-
What is the most commonly injured organ in blunt trauma?
Liver
-
What is the most commonly injured organ in penetrating trauma?
Small bowel
-
What is the most common anatomic reason for upper airway obstruction?
Tongue
-
What does diagnostic peritoneal lavage miss?
Retroperitoneal bleeding
Contained hematomas
-
What areas are checked in a FAST scan?
- 1. Pericardium
- 2. Around liver fossa
- 3. Around spleen
- 4. Around pelvis
-
What is typically missed in a FAST scan?
Retroperitoneal bleeding
Hollow viscous injuries
-
What do trauma CT scans miss?
Hollow viscous injuries
Diaphragm injuries
-
When does abdominal compartment syndrome occur?
Massive fluid resuscitation
Trauma
Abdominal surgery
-
What vessels are damaged in an epidural hematoma?
Middle meningeal artery
-
In a epidural hematoma, where does the blood accumulate?
Between the dura mater and the skull
-
In a subdural hematoma, where does the blood accumulate?
Between the dura mater and the arachnoid membrane
-
What is the source of blood in a subdural hematoma?
Tearing of bridging veins
-
How often are skull fractures seen in epidural hematomas?
85 to 95% of the time
-
What types of attenuation values do chronic hematomas have?
Low attenuation values
-
What the three layers of meninges surrounding the brain and spinal cord?
- Dura mater
- Arachnoid mater
- Pia mater
-
What is the typical symptoms for patients presenting with acute epidural hematoma?
Initial loss of conscious
Lucid interval
Sudden deterioration
-
How do patients typically present after subdural hematomas?
Often in elderly patients after falls or MVAs
-
When do skull fractures need to be taken to the OR?
Depressed skull fractures
Compound skull fractures
-
What is the pathogenesis of diffuse axonal injury?
Widespread disruption of axons from acceleration or deceleration injury
-
Within the layers of the meninges, where does CSF reside?
Between the arachnoid and pia mater
-
What is the equation for cerebral perfusion pressure (CPP)?
MAP - ICP
-
What are the major parts of the inner surface of the skull base?
-
What is the most common site of facial nerve (VII) injury?
Geniculate ganglion
-
What is another name for C1?
Atlas
-
What is another name for C2?
Axis
-
What is distinct about the atlas vertebrae?
The atlas has no body
-
What joint is involved in flexion/extension of the neck?
Atlas - occipital joint
-
What joint is involved in the lateral rotation of the neck?
Atlas - axis
-
What is another name for a C1 fracture?
Jefferson fracture
-
What is the mechanism of a C1 fracture?
Jefferson fracture - axial compression forces
-
What is unique about the C2 vertebrae?
Odontoid process (dens) emerging from anterior aspect of body of vertebrae
-
What is the mechanism for a Hangman's fracture?
Hyperextension of neck leading to a C2 fracture
-
What structures are disrupted in a Hangman's fracture?
Anterior longitudinal ligament
Pars interarticularis
-
What are the different types of odontoid fractures?
- Type I - Above base of odontoid
- Type II - At base of odontoid
- Type III - extends to vertebral body
-
What are the three columns of the thoracolumbar spine?
-
What is the difference between a burst and a wedge fracture?
Wedge fracture only involves anterior column
-
What separates anterior and middle columns of the spine?
Anterior includes the anterior 1/2 of the vertebral body
-
What is the pathognomonic sign for hyperparathyroidism?
Subperiostial bone resorption of radial aspect of middle phalanges
-
What is the most common cause of primary hyperparathyroidism?
Parathyroid adenoma (80%)
-
What is the most common cause of secondary hyperparathyroidism?
Renal failure
-
What is the basic structure of the parathyroid glands?
4 glands
Superior and inferior glands
-
What is the embryological origin of the parathyroid glands?
Superior - 4th branchial pouch
Inferior - 3rd branchial pouch
-
What makes up Hesselbach's triangle?
- Rectus muscle (medial border)
- Inguinal ligament (inferior border)
- Inferior epigastric artery (lateral border)
-
What does the inguinal ligament come from?
External oblique
-
What makes up the floor of the inguinal canal?
Transversalis muscle
-
What abdominal wall muscle does the cremasteric muscle come from?
Internal oblique
-
Relative to Hesselbach's triangle, where do direct hernias form?
Medial to the inferior epigastric artery
-
Relative to Hesselbach's triangle, where do indirect hernias form?
Lateral to the inferior epigastric artery
-
What are the most common types of inguinal hernias?
Indirect hernias
-
Where do indirect inguinal hernias come from?
Patent processus vaginalis
-
Where do sliding inguinal hernias come from in males?
Cecum or sigmoid colon
-
Where do sliding inguinal hernias come from in females?
Ovaries/fallopian tubes
-
What types of hernias are infants/children more likely to get?
Almost always indirect inguinal hernia
-
What is the most common complication after an inguinal hernia repair?
Urinary retention
-
What is the inguinal canal created by?
External oblique aponeurosis/inguinal ligament curls on itself to form U shaped structure
-
What is inside the inguinal canal in males and females?
Males - spermatic cord
Females - round ligament
-
What are the components of the spermatic cord?
Vas deferens
Testicular artery/vein (Pampiniform plexus)
Genital branch of genitofemoral nerve
-
What are the boundaries of the femoral canal?
- Inguinal ligament
- Femoral vein
- Lacunar (Cooper's ligament)
-
Where do epigastric hernias occur?
Above umbilicus
Through linea alba
-
What arteries supply the adrenal glands?
- Superior adrenal
- Middle Adrenal
- Inferior Adrenal
-
Where does the superior adrenal artery emerge from?
Inferior phrenic artery
-
Where does the inferior phrenic artery emerge from?
