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Blunt Neck Trauma

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1021. Pneumothorax (Traumatic)

include chest pain from the causative injury and sometimes dyspnea. Diagnosis is made by chest x-ray. Treatment is usually with tube thoracostomy. (See also .) is discussed elsewhere. Pneumothorax can be caused by penetrating or blunt trauma; many patients also have a (hemopneumothorax). In patients with penetrating wounds that traverse the mediastinum (eg, wounds medial to the nipples or to the scapulae), or with severe blunt trauma, pneumothorax may be caused by disruption of the tracheobronchial (...) . Lie on stomach. 2. Bend involved knee and loop towel or band around the ankle. 3. Gently pull towel or band to stretch muscle on front of thigh pulling ankle toward buttocks... SOCIAL MEDIA Add to Any Platform Loading , MD, MPH, Stanford University School of Medicine Click here for Patient Education NOTE: This is the Professional Version. CONSUMERS: Topic Resources Traumatic pneumothorax is air in the pleural space resulting from trauma and causing partial or complete lung collapse. Symptoms

2013 Merck Manual (19th Edition)

1022. Cardiac Tamponade

accumulation, as occurs with traumatic hemorrhage, as little as 150 mL may cause tamponade. In trauma, the cause is more often a penetrating rather than blunt mechanism. The wound is often medial to the nipples (for anterior wounds) or the scapulae (for posterior wounds). Tamponade due to blunt trauma involves cardiac chamber rupture, which is typically fatal before patients can be brought for treatment. Symptoms and Signs Classically, patients have Beck's triad, which consists of the following (...) : Hypotension Muffled heart tones Venous pressure increase (eg, neck vein distention) However, hypotension has multiple potential causes in trauma patients, muffled heart tones can be difficult to assess during a noisy trauma resuscitation, and neck vein distention can be absent due to hypovolemia. , a decrease in systolic BP during inspiration of > 10 mm Hg, is also suggestive, but again not easy to assess in a noisy setting. Diagnosis Clinical evaluation Often bedside echocardiography Diagnosis can

2013 Merck Manual (19th Edition)

1023. Glenoid Labral Tear

) is an inherently unstable joint; it has been likened to a golf ball sitting on a tee. To enhance structural stability, the glenoid (anatomically, a very shallow socket) is deepened by the labrum, which is a rubbery, fibrocartilaginous material attached around the lip of the glenoid. This structure can tear during athletics, especially during throwing sports, or as a result of blunt trauma when falling and landing on an outstretched upper extremity. Symptoms and Signs A glenoid labral tear results in deep (...) to Any Platform Loading , MD, Tomah Memorial Hospital, Tomah, WI Click here for Patient Education NOTE: This is the Professional Version. CONSUMERS: Topic Resources The glenoid labrum usually tears as a result of a specific trauma, such as a fall onto an outstretched arm. Tears can also result from chronic overhead movement, as occurs in pitching. A glenoid labral tear causes pain during motion. Treatment is with physical therapy and sometimes surgery. The shoulder (unlike the hip or elbow

2013 Merck Manual (19th Edition)

1024. Splenic Injury

with the elbow straight. 2. With the uninvolved hand, grasp thumb side of hand and bend wrist downward into wrist flexion. 3. To increase the stretch, bend wrist toward... SOCIAL MEDIA Add to Any Platform Loading Topic Resources Splenic injury usually results from blunt abdominal trauma. Patients often have abdominal pain, sometimes radiating to the shoulder, and tenderness. Diagnosis is made by CT or ultrasonography. Treatment is with observation and sometimes surgical repair; rarely, splenectomy (...) , oxidized cellulose, thrombin compounds, fibrin glue), or partial splenectomy, but splenectomy is still sometimes necessary. Splenectomized patients should receive the pneumococcal vaccine; many clinicians also vaccinate against Neisseria and Haemophilus spp. Treatment reference Nonoperative management of blunt hepatic injury: An Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg 73:S288-S293, 2012. Key Points Splenic injury is common and can occur

2013 Merck Manual (19th Edition)

1025. Femoral Shaft Fractures

fixation. The usual injury mechanism for femoral shaft fractures is severe direct force or an axial load to the flexed knee (typically in a motor vehicle crash or automobile-pedestrian collision). Thus, other serious injuries are often present. Symptoms and Signs Fracture causes obvious swelling, deformity (often with shortening), and instability. Up to 1.5 L of blood for each fracture may be lost. is possible, particularly when the cause is blunt trauma and there are other injuries. Diagnosis X-rays (...) Anteroposterior and lateral x-rays are diagnostic. If the fracture resulted from great force, hip x-rays should always be done to look for an ipsilateral femoral neck fracture. The knee also needs to be carefully evaluated. Treatment Immediate splinting with traction Open reduction with internal fixation (ORIF) Immediate treatment is splinting, usually with distraction force (such as with a Hare traction or Sager traction splint), followed by ORIF. Because traction splints apply traction to the lower leg

