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Patient Care > Trauma 2 > Flashcards

Trauma 2 Flashcards

(73 cards)

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1
Q

Abdominal Cavity Borders

A

Superior: Diaphragm
Inferior: Pelvis
Posterior: Lumbar spine
Anterior: Muscular Abdominal Wall

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2
Q

Peritoneum

A

Lines abdominal cavity
Double-walled structure
Separates abdominal cavity into two parts

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3
Q

Peritoneal Cavity

A

True abdominal cavity

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4
Q

Contents of Peritoneal Cavity

A

Liver
Spleen
Stomach
Small intestine
Colon
Gallbladder
Female reproductive organs

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5
Q

Solid Organs

A

Liver
Spleen
Pancreas
Kidneys
Ovaries

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6
Q

Hollow Organs

A

Stomach
Intestines
Gallbladder and bile ducts
Ureters
Urinary bladder
Uterus and fallopian tubes

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7
Q

Major abdominal blood vessels

A

Aorta
IVC
SVC

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8
Q

Liver

A

Largest organ in abdominal cavity
Commonly injured from penetrating trauma
Referred right posterior shoulder pain

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9
Q

Spleen

A

Upper left quadrant
Injured from blunt trauma
Rich blood supply

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10
Q

Kehr’s Sign

A

LUQ pain radiates to left shoulder
Sign of splenic injury

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11
Q

Retroperitoneal Cavity

A

Space behind true abdominal cavity
Risk of concealed exsanguinating hemorrhage with no early symptoms

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12
Q

Contents of retroperitoneal cavity

A

Abdominal aorta
IVC
Most of duodenum
Pancreas
Kidneys
Ureters
Ascending and descending colon

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13
Q

Cullen Sign

A

Hemorrhagic discolouration of umbilical area due to intraperitoneal hemorrhage

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14
Q

Grey Turners Sign

A

Bruising of one or both flanks indicative of retroperitoneal hemorrhage
Pancreatitis

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15
Q

Axial Skeleton

A

Central axis of the body
Skull, vertebral column, bony thorax

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16
Q

Appendicular skeleton

A

Limbs

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17
Q

Pectoral girdle

A

Bones that attach upper limbs to axial skeleton

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18
Q

Pelvic Girdle

A

Paired bones of the pelvis that attach lower limbs to axial skeleton and sacrum

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19
Q

Critical Factors of Falls

A

Height
Surface
Follow path of energy through body

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20
Q

S/Sx Pelvic Injury

A

Tenderness over pubis upon palpation of one plane, SI joint tenderness, hemiparesis, pelvic ecchymosis, hematuria

