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Flashcards in Trauma Facts Deck (25):
1

volume of circulating blood in adult and child

adult (70 kg male)  = ~ 5 L

child 75 mL/kg

2

Class I shock (% blood loss and pathologic findings)

< 15%, mental status = anxious, all others normal

3

Class II shock (% blood loss and pathologic findings)

15-30%, HR>100, UOP sightly decreased (20-30 mL/hr) (BP is still normal but pulse pressure narrowed)

4

Class III shock (% blood loss and pathologic findings)

30-40%, HR>120, now BP is decreased, confused, UOP 5-15 mL/hr

5

Class IV shock (% blood loss and pathologic findings)

> 40% (2L), HR > 140, aneuric, lethargic

6

Class of shock table

A image thumb
7

During the repair process of an unstable fracture, the expression of major collagen types during fracture callus formation can best be characterized by

type II collagen early, followed by type I collagen.

8

At what time after fracture is there a maximal vascular response (blood flow rate) at the fracture site maximized?

2 weeks

9

Ebb phase of systemic metabolic response to trauma

cardiovascular instability, alterations in circulating blood volume, impairment in oxygen transport, and heightened autonomic activity

10

Flow phase of systemic metabolic response to trauma

Hyperdynamic circulatory changes, fever, glucose intolerance (gluconeogenesis), and muscle wasting 

11

During fracture healing, which of the following tissues tolerates the greatest strain before failure?

granulation tissue

12

 serologic tests that are required by the American Association of Tissue Banks (AATB) for musculoskeletal tissue allografts (4)

Hep B

Hep C

HIV

syphillis

13

releative resorption rates of bone graft substitutes

calcium sulfate > tricalcium phosphate > hydroxyapatite

14

shelf life for frozen allograft

one year for fresh frozen stored at -20 degrees C
five years for fresh frozen stored at -70 degrees C
indefinite for freeze-dried

15

levels of energy (percentage over normal) associated amputations:

  • Syme
  • BKA
  • Vascular BKA
  • bilateral BKA
  • AKA
  • vascular AKA

Syme = 15%
BKA = 25% (average)
Vascular BKA = 40%
bilateral BKA = 40%
AKA = 70%
vascular AKA = 100%

16

kids daily Ca intake

1-3 yo = 500 mg/d

4-8 yo = 800 mg/d

9-18 yo = 1000-1500 mg/d

17

talus blood supply

posterior tibial artery

  • via artery of tarsal canal (most important and main supply)

supplies most of talar body
only remaining supply with a talar neck fracture

  • via calcaneal braches

supplies posterior talus

anterior tibial artery

  • suplies head and neck

perforating peroneal arteries via artery of tarsal sinus

  • suplies head and neck

18

most common condyle for Hoffa fx

lateral

19

most common complication TALAR NECK FX

arthritis (2nd is AVN)

20

most common complication femoral neck fx

AVN (non-union 2nd)

21

tibia and BMP #

BMP2 (type III open fx)

significantly fewer invasive interventions (e.g., bone-grafting and nail exchange), significantly faster fracture-healing than did the control patients, increased healing (union) rates, fewer hardware failures, fewer infections, and faster wound-healing (83% compared with 65% had wound-healing at six weeks)

 

BMP 7 (OP1) for nonunion

Clinical and radiographic outcomes were statistically indistinguishable at 9 months between BMP7 vs autograft following treatment and OP-1 avoided donor site morbidity. 

22

SIRS

Heart rate > 90 beats/min
WBC count <4000 cells/mm³ OR >12,000 cells/mm³
Respiratory rate > 20 or  PaCO2 < 32mm (4.3kPa)
Temperature less than 36 degrees or greater than 38 degrees

 

-- 2 or more

23

main artery to the body of the talus

 artery of the tarsal canal, which is a branch of the posterior tibial artery

A image thumb
24

subtalar dislocation blocks to reduction

Medial dislocations (65%) - extensor digitorum brevis

 

Lateral - posterior tibialis tendon

25

AA, cox, prostaglandins pathway

know COX mediates AA to PG-G2

A image thumb