2013 Merck Manual (19th Edition)

1026. Temporal Bone Fractures

SOCIAL MEDIA Add to Any Platform Loading , MD, Stanford University School of Medicine Click here for Patient Education NOTE: This is the Professional Version. CONSUMERS: Temporal bone fractures can occur after severe blunt trauma to the head and sometimes involve structures of the ear, causing hearing loss, vertigo, balance disturbance, or facial paralysis. Temporal bone fractures are suggested by Battle sign (postauricular ecchymosis) Bleeding from the ear Bleeding may come from the middle ear (...) Illness Withdrawal from which of the following substances is most likely to increase a patient’s heat input? Alcohol Cannabis Cocaine Phencyclidine NEWS & VIDEOS Some Lose Independence After Surgical Tx of Femoral Neck Fx WEDNESDAY, March 6, 2019 (HealthDay News) -- A considerable proportion of older patients with femoral neck fracture are institutionalized or require walking aids 12 months after surgical treatment... 3D Model Musculoskeletal Connective Tissues Video How to Do a Median Nerve Block

2013 Merck Manual (19th Edition)

1027. Fractures of the Nose

Illness Withdrawal from which of the following substances is most likely to increase a patient’s heat input? Alcohol Cannabis Cocaine Phencyclidine NEWS & VIDEOS Some Lose Independence After Surgical Tx of Femoral Neck Fx WEDNESDAY, March 6, 2019 (HealthDay News) -- A considerable proportion of older patients with femoral neck fracture are institutionalized or require walking aids 12 months after surgical treatment... 3D Model Musculoskeletal Connective Tissues Video Prone Quadriceps Stretch 1. Lie (...) are subperichondrial blood collections that may lead to avascular or septic necrosis of the cartilage with resultant deformity (saddle nose). Cribriform plate fracture may cause a CSF leak, with increased risk of meningitis or brain abscess. Fortunately, this complication is rare. Symptoms and Signs Facial trauma resulting in epistaxis may indicate a nasal fracture. Other symptoms and signs include obvious or subtle nasal deformity, swelling, point tenderness, crepitus, and instability. Lacerations, ecchymosis

2013 Merck Manual (19th Edition)

1028. Overview of Fractures, Dislocations, and Sprains

to fractures, musculoskeletal injuries include and subluxations (partial joint dislocations) Musculoskeletal injuries are common and vary greatly in mechanism, severity, and treatment. The extremities, spine, and pelvis can all be affected. Some fractures are discussed elsewhere in T he M anual : Musculoskeletal injuries may occur in isolation or as part of multisystem trauma (see ). Most musculoskeletal injuries result from blunt trauma, but penetrating trauma can also damage musculoskeletal structures (...) , particularly posteriorly displaced supracondylar humeral fractures, disrupt the vascular supply sufficiently to cause distal limb ischemia; this vascular disruption may be clinically occult for hours after the injury. Nerve injuries: Nerves may be injured when stretched by displaced pieces of a fractured bone, when bruised by a blunt blow, when crushed in a severe crush injury, or when torn by sharp bone fragments. When nerves are bruised (called neurapraxia), nerve conduction is blocked, but the nerve

2013 Merck Manual (19th Edition)

1029. Explosives and Blast Injuries

Overview of Heat Illness Withdrawal from which of the following substances is most likely to increase a patient’s heat input? Alcohol Cannabis Cocaine Phencyclidine NEWS & VIDEOS Some Lose Independence After Surgical Tx of Femoral Neck Fx WEDNESDAY, March 6, 2019 (HealthDay News) -- A considerable proportion of older patients with femoral neck fracture are institutionalized or require walking aids 12 months after surgical treatment... 3D Model Musculoskeletal Connective Tissues Video How to Do a Median (...) are probably mortally injured, technical rescue capabilities and extrication are likely to be required, and advanced life support and high victim-to-care-provider ratios are required for any survivors. In the secondary perimeter (critical casualty zone), survivors will have multiple injuries, and standard rescue capabilities and moderate victim-to-care-provider ratios are required. In the blast periphery (walking-wounded zone), most casualties will have non–life-threatening injuries and psychologic trauma

