CSTR Exams Questions and Answers on Anatomy and Trauma, Exams of Nursing

Download CSTR Exams Questions and Answers on Anatomy and Trauma and more Exams Nursing in PDF only on Docsity! CSTR exams Questions with correct Answers Latest Update 2023///.  AIS Components for ISS Scaling- Body Region - ✅✅✅1. Head/Neck  2. Face  3. Chest  4. Abdominal/Pelvic Contents  5. Extremities/Pelvic Girdle Severe  6. External- Skin and Burns  Types of head injuries - ✅✅✅scalp wounds, skull fractures, brain injuries  The adult skeletal system - ✅✅✅206 bones  Skull base fractures - ✅✅✅orbital roof, ethmoid, basilar process of occipital bone, petrous and squamous process of temporal bone (mastoid or petrous)  Skull Vault fractures - ✅✅✅frontal, parietal, occipital, temporal bones (specifies squamous)  IV. Troclear - extraocular movements  V. Trigeminal - some movements of the jaw, sensation  VI. Abducens- lateral extraocular movement  VII. Facial - facial muscle movement, taste  VIII. Acoustic- hearing, balance  IX. Glossopharyngeal - pharynx- motor, ear/pharynx, tongue- movement  X. Vagus - palate, larynx, pharynx, involuntary muscles  XI. Accessory - sternocleidomastoid/trapezius muscles  XII. Hypoglossal - tongue  Facial Bones - ✅✅✅• Orbits • Nasal bones • Maxillae • Mandible • Palatine • Vomer  Facial Mechanisms of Injury - ✅✅✅deep lacerations, deformity, difficulty speaking, visual changes, entrapment of muscles, rhinorrhea, otorrhea, trismus  LeFort Fractures - ✅✅✅Type I: maxilla dissociated from skull base - nasal aperture; "floating palate"  Type II: central midface dissociation - inferior orbital rim, orbital floor; "pyramidal"  Type III: complete midface dissociation - lateral orbital wall, zygomatic arch; "floating face"  Other types of Facial Injuries - ✅✅✅injuries to the nose, mandible, maxilla, eyes, ears • Tracheostomy - done when a patient is stabilized • Neck Exploration • Intubation  Vertebral Column Dislocation - ✅✅✅• 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 Cord Descriptors - ✅✅✅• Neurodeficits • Paresis- inability to move • Quadriplegia, tetraplegia - affects all parts • Paraplegia - affects lower half of the body in terms of movement • Hemiplegia - half of the body can't move  Spinal Injury Diagnostics and Procedures - ✅✅✅CT scan, MRI Procedures- cervical collar, tongs, halo traction, spinal decompression  Cervical Spine - ✅✅✅• 7 vertebrae • C1-atlas, c2- axis - responsible for assisting with movement of the head. • If spinal cord injured at c1-C2- typically quadriplegic  Thoracic Bone Structures - ✅✅✅• 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 - ✅✅✅very important to know the number of ribs fractured on each side. Segmental - flail  Thoracic Muscular Structures - ✅✅✅Diaphragm - muscle separating the chest and its contents from abdomen and its contents  Intercostal - assists in breathing  Thoracic Organs - ✅✅✅lungs, heart, esophagus, trachea, thymus glands  Thoracic Injury Descriptors - ✅✅✅• 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 - ✅✅✅• FAST exam • Pericardiocentesis • CT scan • Ct angiography - uses dyes • Aortography • Needle Thoracentesis  Thoracic Trauma Procedures - ✅✅✅chest tube/thoracostomy  thoracotomy • Aortic rupture - aortography is used to detect this.  Rib Fractures - ✅✅✅common in older pts; can lacerate the surface of the lung and can cause pneumothorax or hemothorax; can cause crepitus; pts breathe rapidly and shallowly  Rib Fractures-Flail Chest - ✅✅✅be careful when looking at the medical record as segmental indicates detachment  a life-threatening medical condition that occurs when a segment of the rib cage breaks due to trauma and becomes detached from the rest of the chest wall  cardiac tamponade - ✅✅✅pressure on the heart caused by fluid in the pericardial space  Aortic rupture - ✅✅✅Dx in which the arterial wall breaks open as could happen in aortic dissection, ruptured aortic aneurysm trauma,aortography is used to detect this  Tension Pneumothorax - ✅✅✅a life threatening blunt injury • Severe respiratory distress • Hypotension • Distended neck veins - cannot return blood back to the heart. • Tracheal deviation • Cyanosis - late sign  ABDOMEN AND PELVIS Bones - ✅✅✅• Lumbar Spine • Pelvic Bones  Abdominal Muscle Structures - ✅✅✅• Rectus Abdominis • External Oblique • Internal Oblique • Transverse Abdominis • Urethra- means for expelling urine  Reproductive System Structures- Female - ✅✅✅Ovaries  Fallopian tubes  Uterus  Cervix  Vagina  Vulva  Reproductive System Structures- Male - ✅✅✅Scrotum, Testes, vas deferens, Prostate, urethra, Penis  Abdominal Quadrants-RUQ - ✅✅✅liver, gallbladder, Rt kidney  Abdominal Quadrants-RLQ - ✅✅✅Intestines  Abdominal Quadrants-LUQ - ✅✅✅Spleen, Stomach, Pancreas, Left Kidney  Abdominal Quadrants-LLQ - ✅✅✅Intestines  Abdominal Vascular Structures - ✅✅✅• Aorta- descending • Mesentery Arteries - Superior and Inferior - help feed the GI contents. • Renal Arteries • Iliac Arteries - external and internal • Vena Cava - iliac, renal, hepatic • Portal System - Mesenteric, Splenic.  