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41 Cards in this Set

  • Front
  • Back
Why should IV fluid be administered cautiously in traumatic brain injury (TBI)?
to avoid cerebral edema (increased ICP)
What is the 3rd most common cause of death in the US?
traumatic injury
What are signs of basilar skull fractures?
• CSF rhinorrhea
• hemotympanum
• periorbital ecchymosis (raccoon eyes)
• retroauricular ecchymosis (Battle's sign)
What does the neurologic exam assess?
• mental status
• anisocoria
• cranial nerve function
• decorticate or decerebrate posturing
• DTRs
• motor/sensory/brainstem function
• pupil size & reactivity
What is a concussion?
• a diffuse head injury usually associated with transient loss of consciousness
• occurs immediately following blunt head trauma
• symptoms of amnesia and confusion are clinical hallmarks
What is the treatment for an epidural hematoma?
burr hole decompression
Which patients are more susceptible to subdural hematomas?
patients with cortical atrophy (ex. alcoholics, elderly)
True/False: Subdural hematomas do not cross the midline
The correct answer is: True
What is Xanthochromia?
• yellow-to-pink CSF
• usually is seen by 12 hours after the onset of bleeding
• more likely in non-traumatic subarachnoid hemorrhage
What are manifestations of transtentorial herniation?
• dilated ipsilateral pupil
• contralateral hemiparesis
What are factors that determine the degree of neurologic injury from penetrating trauma?
• the energy of the missile
• whether the trajectory involves a single or multiple lobes or hemispheres of the brain
• the amount of scatter of bone and metallic fragments
• whether a mass lesion is present
What are treatment options for traumatic head injury?
• anti-edema agents (ex. corticosteroids)
• elevate the head
• hyperventilation
• hypothermia
• osmotic agents (ex. mannitol)
What is the treatment for closed spinal cord injuries (SCI)?
high-dose methylprednisolone
What is the most common etiology for facial fractures in the urban setting? in the community setting?
• urban setting: assault and penetrating trauma
• community setting: MVAs & sporting and recreational injuries
What bones make up the orbit?
• frontal
• ethmoid
• lacrimal
• maxilla
• palatine
• sphenoid
• zygoma
The orbital foramina contains which cranial nerves?
CN II, III, VI, and branches of V
What is a Marcus Gunn pupil?
• initial dilation with the swinging light test
• suggests retinal or optic nerve injury
What does a teardrop pupil suggest?
globe rupture
What does monocular diplopia suggest?
lens dislocation
Binocular diplopia may suggest what?
• entrapment of the inferior rectus
• cranial nerve injury
What does a halo/double-ring sign suggest?
CSF rhinorrhea
What antibiotics should be administered to patients with sinus fractures or with nasal packing?
• Augmentin (amoxicillin-clavulanate)
• Bactrim
• 1st gen. Cephalosporin
What is the most common type of orbital fracture?
orbital blowout fracture
What are indications for orbital surgery?
• enophthalmos
• entrapment of extra-ocular muscles
• persistent diplopia
How do you reduce a TMJ dislocation?
with the clinician standing behind the seated patient and pushing downward and backward on the posterior molar
What are the borders of zone 1 in the neck?
clavicle to the cricoid cartilage
What are the borders of zone 2 in the neck?
cricoid cartilage to the base of the mandible
What are the borders of zone 3 in the neck?
mandible to the base of the cranium
What are the primary killers of acute trauma patients?
• hypoxia
• hypoventilation
What is an open pneumothorax?
• occurs when there is a pneumothorax associated with a chest wall defect
• pneumothorax communicates with the exterior
What is the definitive management of an open pneumothorax?
placement of an occlusive dressing over the wound and immediately place an intercostal chest tube
What is the mainstay of therapy for simple rib fractures?
What part of the aorta is at greatest risk from shearing forces of sudden deceleration?
the fixed descending aorta (ligamentum arteriousm)
What is commotio cordis?
• when a blow directly over the heart during the vulnerable portion of the T wave induces ventricular fibrillation
• R on T phenomenon
What are complications of myocardial contusion?
• cardiac arrhythmia (most important)
• cardiac tamponade
• hypotension
• intracardiac thrombus
What is pulsus paradoxus?
• a 10-15 mm drop in systolic blood pressure with inspiration
• may be seen in cardiac tamponade
What is the most commonly injured organ in blunt trauma?
What is the most common presenting finding of spleen trauma?
hypotension from hemorrhage
What injury should be suspected with fractures of the 11th-12th ribs or flank tenderness?
kidney trauma
What diagnostic tests can be used to differentiate between a lacterated or contused kidney?
• IVP (intravenous pyelogram)
• CT scan
In blunt trauma, what is the most common part of the bowel that is injured?
duodenum (due to its location and its ligamentous attachments)