2013 Merck Manual (19th Edition)

1030. Treatment of Acute, Unstable Chest Wall Injuries

or disease Intervention/treatment Phase Blunt Injury of Thorax Flail Chest Chest Wall Injury Trauma Rib Fracture Procedure: Surgical fixation Not Applicable Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 207 participants Allocation: Randomized Intervention Model: Parallel Assignment Masking: None (Open Label) Primary Purpose: Treatment Official Title: A Multi Centered Randomized Controlled Trial of Operative Versus Non-operative (...) Eastern Health The Ottawa Hospital Alberta Health Services Information provided by (Responsible Party): St. Michael's Hospital, Toronto Study Details Study Description Go to Brief Summary: Unstable chest injuries are common in poly trauma patients. They can lead to severe pulmonary restriction, loss of lung volume, difficulty with ventilation and can render the patient to require intubation and mechanical ventilation. Traditionally these injuries have been treated non-operatively, however in the past

2011 Clinical Trials

1031. Treatment of Intertrochanteric Fracture With New Type of Intramedullary Nail

compression screw locking screw, its main features are: The proximal femoral nail was made from titanium, its proximal part is narrow inside and wide outside structure. It looks like a trapezoidal in cross-section. This device was matched with the anatomy of proximal femur and its mechanical reliability. The tip of compression screw was designed thread. It can come through the intramedullary nail, produce slide and sustained pressure. The femoral support screw was made in cylindrical, had a blunt rounded (...) tip. The tip of the femoral support screw was tabling with the groove of compression screw. This design can support interior mechanical stability. At the same time, the support screw from the femoral head and neck compression screw can slide fine-tuning, so it has a direct offset against varus and femoral neck rotating shift to prevent secondary loss of fracture reduction. The screw in the femoral head also can prevent cutting occurs. This device can be used in minimally invasive approach

2011 Clinical Trials

1032. Laryngotracheal Stenosis: Clinical Profile, Surgical Management and Outcome Full Text available with Trip Pro

records. After assessment of extent of stenosis, they were subjected to surgical interventions (endoscopic/open approach). Outcome after surgical interventions was assessed. Results 60 patients were included in the study, in the age group of 2.5-50 years. There were 46 (77%) male patients and 14 (23%) female patients. Intrinsic trauma, secondary to prolonged intubation was the most common cause of LTS, seen in 23 (38%) cases followed by post traumatic stenosis (strangulation-18 (30%), blunt injury-15 (...) (25%), penetrating neck injury-4 (7%)). Stenosis was divided into 6 types based on subsite involvement. Of which, cervical trachea was the commonest site of involvement (25/60 cases). Majority of cases had fixed vocal cords at presentation (55%), more commonly due to post traumatic injury. 60 cases had undergone a total of 110 surgical procedures (endoscopic-56,open approach-54). In the end, overall decannulation rate is 93.3%. In site wise tracheal stenosis, isolated subglottis, combined glottis

2011 Indian Journal of Otolaryngology and Head & Neck Surgery

1033. Retropharyngeal haematoma – an unusual cause of airway obstruction Full Text available with Trip Pro

Retropharyngeal haematoma – an unusual cause of airway obstruction Retropharyngeal haematoma is a rare and potentially fatal cause of airway obstruction. The treatment of retropharyngeal haematoma is contentious. We report a case of an 84 year old woman on aspirin and warfarin who developed a retropharyngeal haematoma following minor blunt head and neck trauma. The patient presented insidiously with Capp's triad and developed delayed airway obstruction necessitating emergency fibreoptic

2011 Journal of surgical case reports

1034. An elderly woman with increasing dyspnoea after a fall. Full Text available with Trip Pro

the haematoma and to achieve haemostasis. The authors could demonstrate that the source of bleeding was a minor injury of the anterior longitudinal ligament. Retropharyngeal haematoma is a potentially life-threatening condition because it can rapidly progress to airway obstruction. Large retropharyngeal haematoma after minor blunt head and neck trauma is not a well-recognised condition. This case, however, illustrates that precarious retropharyngeal haematoma can occur after low-energy trauma even without

2011 Emergency Medicine Journal

1035. Post-concussion syndrome Full Text available with Trip Pro

of Physical Medicine and Rehabilitation . 84 (12): 1885–94. : . . Schapiro S, Mandel S, Sataloff RT (1993). Minor Head Trauma: Assessment, Management, and Rehabilitation . Berlin: Springer-Verlag. p. 152. . Willer B, Leddy JJ (September 2006). "Management of concussion and post-concussion syndrome". Current Treatment Options in Neurology . 8 (5): 415–426. : . . ^ Schnadower D, Vazquez H, Lee J, Dayan P, Roskind CG (2007). "Controversies in the evaluation and management of minor blunt head trauma (...) by other disorders, so there is considerable risk of misdiagnosis. Headaches that occur after a concussion may feel like or . Most headaches are tension-type headaches, which may be associated with a neck injury that occurred at the same time of the head injury. Physical [ ] A common condition associated with PCS is . While most people have headaches of the same they experienced before the injury, people diagnosed with PCS often report more frequent or longer-lasting headaches. Between 30% and 90

