ATLS Examination

ATLS Missed/associated injury with a displaced thoracic spine fracture? - Answer- thoracic aortic rupture Missed/associated injury of a posterior knee dislocation? - Answer- femoral fracture and posterior hip dislocation Missed/associated injury of a knee dislocation or displaced tibial plateau fracture? - Answer- Popliteal artery and nerve injuries Missed/associated injury of a calcaneal fracture? - Answer- Spine injury or fracture, tibial plateau fracture When are most extremity injuries appropriately dianogsed and managed? - Answer- During secondary survey Injury to which nerves causes wrist drop and foot drop? - Answer- radial and peroneal nerve respectively What is the normal ratio between the blood pressure at the ankle divided by that of an uninjured arm? - Answer- 0.9, if below, means potential injury exist. When testing sensation, what area of the body corresponds to C5? Which nerve is this? - Answer- The lateral aspect of the upper arm, the axillary nerve When testing sensation, what area of the body corresponds to C6? Which nerve is this? - Answer- Palmar aspect of the thum and index finger, median nerve When testing sensation, what area of the body corresponds to C7? - Answer- Palmar aspect of the long finger When testing sensation, what area of the body corresponds to C8? Which nerve? - Answer- Palmar aspect of the little finger, the ulnar nerve When testing sensation, what area of the body corresponds to T1? - Answer- Medial aspect of the forearm When testing sensation, what area of the body corresponds to L3? - Answer- Medial aspect of the thigh When testing sensation, what area of the body corresponds to L4? - Answer- Medial aspect of the lower leg, especially over the medial malleolus When testing sensation, what area of the body corresponds to L5? Associated nerve? - Answer- Dorsum of the foot between the first and second toes (common peroneal) When testing sensation, what area of the body corresponds to S1? - Answer- Lateral aspect of the foot When testing motor function, what motion tests for C5? what is the associated nerve? - Answer- Shoulder abduction, axillary nerve When testing motor function, what motion tests for C6? what is the associated nerve? - Answer- Elbow flexion (C5 and C6), musculocutaneous nerve Which brachial nerves are tested by assessing a patient's ability to extend their elbow? - Answer- Radial nerve, C6, C7, C8 Which nerves are assessed when testing a patient's grip strength? - Answer- Dorsiflexion of the wrist = radial nerve, C6 Flexion of the fingers = median and ulnar nerves, C7, C8 Which nerves are assessed when testing patient's motor ability with finger add and abduction? - Answer- Ulnar nerve, C8 and T1 What movement tests a patients deep peroneal and L5 nerve motor function? - Answer- Dorsiflection of the great toe and ankle What movements tests a patient' posterior tibial and S1 nerve motor function? - Answer- Plantar flexion What is the earliest symptom/sign of compartment ischemia? - Answer- pain, especially on passive stretch of invovled muscle of the injured extremity. What is a late sign of inhalation burn injury? - Answer- Stridor = indiation for immediate endotracheal intubation Patients with greater than what % of TBSA burn require fluid resuscitation? - Answer- 20% What is the prefered solution for resuscitation of burn victims? - Answer- Lactated ringers. Why do first degree burns not require IV fluid replacement? - Answer- Because the epidermis is not compromised in this type of burn What characterizes a partial thickness burn? - Answer- red or mottled appearance of the skin associated with swelling and blisher formation. Can have a weeping, wet appearance and painfully hypersensitive.