test

rotator cuff injury

supraspinatus is the common site of injury

Neer ( is mainly used for proximal humerus fractures, not rotator cuff tears.) and Hawkins-Kennedy tests suggest subacromial impingement/rotator cuff pathology, but they are not definitive. They are screening/clinical tests, not confirmatory.

MR examination is the golden standard for rotator cuff tears.

Level I trauma center

provides the highest level of trauma care, including:

• 24/7 trauma surgery coverage

• Emergency medicine

• Orthopedic surgery

• Neurosurgery

• Critical care

• Imaging and blood bank support

• Definitive care for severe/multiple trauma

The rotator cuff consists of

supraspinatus,

infraspinatus,

subscapularis

teres minor muscle

primary survey

• A = Airway with cervical spine protection

• B = Breathing

• C = Circulation with hemorrhage control

• D = Disability / neurological status

• E = Exposure / environmental control

ABCDE !

which imaging technique is part of primary survey

abdominal US

FAST ultrasound

we look for free fluid in specific dependent spaces:

• Hepatorenal recess / Morrison’s pouch

• Splenorenal recess

• Pelvis, especially perivesical/perivesicular space

• Pericardial space, depending on FAST/eFAST protocol

so we can find :

pancreatic space

hepatorenal angle

pre vascular space

not the pancreatic space !

The following parameters must be considered when intubation a patient;

A. GCS

B. paO2

C. pCO2

D. O2 Saturation

Olecranon and patella fractures

traction/distraction forces from strong muscle pull.

Compression fracture

for impacted/compression fractures, e.g. vertebral compression

Bending fracture

in long bone transverse fractures

Salter–Harris classificatio

• Type I — S = Slip / Straight across

  Fracture goes through the growth plate only.

• Type II — A = Above

  Fracture goes through the growth plate and metaphysis.

• III → Type III — L = Lower

  Fracture goes through the growth plate and epiphysis.

• IV → Type IV — T = Through

  Fracture goes through everything

• V → Type V — R = Rammed / Ruined

  Compression/crush injury of the growth platee

The most common zone of clavicular fractures are the following

Middle 1/3rd

Classifications of Acromioclavicular dislocations are the following

Rockwood

It is true about posterior shoulder dislocations

It is rarer than anterior shoulder dislocations

B. May be seen in epileptic patients

C. The “Lightbulb sign” may be seen in the x ray

Which primary wounds should not be sutured?

• Vulnus scissum = cut/incised wound, often from scissors/sharp object

• Vulnus caesum = incised/chopped wound

• Vulnus morsum = bite wound

• Vulnus contusum = contused/crushed wound

morsum

What is the correct order in treating cut wounds

Disinfection, Drapes, Local anesthetics administrations, wound cleaning, debridement, suture,

sterile bandaging.

Primary cut wounds may be sutured

Cut wounds with clear borders within 6 hours

Determine the injured patient’s GCS score if the patient opens their eyes to painful stimulus, their speech is confused, and they localize pain.

• Eye opening to pain = E2

• Confused speech = V4

• Localizes pain = M5

During the E-FAST examination, which anatomical regions do we examine?

a) Hepatorenal recess
b) Splenorenal recess
c) Rectovesical recess / pouch of Douglas
d) Pericardium
e) Chest – pleura

Based on the AO fracture classification, name the fracture of the distal femoral metaphysis that does not involve the joint.

33A

• 33 = distal femur

• A = extra-articular fracture, meaning the joint is not involved

• B = partial articular fracture

• C = complete articular fracture

Which examinations/tests belong to the examination of the shoulder joint? (Multiple choice)

• Neer test — impingement/rotator cuff pathology

• Jobe test / Empty can test — supraspinatus/rotator cuff

• Hawkins test — shoulder impingement

Watson test

scaphoid/scapholunate instability in the wrist

Thompson test

Achilles tendon rupture