2012 Wikipedia

1036. Pneumothorax Full Text available with Trip Pro

an international consensus conference". Journal of Trauma . 46 (3): 466–72. : . . Wilkerson RG, Stone MB (January 2010). "Sensitivity of bedside ultrasound and supine anteroposterior chest radiographs for the identification of pneumothorax after blunt trauma". Academic Emergency Medicine . 17 (1): 11–17. : . . Volpicelli G (February 2011). "Sonographic diagnosis of pneumothorax". Intensive Care Medicine . 37 (2): 224–32. : . . Staub, LJ; Biscaro, RRM; Kaszubowski, E; Maurici, R (8 February 2018). "Chest (...) Pneumothorax Pneumothorax - Wikipedia Pneumothorax From Wikipedia, the free encyclopedia "Collapsed lung" redirects here. For other uses, see . Pneumothorax Other names Collapsed lung A large right-sided spontaneous pneumothorax (left in the image). An arrow indicates the edge of the collapsed lung , Symptoms Chest pain, , Usual onset Sudden Causes Unknown, trauma , , smoking , , , Prevention Stopping smoking Treatment , needle aspiration, , Frequency 20 per 100,000 per year A pneumothorax

2012 Wikipedia

1037. Otitis media Full Text available with Trip Pro

4,900 deaths in 1990. Contents Signs and symptoms [ ] Otitis media. An integral symptom of acute otitis media is ; other possible symptoms include , and (in infants). Since an episode of otitis media is usually precipitated by an (URTI), there are often accompanying symptoms like a and . Discharge from the ear can be caused by acute otitis media with perforation of the ear drum, chronic suppurative otitis media, tympanostomy tube otorrhea, or acute otitis externa. Trauma, such as a , can also lead (...) of the tympanic membrane, which is called bullous myringitis ( myringa being Latin for "eardrum"). However, sometimes even examination of the eardrum may not be able to confirm the diagnosis, especially if the canal is small. If wax in the ear canal obscures a clear view of the eardrum it should be removed using a blunt cerumen curette or a wire loop. Also, an upset young child's crying can cause the eardrum to look inflamed due to distension of the small blood vessels on it, mimicking the redness associated

2012 Wikipedia

1038. Orthopedic cast

of the patient's toes, to create a rigid support which limits motion of the metatarsals in both weight bearing and non-weight bearing leg casts. These are referred to as toeplates in the orthopedic discipline of medicine. This addition may be applied to further support and stabilize the by limiting motion through a higher degree of immobilization, as well as protecting the toes from additional blunt force trauma. Typically leg casts which incorporate a toeplate are prescribed for injuries to the foot (...) arm or long leg cast. Body casts [ ] Body casts, which cover the trunk of the body, and in some cases the neck up to or including the head (see Minerva Cast, below) or one or more limbs, are rarely used today, and are most commonly used in the cases of small children, who cannot be trusted to comply with a , or in cases of radical surgery to repair an injury or other defect. A body cast which encases the trunk (with "straps" over the shoulders) is usually referred to as a body jacket

2012 Wikipedia

1039. Hernia

likely to occur. The physiological school of thought contends that in the case of , the above-mentioned are only an symptom of the underlying cause. They contend that the risk of hernia is due to a physiological difference between patients who suffer hernia and those who do not, namely the presence of extensions from the aponeurotic arch. Abdominal wall hernia may occur due to trauma. If this type of hernia is due to blunt trauma it is an emergency condition and could be associated with various solid (...) with a ), contains the following entities: : a hernia through Petit's triangle (inferior lumbar triangle). It is named after French surgeon (1674–1750). : a hernia through Grynfeltt-Lesshaft triangle (superior lumbar triangle). It is named after physician Joseph Grynfeltt (1840–1913). : two adjacent loops of small intestine are within a hernial sac with a tight neck. The intervening portion of bowel within the abdomen is deprived of its blood supply and eventually becomes necrotic. : hernia through Patient

2012 Wikipedia

1040. History of surgery Full Text available with Trip Pro

" into a scientific discipline capable of treating many diseases and conditions. Contents Origins [ ] The first surgical techniques were developed to treat injuries and traumas. A combination of archaeological and anthropological studies offer insight into man's early techniques for suturing lacerations, amputating unsalvageable limbs, and draining and cauterizing open wounds. Many examples exist: some Asian tribes used a mix of saltpeter and sulfur that was placed onto wounds and lit on fire to cauterize wounds (...) ; the Dakota people used the quill of a feather attached to an animal bladder to suck out purulent material; the discovery of needles from the stone age seem to suggest they were used in the suturing of cuts (the used needles of for the same purpose); and tribes in India and South America developed an ingenious method of sealing minor injuries by applying termites or scarabs who bit the edges of the wound and then twisted the insects' neck, leaving their heads rigidly attached like staples. Trepanation

2012 Wikipedia

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