Surgery/Trauma Test 3

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1. center lower
2. increase SID when possible
3. depress shoulders as much as possible
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Terms in this set (64)
posteriorWhat spine column shows the neural arch, spinous process, and adjacent soft tissues (includes pedicles, facets, apophyseal joints, laminae, spinous process and ligaments)?unilateralWhat type of subluxation is between 25% to 50% of the vertebral body?bilateralWhat type subluxation is greater than 50% of the vertebral body and is extremely unstable due to 3 column involvement?up side intervertebral foramenPosterior obliques of the C-spine show what anatomy/articulations?down side intervertebral foramenAnterior obliques of the C-spine show what anatomy/articulations?spinous processes and zygapophyseal jointsLateral projections of the C-spine show what anatomy/articulations?1. symmetry (no space should be 50% wider than the one directly above or below it) 2. spinous processes (midline)What two things should be evaluated on the AP C-spine radiograph?3 columns, top of T1 visible, bodies are uniform height, odontoid in tact and close to C1What should be evaluated on a lateral C-spine radiograph?Jefferson (Type II)burst pattern, comminuted fracture of C1 ring; caused by severe axial force causing compression (diving injuries); if transverse longitudinal ligament ruptures, considered the most unstable of all cervical fracturesClay Shovelerstype of flexion injury; fracture of C6, C7, and T1, forcible spinous process detachment, caused by sudden load on flexed spine; most stable C-spine fractureHangmanextension injury; 25% of all C2 fractures; bilateral fracture of the pars interarticularis; caused by hyperextension or sudden deceleration (forehead to windshield)Flexion Teardroptype of flexion injury; unstable and associated with high incidence of cord damage; anteroinferior body fracture, facet joints and interspinous distances widened and the disk space may be narrowed, remainder of body displaced backward - 70% have neurologic deficit; most severe and unstable C-spine fractureExtension TeardropSimilar to flexion teardrop radiographically, but more stable because its an avulsion fx, not compression fx; occurs at lower cervical levels; posterior neural arch of C1 compressed- stable since transverse ligament and anterior arch of C1 are not involved.Type 1type of dens fracture; accounts for 4%; oblique fracture at the tip of the densType 2type of dens fracture; accounts for 66%; transverse fracture at the base of the pegType 3type of dens fracture; accounts for 30%; oblique fracture at base of peg extending into the bodyflexionInjuries that occur with ___________ include: subluxation, wedge, avulsion, interfacet dislocation, teardrop, anterior atlanatoaxial dislocationextensionInjuries that occur with ________________ include: teardrop, dens fracture, hangmans fracturecompressionInjuries that occur with _______________ include: Jefferson fracturerotationInjuries that occur with ____________ include: subluxation (perched/locked)Jefferson Bit Off a Hangman's ThumbWhat is the numonic to remember which cervical fractures are unstable?-Jefferson fracture -Bilateral facet dislocation -Odontoid fracture -Any subluxation -Hangman's fracture -Teardrop fractureWhich cervical fractures are considered unstable?fluid in the right lung, pneumothorax in the left lungWhat does a right lateral decubitus demonstrate?fluid in the left lung, pneumothorax in the right lungWhat does a left lateral decubitus demonstrate?closestPosterior oblique rib projections demonstrate pathology on the side ____________ to the IRfarthestAnterior oblique rib projections demonstrate pathology on the side ______________ from the IR; and demonstrate injuries on the opposite sideflail chestthree or more adjacent ribs are fracture at two points; life threatening - segment of the chest wall bones break under extreme stress and become detached from the rest of the chest wall; segment moves in opposite direction than the rest of the chest wallpneumothoraxfree air in pleural space; may be open or closed; blunt trauma is the usual cause; may have associated rib fractures; usually self-correctingpleural effusionfluid in the pleural spacehemothoraxblood in the pleural spaceatelectasislung collapse; loss of air-volume; localized consolidation of tissue density; represents an air-less state of lung tissue; most commonly caused from surgery and mucus "plugs"lower and upperIf you have a patient over 6 feet tall and less than 45 cm wide what two abdomen exposures are needed?right and leftIf you have a patient shorter than 6 feet and wider than 45 cm what two abdomen exposures are needed?consolidationa region of (normally compressible) lung tissue that has filled with liquid, a condition marked by induration (swelling or hardening of normally soft tissue) of normally aerated lung; something "hazy" in the lung field - "a collection"away fromWhen a patient has a pneumothorax, pleural effusion, or large mass, the trachea is deviated ______________ the affected sidetowardsWhen a patient has a large atelectasis, lobectomy or pneumoectomy, pleural fibrosis, or pulmonary fibrosis, the trachea is deviated _____________ the affected sideno more than 50%What is the maximum amount of space the heart can normally occupy within the thorax?directDisplacement of interlobar fissures (shift and become bowed) and areas of consolidation with no air-bronchogram are signs of ___________ atelectasisindirectRemaining lung tries to compensate for collapsed portion, elevation of the hemi-diaphragm, displacement of the mediastinum and hilum, and over inflation of remaining lung are signs of ___________ atelectasistension pneumothoraxa type of pneumothorax in which air that enters the chest cavity is prevented from escaping; usually due to injury-Seatbelt -Physical strength of patient -Speed and force -Patient position on impactWhat are some reasons injuries may vary in front end collisions?-abdominal pain -paleness -fatigue -thirst -feeling cold -lightheadednessWhat are the signs and symptoms of internal bleeding?heart and lungsWhich vital organs are injured as a result of various fractures in the thorax?rear endInjuries related to a _______ ______ crash include: whiplash, minor strain, subluxation, fracture, strained muscles, tendons, or ligaments, herniated discs, or possible vertebral fracturesfront endInjuries related to a ________ ______ crash include: skull/brain, facial, pelvis, lower extremeties, spine, and abdomen injuries as well as flail chesttraumatic brain injurytemporary or permanent, partial or total functional disability or psychosocial maladjustment; can result from whiplash, can't see on CT or MRImildDizziness, loss of balance, blurred vision, ringing in ears, bad taste in mouth, and lethargic are _______ symptoms of traumatic brain injurymoderate/severeSevere headache, slurred speech, excessive vomiting, and dilation of both pupils are ____________/____________ symptoms of traumatic brain injurysurfactantliquid coating the inside of the lung; helps keep them open by reducing surface tension; for infants so they can breathe once born without it the lungs may collapse or infant has to work harder to breatheRDS (respiratory distress syndrome)lung pathology in neonates; poor lung expansion and granulated, not enough surfactantpneumoniaresult of exposure in utero or birth; jaundice skin, poor oxygen, lethargic; disturbed densities, hard to differentiate from RDS, start antibiotics, PA and lateral erecttransient tachypneaAbnormal delays in the transition from fetal lung physiology to extrauterine function (C section) usually resolved within 2 days; lungs appear over expanded and hazymeconium aspiration syndromeFetus under stress may pass some meconium stools into amniotic fluid and can be inhaled into the lungs; air sacs may collapse from a blocked airway; lung may rupture causing atelectasis or pneumothorax1. chin in lung field (correct - use 10-15 degree sponge) 2. arms in lung field (correct - have nurse hold patient's arms up and legs down) 3. inspiration (correct - make baby cry)What are the three main reasons for a repeat neonatal chest x-ray?