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21
Q

Risk of Pelvic injury

A

Internal bleeding, bladder/genital trauma
up to 2000mL blood loss

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22
Q

Diaphysis

A

Long, narrow shaft
Dense, compact bone

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23
Q

Metaphysis

A

Head of bone
Between epiphysis and diaphysis

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24
Q

Medullary canal

A

Contains marrow

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25
Periosteum
Outer fibrous covering Allows for increase in diameter Vascular Nerves
26
Epiphysis
Articulated, widened end Allows bone to lengthen, hyaline cartilage Cancellous bone with red blood marrow Weakest point in child's bone
27
Open Fracture
Wound extends from body surface to fracture site Produced by bones or object causing fracture Infection risk Bone end not necessarily visible
28
Direct Fracture
Break occurs at point of impact
29
Indirect fracture
Force transmitted along bone Injury occurs at some point distant to point of impact
30
Twisting Fracture
Distal limb remains fixed Proximal part rotates Shearing, fracturing occur
31
Avulsion Fracture
Muscle and tendon unit with attached fragment of bone ripped off bone shaft
32
Stress Fracture
Feet secondary to prolonged running or walking
33
Pathological Fracture
Fracture with minimal force
34
Transverse Fracture
Cuts shaft at right angle to long axis Often direct injury
35
Greenstick Fracture
Pliable bone splinters on one side without complete break In children
36
Spiral or twisting fracture
Fx coils through bone like spring Occurs with torsion
37
Oblique fracture
Angle to long axis of shaft
38
Comminuted fracture
Bone broken into 3+ pieces
39
Impacted fracture
Bone ends jammed together Occurs with compression No loss of function
40
Don Juan Syndrome
Fall onto feet Bilateral heel fractures Compression fractures of vertebrae Bilateral Colles' fractures
41
Blood Loss Fractures
Tib/fib: 500 Femur: 1000-1200 Pelvis: 2000
42
Sprains
Stretching, tearing of ligaments surrounding joint Occur when joint is twisted beyond normal range of motion No typical deformity
43
Grades of Sprain
I: Minor + incomplete, stable II: significant but incomplete, intact but unstable III: complete tear, unstable
44
Strains
Tearing, stretching of musculotendonous unit Spasm, pain on movement No deformity, swelling Pain on active movement
45
6 P's of MSK assessment
Pain Pallor Pulselessness Paresthesias Paralysis Polar/Pressure
46
MOA Acetaminophen
Activation of descending serotonergic inhibitory pathways in CNS More antipyretic
47
Side effects acetaminophen
Very safe Number one cause of hepatic toxicity
48
Pts good for acetaminophen
Mild to moderate pain Severe pain co-administered with stronger analgesic
49
Pts not good for acetaminophen
Hepatic dysfunction Drinking alcohol Taken large doses recently
50
Ibuprofen MOA
Inhibits free arachidonic acid conversion to prostaglandins and thromboxane A2s Reduce pain, inflammation and platelet aggregation
51
Side effects Ibuprofen
Ability to form clots Bronchoconstriction/worsening asthma Irritates stomach wall lining Renal toxicity in high doses
52
Ibuprofen good pts
Mild to moderate Severe pain with stronger analgesic
53
Ibuprofen not good pts
Inability to clot, renal failure, asthma/autoimmune symptoms
54
Ketorolac MOA
NSAID similar to ibuprofen
55
Side effects ketorolac
Bronchoconstriction Impaired clotting Compounded with NSAID use
56
Good ketorolac pts
Unable to tolerate oral meds Mild to moderate pain Severe pain with stronger analgesic
57
Precautions Morphine
Resp depression Hypotension N/v Dizziness, mental clouding, sedation Pruritis fro histamine release Bradycardia
58
MoA Morphine
Binds opioid receptors Inhibits ascending pain pathways Alters perception of and response to pain Produces generalized CNS depression
59
Good morphine pts
Moderate to severe pain Cardiac ischemia Going through pre/post reperfusion
60
Bad morphine pts
High tolerance to morphine Weak BP Depressed resp drive
61
Wooden chest
Rapid administration of large doses of fentanyl cause skeletal and thoracic muscle rigidity
62
Fentanyl
Synthetic opioid binding to Mu Works on CNS Concentration greater than morphine Less BP effect
63
1st Degree Burn
Affects epidermis Redness w/o blistering
64
2nd Degree Burn
Burn into dermis May go into glands and hair follicles Redness + blistering
65
3rd degree burn
Entire epidermis and dermis, pale and leathery
66
Minor Burns
2nd degree <15% or <10% ped 3rd degree <2% not involving eyes, ears, face, hands, perineum, feet
67
Moderate Burns
2nd degree 15-20% or 10-20 child 3rd degree 2-10%
68
Major Burns
2nd degree >25% or 20% peds 3rd degree >10% Hands, face, eyes, ears, feet, perineum Inhalation electrical Associated injuries Poor risk pts
69
Parkland formula
4ml/kg/%bsa in first 24 hrs 1/2 in first 8 1/2 in next 16 urine output 30-50ml/hr
70
AC Current
Muscular tetany Locked on May paralyze rest muscles VF arrest
71
Direct Current
Unidirectional flow of electrons Pts thrown aSystole
72
Rhabdomyolysis
Breakdown of striated muscle tissue Direct damage Metabolic Causes Drugs and Toxin CK >1000
73
Complications of rhabdo
myoglobin causes tubular obstruction HyperK Phosphate binds to calcium DIC

Patient Care (11 decks)

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