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MSK Week 4 > Trauma > Flashcards

Trauma Flashcards

1
Q

what type of shock do trauma victims experience?

A

hemorrhagic

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2
Q

what is main cause of hemorrhagic shock?

A

hypovolemia

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3
Q

what happens to HR in hemorrhagic shock

A

increases

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4
Q

what happens to SV in hemorrhagic shock?

A

decreases

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5
Q

what happens to PVR in hemorrhagic shock?

A

increases

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6
Q

why does PVR increases in hemorrhagic shock?

A

bc it needs to maintain flow to brain and heart, not rest of body

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7
Q

what percent of blood loss leads to SBP changes?

A

30-40%

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8
Q

what class of hemorrhagic shock is where BP starts to change?

A

class III….1 and II are normal

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9
Q

what is the lethal triad of hemorrhagic shock?

A

acidosis
hypothermia
coagulopathy

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10
Q

what are the two main stimuli of hormone release in trauma?

A

afferent pain nerve stimulation and hypovolemia baroreceptor response

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11
Q

name the seven hormones released in trauma

A 
renin
aldosterone
epi/norepiv
vasopressin
growth hormone
glucagon
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12
Q

when you give fluids what can happen in trauma situation?

A

if giving lots can have 3rd spacing where fluid accumulates anywhere its not supposed to like face and lungs

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13
Q

name five local mediators released in trauma

A

histamine and serotonin
prostaglandins
complement proteins
endotoxins

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14
Q

what do the local mediators of trauma help with?

A

local hemostasis, inflammation and repair

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15
Q

what three issues do local mediators cause in trauma

A

DIC
hypoxemia
acidosis
cellular damage

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16
Q

what are the four metabolic changes in trauma?

A

hyperglycemia
catabolism
fatty acid mobilization
acidosis

17
Q

does nitrogen excretion go up or down with trauma?

A

way up!

18
Q

what are stress radiographs used for?

A

evaluation of joint stability

19
Q

what is the contrast study of the spine called?

A

myelogram

20
Q

what is the contrast study of the joint called?

A

arthrogram

21
Q

on bone scans…how does healing bone appear after fracture?

A

HOT…lights up

22
Q

is avascular necrosis hot or cold on bone scan?

A

cold…doesnt light up

23
Q

will you see stress fracture on an xray? what about bone scan?

A

not on x ray but will see it on bone scan

24
Q

what is difference in open versus closed fracture?

A

closed means no skin break and open means skin break

25
Q

what is difference in simple and comminuted fractures?

A

simple is clean break and comminuted is sorta shattered

26
Q

what are the four Rs of fracture treatment?

A

recognition
reduction
retention
rehab

27
Q

what are three cases where you have to do open and not closed reduction of a fracture?

A

precise reduction is required like intraarticular fracture

when surgery is needed for function anyway

28
Q

what are four ways to achieve retention of reduction?

A

traction
cast/brace
external fixation
internal fixation devices (plates and screw)

29
Q

when does primary bone healing occur?

A

when there is no motion at the bone fracture site

30
Q

does primary bone healing lead to a callus?

A

NO

31
Q

how does primary bone healing occur?

A

osteoclasts cut through the fracture site and blasts fill it with matrix

32
Q

when does secondary bone healing occur?

A

healing in fractures that have some motion but not enough to totally disrupt the fracture

33
Q

does secondary bone healing lead to a callus?

A

YES

34
Q

describe the process in secondary bone healing

A

bridging periosteal soft tissue forms with hard tissue…callus is formed and you get endochondral ossification

35
Q

what three issues can arise if bone does not heal properly?

A

malunion
nonunion
pseudoarthrosis

36
Q

what is malunion?

A

healing of fracture in nonanatomic position

37
Q

what is nonunion?

A

failure to regenerate any new bone and heal fracture at all

38
Q

what is pseudoarthrosis?

A

formation of false joint

MSK Week 4 (8 decks)

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