Pestana Surgery

Front 1

Basal Skull Fx Work Up

Back 1

CT if in coma
C-Spine Injury!
nothing to do about fx

Front 2

A man involved in a high-speed, head-on automobile collision is in coma. He has never had any lateralizing signs, and CT scan shows a small crescent- shaped hematoma, but there is no deviation of the midline structures.

Back 2

Another subdural hematoma, but without lateralizing signs and evidence of displacement of the midline structures, surgery has little to offer. Management will probably be directed at controlling ICP

Front 3

Penetrating wounds anywhere in the neck w/ unstable patient

Back 3

immediate ex lap

Front 4

Zone I of the neck

Back 4

Thoracic Inlet to Cricoid Cartilage
Subclavian vessels, brachiocephalic veins, common carotid arteries, aortic arch, and jugular veins, trachea, esophagus, lung apices, cervical spine, spinal cord, and cervical nerve roots.

Front 5

Zone II of the neck

Back 5

Cricoid cartilage to the angle of the mandible.
Carotid and vertebral arteries, jugular veins, pharynx, larynx, trachea, esophagus, and cervical spine and spinal cord.

Front 6

Zone III of the neck

Back 6

A angle of the mandible and the base of the skull.
salivary and parotid glands, esophagus, trachea, vertebral bodies, carotid arteries, jugular veins, and major nerves (including cranial nerves IX-XII), traverse this zone

Front 7

Flail Chest. Next Step

Back 7

1. R/O other injuries - abdominal and aortic rupture (CXR)
2. Pulmonary Contusion real problem. Monitor w/ ABG & support if needed - w/ b/l chest tubes if tubed (even in OR)
3. Don't need to stabalize flail portion

Front 8

Pulonary Contusion Managment

Back 8

1. Fluid restriction (using colloid), diuretics
2. Respiratory support. intubation, mechanical ventilation, and PEEP PRN

Front 9

Aortic Rupture Next Step

Back 9

1. CXR w/ wide mediastinum
2. Spiral CT
3. Aortogram if equivical

Front 10

Air Embolism Managment

Back 10

1. Cardiac Massage
2. Trendelenburg
3. Thoractomy