury which nerve

18
Q

bumper injury to lateral knee can injure what nerve

A

common peroneal

19
Q

knee dislocation risks injury to what vessel

A

popliteal artery

20
Q

paediatric supracondylar factrure risks injury to what vessel

A

brachial artery

21
Q

should trauma risk injury to what vessle

A

axillary artery

22
Q

how would you asses the vascular status of a limb

A

temperature
colour
pulses
cap refill

if compromised - vascular surgery review

23
Q

signs of excessive skin pressure which could lead to necrosis

A

tenting of the skin

blanching

24
Q

management excessive pressure on the skin

A

reduce fraction as an emergency under analgesia and sedation

25
important complication to the skin in crush or shearing injuries
'degloving' skin is avulsed from blood supplu
26
signs of fracture non union
ongoing pain ongoing oedema movement at fracture sign
27
what is the slowest healing bones in body
tibia - takes 16 weeks to a year :O femoral shaft - takes 2-4 months
28
what is a delayed union
A delayed union is a fracture that has not healed within the expected time
29
commonest cause of delayed union
infection
30
what causes hypertrophic non union
excessive motion at fracture site results in large defective callus infection can also cause
31
causes fo atrophic non union
lack of blood supply chronic disease infection
32
fractures prone to poor healing are
scaophoid distal clavivle subtrochanteric femur fracture jones frature of 5th metatarsal
33
fractures prone to AVN
scaphoid talus femoral neck
34
management of open fracture
IV broad specturm Abx - flucox and gent and met sterile or antiseptic soaked dressing surgical managemetn to debride and stabilised either internally or externally
35
what complete tendon tears need surgically repaire
quadrices patellar as essential for function some others eg achilles or biceps can be managed conservatively
36
management of septic arthritis
joint aspiration IV antibiotics surgical washout