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34 Cards in this Set
- Front
- Back
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all fracture terminology describes the _______ part relative to the __________ part
for example, if the knee is disrupted and the femoral condyles are behind the tibial plateau, this is described as a ___________ dislocation |
distal relative to proximal
ex: femoral condyles behind tibial platea -distal part is ANTERIOR to proximal part -therefore ANTERIOR dislocation |
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def:
amount of offset of distal segment relative to proximal in a fracture |
displacement
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def:
in a fracture, the angle away from normal that the distal fragment makes with the proximal |
angulation
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def:
in a fracture, overlapping of the ends of fracture fragments |
shortening
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def:
fracture with 2 fragments |
simple fracture
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def:
fracture with 3 or more fragments |
comminuted
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draw out the Salter Harris fracture classification scheme
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review this image
http://pediatriceducation.org/wp-content/uploads/2009/01/100305figure24salterharrisd.gif |
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life and limb threats x2 in emergency orthopedics
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compartment syndrome
neurovascular compromise |
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shoulder: 95% of rotator cuff injuries involve this muscle
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supraspinatus
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think of these three structures in overuse hand/wrist injuries
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nerve, tendon, joint
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dx:
tense swelling + pain on passive stretch |
compartment syndrome
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most sensitive sign of a scaphoid fracture
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snuffbox tenderness
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distal radius fracture with dorsal angulation
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colle's fx
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distal 5th metacarpal fx
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Boxer's fracture
usu 2/2 altercation |
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dx:
x-ray normal but finger looks wrong |
tendon injury
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ring structures (pelvis) fracture ______
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twice
ie, check each smooth arc, curve, or ring for relative symmetry and fractures |
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dx:
hip pain, shortened and EXTERNALLY rotated |
fem neck or intertroch fx
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dx:
hip pain, shortened and INTERNALLY rotated |
posterior dislocation
(hip replacement vs MVC) |
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def:
cortex fractures on one side but not the other, usu in kids |
greenstick fracture
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def:
more dense bone impacts into less dense bone, usually in kids |
buckle fracture
(torus fx) |
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most common type of Salter Harris fx
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type II
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Salter harris types with best prognosis
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I-II
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Salter harris types with worst prognosis
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IV-V
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how do you determine whether a particular acetaminophen level is toxic?
ie what info (x3) is needed? |
-acetaminophen level
-time of administration -nomogram (http://goo.gl/O6kFg6) |
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mech:
acetaminophen toxicity |
1. acetaminophen normally metabolized by glucuronidation and sulfonation
2. if overdose -> P450 system activated -> NAPQI (toxic compound produced) 3. some NAPQI bound by glutathione; overwhelmed in overdose -> toxic interaction b/t NAPQI and protein/DNA http://goo.gl/IkzMCg |
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toxic compound in acetaminophen overdose
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NAPQI
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tox screen identifies _________ of parent compounds
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metabolites
NB: this means that FN/FP are possible, both due to TIMING and CHEMICALLY SIMILAR COMPOUNDS |
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poison control #
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800-222-1222
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#1 cause of poisoning death
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carbon monoxide
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mnemonic for AG acidosis
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M-Methanol
U-Uremia (chronic renal failure) D-DKA P-Propylene glycol, paraldehyde I-Infection, Iron, Isoniazid, Inborn errors of metabolism L-Lactic acidosis E-Ethylene glycol S-Salicylates |
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what is the osmol gap?
give formula for serum osm |
gap between calculated and measured serum osm
Sosm = 2Na + Glucose/18 + BUN/2.8 |
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mnemonic for osmol gap
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ME DIE
Methanol Ethylene Glycol Diuretics (Mannitol) Isopropyl Alcohol Ethanol |
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3x methods of bowel decontamination
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-gastric lavage
-activated charcoal* -whole bowel lavage *doesnt bind EtOH, metal |
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3x modes of toxicology treatment
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supportive
decontamination antidote |
