Week 6 Flashcards
(44 cards)
In the rare cases that it does, which way does the hip dislocate?
Posteriorly
How is an ankle fracture treated?
Open reduction and internal fixation.
What is a Lisfranc Fracture?
A fracture dislocation of the TMT joint of the foot. It disrupts the “keystone” of the arch of the foot and requires surgery to correct.
Which nerves intimately intertwined with the humerus?
Radial
How should fractures in the arm be treated in most cases?
Bracing, as it is not typically weight bearing intramedullary nails are rarely used. Surgery is only used when absolutely necessary due to the risk of damaging nerves and arteries located near the bones. Only ~20% of humerus fractures will require surgery.
Which structures are of concern in surgery involving the clavicle?
The supraclavicular nerve and brachial plexus, as well as the subclavian artery are at risk of damage from both the injury and the surgery.
What is an AMPLE History?
A: Allergies M: Medications P: Prior Medical History L: Last Meal E: Events Leading to the Injury
What nerve is frequently damaged with dislocation of the shoulder?
The axillary nerve.
Which nerve is commonly injured with fractures and/or dislocations of the elbow?
The ulnar nerve.
What is the best imaging test when you believe that there are bone fragments related to a fracture?
CT with X-Ray
How hot does water need to be to burn you in 1 second? 10 minutes?
70 degrees, 49 degrees.
What is the Rule of Nines?
Way to calculate surface area burned. Each arm is 9%, Face is 9%, Torso is 36%, Legs are each 18% {and the genitals are 1%}. The size of an individuals palms is ~ 1% their body surface area.
How do you calculate Basal Fluid Rate?
Basal Fluid Rate: 40mL/Kg for first 10; 20mL/Kg for second 10; 10mL/Kg for anything more. 40:20:10 Rule.
How much fluid should be given for ≥ 2nd degree burns in the first 24 hours? How much SA {approximately} needs to be burned to worry about fluids?
2 - 4 mL of Ringers Lactate / Kg / % Burn
Ie. (3mL)(50Kg)(35) 5 250mL
If less than their basal requirements they likely do not need fluid resuscitation {~ 20% + SA burned}. 50% in the first 8 hours; 25% in the second and third.
For peds patients use Parkland + Basal Maintance. Adults are Parkland only!
What is an Escharotomy?
Opening of the eschar {leathery burned skin} by incision to help prevent compartment syndrome.
When should an Escharotomy be performed?
When there is no pulse, cyanosis, or neurological symptoms. {Pressure is preventing blood flow}.
What is in Ringer’s Lactate?
Sodium, Chloride, Lactate, Potassium, and Calcium
What is the fancy word for Bunions?
Hallux Valgus
What is involved in a first, second, third, and fourth degree burn?
Epidermis, Superficial Dermis, Sub-Dermis, Anything Deeper.
What is the most common cause of Hallux Valgus?
Stupid shoes.
What is the fancy name for OA of the first MTP? How will these patients walk?
Hallux Rigidis; On the outside of their foot to avoid pain.
What is Morton’s Neuroma? How does it present?
A thickening and sclerosing of the endoneurium and perineurium along with demyelination occurring in the foot, most commonly between the third and fourth metatarsals. Feels like a tingling, burning, or numbness in your heel or as if you are walking on a pebble.
What is Plantar Fasciitis, how does it present, and how is it treated?
Inflammation of the Plantar Fascia. Usually involves pain over the heel which is worst in the morning with the first few steps and may hurt after a long day on your feet. NOT typically fixed with surgery. 80 - 90% self resolve in 1 year, braces while sleeping, weight loss, and PT can help.
How is an Achilles Rupture treated?
May be treated surgically or non-surgically. Controversial whether there is a higher risk of recurrence with non-surgical treatment. Two weeks with a cast and no weight bearing, 4 weeks cast with weight bearing. Need PT, should return to normal in 6 months. The cast must be done at 30 degrees plantar flexion!
