CSTR STUDY GUIDE: Complete Study Set (Qs And As)
AIS Components for ISS Scaling-Body Region Right Ans - 1. Head/Neck
2. Face
3. Chest
4. Abdominal/Pelvic Contents
5. Extremities/Pelvic Girdle Severe
6. External- Skin and Burns
The adult skeletal system Right Ans - 206 bones
Skull base fractures Right Ans - orbital roof, ethmoid, basilar process of
occipital bone, petrous and squamous process of temporal bone (mastoid or
petrous)
Skull Vault fractures Right Ans - frontal, parietal, occipital, temporal bones
(specifies squamous)
Brain Hematomas Right Ans - EPH, SAH, SDH, IPH, ICH
uncal herniation, transtentorial Right Ans - (cerebellum) - code ICD-10 -
cord contusion = AIS code of 140202.5 = 5 squared = 25 ISS score.
Meninges Right Ans - three protective membranes that surround the brain
and spinal cord
dura mater, arachnoid, and pia mater
Intracranial Injuries-Focal injuries Right Ans - picked up on CT scan.
Contusion, epidural hematoma, subdural hematoma, subarachnoid hematoma,
intracerebral/intraparenchymal hemorrhage
Intracranial Injuries-Nonfocal Head Injuries Right Ans - concussions, shear
injury, diffuse axonal injury (DAI), anoxic brain injury (ABI) - these go down to
the cellular level.
Facial Bones Right Ans - • Orbits
• Nasal bones
• Maxillae
• Mandible
,• Palatine
• Vomer
Facial Mechanisms of Injury Right Ans - deep lacerations, deformity,
difficulty speaking, visual changes, entrapment of muscles, rhinorrhea,
otorrhea, trismus
Facial Diagnostics and Procedures Right Ans - CT scan, MRI scan, X rays,
ORIF, Enucleation or removal of the eyeball.
Neck Injury Indicators Right Ans - • Bleeding
• Stridor
• Difficulty Breathing
• Bruising to the Neck
• Deviated Trachea
• Subcutaneous emphysema
• Zones of the Neck:
1. Angle of the mandible to base of the skull 2. Cricothyroid Cartilage
Neck Trauma procedures Right Ans - • Cricothyroidotomy - needle through
a catheter
• Tracheostomy - done when a patient is stabilized
• Neck Exploration
• Intubation
Vertebral Column Dislocation Right Ans - • Ligamentous injuries -
ligaments' purpose is to keep spine aligned.
• Dislocations - unilateral facet, bilateral facet
• Subluxation- partial dislocation
Vertebral Column Fractures -
• Simple
• % compression or wedge
• Comminuted or burst - broken into pieces
• Tear drop
Spinal Cord Injuries -
• Concussion - numbness and tingling
• Contusion- bruising
• Transection
• Interruption in vascular supply
,• SCIWORA - spinal cord injury with radiological arteries
Spinal Injury Diagnostics and Procedures Right Ans - CT scan, MRI
Procedures- cervical collar, tongs, halo traction, spinal decompression
Cervical Spine Right Ans - • 7 vertebrae
• C1-atlas, c2- axis - responsible for assisting with movement of the head.
• If spinal cord injured at c1-C2- typically quadriplegic
Thoracic Spine Right Ans - • Contains 12 vertebrae
• If spinal cord injured here, typically Paraplegia
Lumbar Spine Right Ans - • Contains 5 vertebrae
• Spinal cord ends L1 to L2 level
Sacral Spine Right Ans - • 5 fused vertebrae
• Joins with the pelvic bones
coccyx Right Ans - • 3-5 very small fused bones
• Tail bone
Thoracic Bone Structures Right Ans - • Spinal column
• Ribs
• Clavicles
• Scapulae - if this bone is fractured, be suspicious for lung contusion.
• Sternum
• Xiphoid process - tip of the sternum
Rib fracture documentation Right Ans - very important to know the
number of ribs fractured on each side. Segmental - flail
Thoracic Muscular Structures Right Ans - Diaphragm - muscle separating
the chest and its contents from abdomen and its contents
Intercostal - assists in breathing
Thoracic Organs Right Ans - lungs, heart, esophagus, trachea, thymus
glands
Thoracic Injury Descriptors Right Ans - • Shortness of breath
, • Cyanotic- bluish
• Deviated Trachea
• Subcutaneous Emphysema
• Abdominal Breathing
• Paradoxical Movement - also known as flail chest, the ribs seem to be
floating or moving.
• Pale and clammy
Thoracic Trauma diagnostics Right Ans - • FAST exam
• Pericardiocentesis
• CT scan
• Ct angiography - uses dyes
• Aortography
• Needle Thoracentesis
Thoracic Trauma Procedures Right Ans - chest tube/thoracostomy
thoracotomy
cardiac massage
defibrillation
pericardial window
median sternotomy
cross- clamp aorta
Thoracic Injuries Right Ans - • Tension Pneumothorax - usually results
from a blunt injury
• Rib Fractures
• Flail Chest - be careful when looking at the medical record as segmental
indicates flail.
• Sucking Chest Wounds
• Pneumothorax - chest tube is inserted.
• Hemothorax- chest tube is inserted
• Pulmonary contusions
• Blunt cardiac injury
• Aortic transection- aortography is used to detect this.
• Pseudoaneurysm
• Cardiac tamponade is pressure on the heart muscle, which occurs when the
pericardial space fills up with fluid faster than the pericardial sac can stretch.
It is detected by an angiography and usually is treated by pericardiocentesis--
a needle is inserted into pericardial sac.