Aorta or celiac axis
-
Where does the middle adrenal artery emerge from?
Aorta
-
Where does the inferior adrenal artery come from?
Renal artery
-
Where do the left and right adrenal veins drain into?
- Left adrenal vein > left renal vein
- Right adrenal vein > IVC
-
What is the most common source of extrahepatic collateral blood supply to hepatocellular carcinomas?
Inferior phrenic artery
-
What layer covers the kidneys and adrenals?
Gerota's fascia
-
What are the most common types of kidney stones?
Calcium oxalate stones (75%)
-
What is the second most common type of kidney stone?
Struvite stone (Magnesium ammonium phosphate) (15%)
-
What type of urinary infection is associated with struvite stones?
Proteus mirabilis
-
What types of stones are seen in patients who had their terminal ileums resected and why?
Calcium oxalate - increased calcium oxalate reabsorption in colon, higher chance of precipation of those stones in kidney
-
What is the number 1 type of testicular tumor?
Seminoma
-
What are different types of nonseminomatous testicular cancers?
- Embryonal
- Yolk Sac
- Teratoma
- Choriocarcinoma
-
What markers are elevated in non-seminomatous testicular cancers?
AFP
Beta-HCG
-
What are three muscular groups that make up the diaphragm?
Pars lumbaris
Pars costalis
Pars sternalis
-
What types of hernias form at the junction between the pars lumbaris and pars costalis?
Bochdalek hernias
-
What types of hernias form between the pars sternalis and the pars costalis on the right side?
Morgagni's hernia
-
What is the name of the space between the pars sternalis and pars costalis on the left side?
Larrey space
-
What is eventration?
Area of congenital weakness in diaphragm
-
What are the stages of bone healing?
- 1. Inflammation
- 2. Soft callus formation
- 3. Mineralization of callus
- 4. Removal of callus
-
What is the mnemonic for Salter Harris Fractures?
- SALTR
- S - same/straight across
- A - Above (physis)
- L - Lower (below physis)
- T - Through
- R - Rammed (crushed)
-
What types of Salter Harris fractures require open reduction and internal fixation (ORIF)?
Salter Harris Types III, IV and V
-
What fractures are associated with avascular necrosis?
Talus
Scaphoid
Femoral neck
-
What bone connects to the tibia?
Talus
-
What bone connects to the talus?
Navicular
-
What bones are directly distal to the navicular?
Cuneiform bones (lateral, intermediate, medial)
-
What bone is lateral to the lateral cuneiform bone?
Cuboid bone
-
What bones are distal to the cuneiform bones?
Metatarsal bones
-
What types of fractures are most commonly associated with nonunion?
Clavicle fractures
5th metatarsal fracture
-
What is another term for the 5th metatarsal fracture?
Jones fracture
-
What types of fractures are associated with compartment syndrome?
Supracondylar humerus
Tibia
-
What are the components of the intervertebral disk?
Annulus fibrosis
Nucleus pulposus
-
What is the most common type of shoulder dislocation?
Anterior shoulder dislocation (95%)
-
What are the most common causal associations with a posterior shoulder dislocation?
Seizures
Electrocution
-
What structure is at risk for injury in an anterior shoulder dislocation?
Axillary nerve
-
What structure is at risk for injury in a posterior shoulder dislocation?
Axillary artery
-
Which structure contains the ovarian vessels and nerve?
Infundibular ligament -
Contains ovarian artery, vein, nerve
-
What is the blood supply to the ovaries?
Ovarian artery
Uterine artery - adnexal branch
-
What is the most common US finding in ovarian torsion?
Large ovary (> 4 cm)
-
What are the most common presenting sx of ectopic pregnancy?
Pelvic pain
Vaginal bleeding
-
What is the major cause of vulvar hematomas?
Blunt trauma
-
When can vulvar hematomas be managed conservatively?
- 1) Lack of rapid expansion
- 2) Ability to void clear urine
-
What is endometriosis?
Presence of ectopic endometrial glands and stroma in aberrant locations
-
What is the most common site of involvement of endometriosis?
Ovaries
-
What happens to leiomyomas with uterine artery embolization?
Ischemia which causes necrosis and shrinkage of myomas
-
What are sx of leiomyomas?
Pressure from an enlarging uterus
Bleeding
Dysmenorrhea
Adverse pregnancy outcomes
-
What type of cancer is vaginal cancer typically?
Squamous cell
-
What drug is associated with clear cell carcinoma of the vagina?
DES (diethylstilbestrol)
-
What types of cancers are endometrial cancers typically?
Adenocarcinomas
-
What histologic types of endometrial cancers are associated with a worse prognosis?
Papillary serous
Clear cell
-
What cell type of ovarian cancer is most common?
Epithelial (85%)
-
Ultrasound findings of acute cholecystitis?
- Thickening of gallbladder wall
- Pericholecystic fluid
- Gallbladder distention
- Presence of impacted gallstone
- Sonographic murphy's sign
-
What intestinal artery do emboli typically go to?
SMA
-
What is the definition of volvulus?
Loop of gut has twisted on itself
-
What anatomic landmark is associated with the ligament of Treitz?
Junction between duodenum and jejunum
-
What is the most common site for colonic volvulus?
Sigmoid colon
-
What is the taeniae coli?
Condensations of the outer muscular layer along the length of the colon
-
What causes haustra to form in the colon?
Taeniae coli are 1/6 of the length of the entire colon - causes pouches of colon to form
-
What is the widest part of the colon?
Cecum
-
What are the spaces between haustra called?
Plicae semilunaris
-
What are valvulae connivente?
Muscular bands encircling small bowel
-
What is the definition of ileus vs obstruction?
Non-mechanical stasis of bowel vs mechanical stasis of bowel
|
|
