Cushing’s Triad for vital signs
wide pulse pressure
bradycardia
abn resp
neuro status exam should include (4)
Glasgow Coma Scale (15/15)
pupils
sucking reflex (infants)
muscle tone
how to decide for CT?
PECARN, CHALICE, CATCH
or any substance use
low pressure bleed, associated w/ LOC, lingering symptoms
subdural hematoma
subdural hematoma is what kind of bleed
venous bleed
CT findings: crescent-shaped, usually in the parietal area, crosses suture lines
subdural hematoma
CT finding: elliptical shape, doesn’t cross sutures
epidural hematoma
head injury w/ brief LOC –> lucid period –> deterioration
epidural hematoma
bleed of parenchymal & subarachnoid vessels
subarachnoid hemorrhage
CT: small, dense “slivers” of blood in cisterns, sulci, & fissures. Blood in CSF
subarachnoid hemorrhage
blood in CSF?
subarachnoid hemorrhage
epiphyseal separation through the physis
Salter-Harris I
fracture through a portion of the physis but exiting across the metaphysis
salter-harris II
salter-harris mnemonic
Separation Above Lower Thru Reduction
fracture through the physis but exiting across the epiphysis into the joint
salter harris III
fracture through metaphysis, physis, and epiphysis
salter harris IV
crush injury to the physis
salter harris V
non-displaced spiral fracture of the tibia. Inability/refusal to walk
Toddler’s fx
concerns for abuse with which fractures?
multiple healed fxs
corner or bucket handle fracture
femur fracture
spiral fracture
best exam for osteomyelitis
MRI
fever, constant worsening joint pain, warm & swollen joint, pain on ROM, won’t voluntarily move joint at all
acute septic arthritis
difference between acute septic synovitis & transient synovitis
TS is inflammatory- no fever, WBC & ESR can be normal
Kocher criteria for sepsis
WBC > 12,000 ESR > 40 Fever > 101.3 Non-weight bearing on the affected side 2/4 --> Joint Aspiration
Legg-Calve-Perthes disease
Idiopathic avascular necrosis of the femoral head
SCFE
femoral head “slips,” exposes the anterior/superior aspects of the femoral neck
acute or subacute knee (referred) or hip pain in an obese male
on imaging, “the ice cream has fallen off the cone”
SCFE- surgical emergency
