TCAR POST | TCAR POST TEST EXAM 50
QUESTIONS AND CORRECT {VERIFIED}
ANSWERS NEWEST UPDATE|ALREADY
GRADED A+.
3 questions to ask in trauma - ANSWER - -what was the dose of energy?
-where did it go?
-what injuries are likely?
2 q's to ask in GSW - ANSWER - caliber
type of gun
# of entrance/exit wounds
high/low velocity
1st question to ask in any traumatic injury? - ANSWER - what was the dose of
energy involved?
(was it high or low?)
what is the caliber of a bullet? - ANSWER - diameter
aka diameter of a bullet - ANSWER - caliber
,what happens to projectiles when they enter the body - ANSWER - projectiles
don't travel in a straight line
consider temporary cavity wound
what should you consider about tissue a projectile enounters - ANSWER -
temporary cavitation
primary goal of GSW surgery - ANSWER - usually damage repair & not bullet
removal
-if superficial, it may migrate the surface with time
important thing to remember about retained projectiles - ANSWER - they may
migrate over time. bullett migration might explain unexplained clinical findings
(VP Cheney accidentally shot his friend while hunting in 2006. ICU and did great.
moved to an inpatient unit. had a silent MI bc a shot gun pellets migrated into a
canary artery causing an infract. so had a MI but fibrinolytic not the answer in this
case b/c it was a "projectile embolus"
aka brestbone - ANSWER - sternum
what attaches the ribs to the sternum - ANSWER - cartliage
what breaks thoracic bones - ANSWER - significant force
-1-2nd ribs, posterior ribs, sternum, scapulae, T2-10
gives us info about the force aka "dose" of energy received
consider injury to internal structures b/c force
,ribs that are the most frequently broken - ANSWER - ribs 4-9 b/c long, thin, and
poorly protecte
it is harder to break a short pencil (T1-2) and easier to break a longer one
*ask how many and where to understand the force involved
what is the significance of posterior rib fractures - ANSWER - unusual direction of
injury
shorter stubby ribs
good muscle profection
**posterior rib fractures have a lot of force so need a high dose.
***PRF need a lot of force so high dose of energy. big red flag for t-spine injury
indication of c-spine injury - ANSWER - to injure c-spine, you don't need a big
energy blow. all it takes is shaking around.
c spine versus t spine fractures - ANSWER - c-spine doesn't need a big energy
blow. just some shaking around
t-spine needs a great strong direct blow (not just a shock_
treatment for rib fractures - ANSWER - largely supportive nursing care like
pulmonary toilet
CXR and rib fractures - ANSWER - simple rib fractures are difficult to see on CXR
and can be commonly missed
, (1/2 of all rib fractures aren't identified at the POI CXR)
identify a previous rib fracture on CXR - ANSWER - once healed, rib fractures form
bony callouses and become more visible on CXR
how to tell a pt has a pneumonia from a CXR - ANSWER - dark spot that is not
equal to the opposite side
consider if a pt has a lower rib fracture - ANSWER - liver & spleen injury
acts like BBQ/marshmellow skewers
how high does the diaphragm rise on inspiration - ANSWER - level of 4th ICS
risk of rib fractures - ANSWER - can puncture liver, spleen,, diaphragm
pop lungs
+2 adjacent rib fractures - ANSWER - flail chest
free floating sternum - ANSWER - flail chest
definition of flail chest - ANSWER - +2 adjacent rib fracture
free floating sternum
why is flail chest a problem - ANSWER - b/c breathing is a mechanical process
QUESTIONS AND CORRECT {VERIFIED}
ANSWERS NEWEST UPDATE|ALREADY
GRADED A+.
3 questions to ask in trauma - ANSWER - -what was the dose of energy?
-where did it go?
-what injuries are likely?
2 q's to ask in GSW - ANSWER - caliber
type of gun
# of entrance/exit wounds
high/low velocity
1st question to ask in any traumatic injury? - ANSWER - what was the dose of
energy involved?
(was it high or low?)
what is the caliber of a bullet? - ANSWER - diameter
aka diameter of a bullet - ANSWER - caliber
,what happens to projectiles when they enter the body - ANSWER - projectiles
don't travel in a straight line
consider temporary cavity wound
what should you consider about tissue a projectile enounters - ANSWER -
temporary cavitation
primary goal of GSW surgery - ANSWER - usually damage repair & not bullet
removal
-if superficial, it may migrate the surface with time
important thing to remember about retained projectiles - ANSWER - they may
migrate over time. bullett migration might explain unexplained clinical findings
(VP Cheney accidentally shot his friend while hunting in 2006. ICU and did great.
moved to an inpatient unit. had a silent MI bc a shot gun pellets migrated into a
canary artery causing an infract. so had a MI but fibrinolytic not the answer in this
case b/c it was a "projectile embolus"
aka brestbone - ANSWER - sternum
what attaches the ribs to the sternum - ANSWER - cartliage
what breaks thoracic bones - ANSWER - significant force
-1-2nd ribs, posterior ribs, sternum, scapulae, T2-10
gives us info about the force aka "dose" of energy received
consider injury to internal structures b/c force
,ribs that are the most frequently broken - ANSWER - ribs 4-9 b/c long, thin, and
poorly protecte
it is harder to break a short pencil (T1-2) and easier to break a longer one
*ask how many and where to understand the force involved
what is the significance of posterior rib fractures - ANSWER - unusual direction of
injury
shorter stubby ribs
good muscle profection
**posterior rib fractures have a lot of force so need a high dose.
***PRF need a lot of force so high dose of energy. big red flag for t-spine injury
indication of c-spine injury - ANSWER - to injure c-spine, you don't need a big
energy blow. all it takes is shaking around.
c spine versus t spine fractures - ANSWER - c-spine doesn't need a big energy
blow. just some shaking around
t-spine needs a great strong direct blow (not just a shock_
treatment for rib fractures - ANSWER - largely supportive nursing care like
pulmonary toilet
CXR and rib fractures - ANSWER - simple rib fractures are difficult to see on CXR
and can be commonly missed
, (1/2 of all rib fractures aren't identified at the POI CXR)
identify a previous rib fracture on CXR - ANSWER - once healed, rib fractures form
bony callouses and become more visible on CXR
how to tell a pt has a pneumonia from a CXR - ANSWER - dark spot that is not
equal to the opposite side
consider if a pt has a lower rib fracture - ANSWER - liver & spleen injury
acts like BBQ/marshmellow skewers
how high does the diaphragm rise on inspiration - ANSWER - level of 4th ICS
risk of rib fractures - ANSWER - can puncture liver, spleen,, diaphragm
pop lungs
+2 adjacent rib fractures - ANSWER - flail chest
free floating sternum - ANSWER - flail chest
definition of flail chest - ANSWER - +2 adjacent rib fracture
free floating sternum
why is flail chest a problem - ANSWER - b/c breathing is a mechanical process
