Trauma cont.

Question 1

What are the Retroperitoneal Organs?

Answer 1

SAD PUCKER
- Suprarenal glands
- Aorta
- Duodenum (middle parts)
- Pancreas (except tail)
- Ureters
- Colon (Ascending/Descending)
- Kidneys
- Esophagus
- Rectum

Question 2

With Hip Rocking, how will a pelvis fracture present?

Answer 2

Mobile pelvis

Question 3

What is the treatment for a Pelvic Fracture?

Answer 3

Temporary binder or possible Internal Fixation

Question 4

If there is associated bleeding due to a Pelvic Fracture, what are some (3) treatment options?

Answer 4

Preperitoneal packing
Angiography and Angioembolization
Laparotomy

Question 5

How may a Ureter Injury present?

Answer 5

Expanding hematoma or there will be extravasation of contrast with a CT

Question 6

What 2 tests can be obtained for a possible Ureter Injury?

Answer 6

CT IV Delayed
Cystoscopy

Question 7

Where do Bladder Ruptures usually occur?

Answer 7

Dome of the bladder

Question 8

What is the main symptom with a Bladder Rupture?

Answer 8

Hematuria

Question 9

What 2 tests can be obtained to assess for a Bladder injury?

Answer 9

Retrograde Cystography
Cystoscopy

Question 10

If there is intraperitoneal bleeding with a bladder injury, what is the treatment? Extraperitoneal?

Answer 10

Intraperitoneal – surgery
Extraperitoneal – usually self resolves

Question 11

What portion of the Urethra is usually injured?

Answer 11

Membranous portion – not protected by prostate

Question 12

What are 4 signs of a Urethral injury?

Answer 12

• Blood at tip of meatus
• High-riding prostate
• Perineal bruising
• Unable to void

Question 13

What are 4 signs of a Urethral Injury?

Answer 13

• Blood at tip of meatus
• High-riding prostate
• Perineal bruising
• Unable to void

Question 14

What test should be done to assess for Urethral Injury?

Answer 14

Retrograde Urethrogram

Question 15

If the Urethral injury is low grade, what is the treatment?

Answer 15

Transurethral catheter

Question 16

If the Urethral Injury is high grade, what is the treatment?

Answer 16

Suprapubic catheter placement +/- surgery

Question 17

If you do not fix a severe Urethral Injury, what is the patient at risk for?

Answer 17

Stenosis of the urethra

Question 18

What are hard signs that a penetrating trauma caused an arterial injury? (3)

Answer 18

• Pulsatile bleeding
• Absent pulses
• Expanding hematoma

Question 19

What 2 things may be felt/heard with a severe arterial injury from penetrating trauma?

Answer 19

Palpable thrill
Audible bruit

Question 20

If a patient is presenting with hard signs of an arterial injury, what is the treatment?

Answer 20

OR immediately

Question 21

What are the soft signs of an arterial injury from penetrating trauma?

Answer 21

• Bleeding
• Asymmetric pulses
• Non-expanding hematoma

Question 22

What diagnostic should be obtained if soft signs of an arterial injury are present?

Answer 22

CTA

Question 23

If there is penetrating trauma but no real signs, how can you assess if there may be an arterial injury?

Answer 23

ABI

Question 24

How will the leg look with a femur fracture? Femur dislocation?

Answer 24

Fracture = Leg shortened and ER
Displaced = IR

Question 25

Intracapsular femoral fracture involves the head and neck. It must be fixed with ______ and there is risk of?

Answer 25

Prosthetic --> AVN of the femoral head

Question 26

Intertrochanteric femoral fractures are fixed with?

Answer 26

Plates and screws

Question 27

Subtrochanteric/Diaphyseal femoral fractures are fixed with?

Answer 27

Medullary rods

Question 28

What symptom will those with a Scaphoid fracture present with?

Answer 28

Pain at the anatomic snuffbox

Question 29

If a patient is presenting with pain at the anatomic snuffbox, what is the likely diagnosis?

Answer 29

Scaphoid fracture

Question 30

The scans may be negative with Scaphoid fractures, thus if a patient has pain at the anatomic snuffbox, what is the treatment?

Answer 30

Cast

Question 31

How will the arm look with an Anterior shoulder dislocation?

Answer 31

Elbow ADDucted Humerus ER

Question 32

Elbow adducted and Humerus ER

Answer 32

Anterior shoulder dislocation

Question 33

What is a possible complication of an Anterior shoulder dislocation?

Answer 33

Axillary nerve compression --> deltoid paresthesia

Question 34

What can cause a Posterior shoulder dislocation?

Answer 34

Electrical shock/seizure/lightening strike

Question 35

How will the arm look with a Posterior shoulder dislocation?

Answer 35

Elbow ADDucted Humerus IR

Question 36

Elbow adducted and Humerus IR

Answer 36

Posterior shoulder dislocation

Question 37

How do Scaphoid fractures occur and why are they dangerous?

Answer 37

FOOSH -- watershed area!

Question 38

With the fracture of the femur or other long bones, what is a possible complication?

Answer 38

Fat Embolism syndrome

Question 39

3 signs of Fat Embolism Syndrome following a long bone fracture?

Answer 39

Respiratory distress Confusion Petechial rash

Question 40

3 signs of Fat Embolism Syndrome following a long bone fracture?

Answer 40

Respiratory distress Confusion Petechial rash