Abdominal Trauma Mechanisms of Injury - ✅✅✅• MCC • MVC • GSW • Stab Wounds • Falls • Assaults • Sports • Seat Belts • Equestrian • Laparoscopy- viewing the abdomen through a scope • Exploratory laparotomy - making an incision into the abdomen surgically and exploring. • Resection- for example of the colon.  Abdominal Injuries - ✅✅✅• Contusions/Lacerations involving the liver, spleen, bowel, renal, bladder, urethra • Fractures - lumbar, pelvic • Blood Vessels  Classification of Splenic Injuries - ✅✅✅Grade 1 - sub capsular hematoma- nonexpanding  Grade 2 - Split- capsular tears  Grade 3 - Deep parenchyma laceration  Grade 4 - artery injured, devascularized parenchyma  Grade 5 - Avulsion of splenic artery, vein. Transhilar injury  Pelvic Bones - ✅✅✅• Ilium • Ischium • Pubis • Acetabulum • Symphysis Pubis • Sacroiliac Joint  Upper Extremity Bones - ✅✅✅• Humerus • Radius/Ulna • Carpals/Metacarpals/ Phalanges  Upper Extremity Joints - ✅✅✅• Sternoclavicular • Acromioclavicular • Glenohumeral • Elbow • Wrist • Hand  Upper Extremity Arteries - ✅✅✅• Subclavian • Femoral • Peroneal  Extremity/Bony Pelvis Trauma Descriptors - ✅✅✅• Dislocation • Compartment Syndrome - life threatening • Angulated • Depressed • Missile • Pain • Guarding • Deformity • Non-Weight Bearing • Inability to Move • Dusky Extremity - dislocation • Bruising  Extremity/Bony Pelvis Trauma Diagnostics and Procedures - ✅✅✅• X- Rays • CT scans • Angiography • Relocation • Closed and open reductions with or without internal or external fixations • Fasciotomy • Splinting • Casting  Extremity/Bony Pelvis Injuries - ✅✅✅• Fractures • Dislocations • Amputations  Fracture Documentation - ✅✅✅• Closed versus open fracture • Internal fixation • External fixator - uniplanar, monoplanar- ring  How will you know in the documentation which fractures are open? - ✅✅✅• Compound • Infected • Missile • Puncture • Foreign Body  Ecchymosis - ✅✅✅bluish discoloration of an area of skin or mucous membrane caused by the extravasation of blood into the subcutaneous tissues as a result of trauma to the underlying blood vessels or fragility of the vessel walls  Abrasion - ✅✅✅a wound caused by superficial damage to the skin, no deeper than the epidermis.  Laceration - ✅✅✅a tear in the skin which results from an injury  Degloving injury - ✅✅✅An avulsion- type injury in which the skin and subcutaneous tissue of the hand are torn off in a glove-like fashion, leaving the musculofascial plane intact  Avulsion - ✅✅✅an injury in which a body structure is forcibly detached. It most commonly refers to a surface trauma where all layers of the skin have been torn away; exposing the underlying structures (e.g. subcutaneous tissue, muscle, tendons). This is similar to an abrasion but more severe, as body parts such as an eyelid or an ear can be partially or fully detached from the body  Debridement - ✅✅✅the medical removal of dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue  Irrigation - ✅✅✅cleaning a wound or body organ by flushing or washing out with water or a medicated solution  Grafting - ✅✅✅refers to a surgical procedure to move tissue from one  ICD-10 Coding - ✅✅✅a classification system that groups health related conditions and procedures for statistical and billing purposes.  Types of ICD-10 Codes - ✅✅✅There are 3 primary sections in PCS (Primary Coding System). • Medical and Surgical (Largest Section in PCS) • Medical and Surgical Related • Ancillary  ICD-10 Format of a PCS Code: - ✅✅✅Section - Body System - Root Operation - Body Part - Approach - Device - Qualifier  ICD-10 Medical and Surgical Section: - ✅✅✅• All Codes n Medical and Surgical Section begin with 0 (a zero) • The first character in a PCS Code represents the section • There are 31 body systems in Medical and Surgical Section  ICD-10 Body System: - ✅✅✅Anatomical Region procedures are performed on multiple body parts and through various types of structures  ICD-10-Body Part - ✅✅✅Indicates site of the body on which the procedure was performed (Example: liver, upper lung, skin of back, etc.)  ICD-10-Device Characters: - ✅✅✅• Used only to specify the devices that remain after the procedure is completed  Four General Types  Grafts and Prostheses  Implants  Simple or Mechanical Appliance • Composed of 3 parameters - best eye, verbal, and motor response • The range is 3-15.  Trauma Score - RANGE - ✅✅✅•Score for multiple trauma injuries with a range of 1-16  Trauma Score Components - ✅✅✅1. GCS  SBP  RR  Capillary Refill  Respiratory Effort  Trauma Score Purpose - ✅✅✅scoring multiple trauma  Trauma Score Factors-Objective data - ✅✅✅Systolic rate, respirations, GCS  Trauma Score Factors-Subjective data - ✅✅✅Capillary refill, Respiratory effort  Revised Trauma Score (RTS) - ✅✅✅~Components: Glasgow Coma Scale (GCS), Systolic blood pressure, Respiratory rate  ~Follow local protocol for use of the trauma scoring system  ~Do not let it interfere with patient care  Revised Trauma Score Evaluation (RTS/E) - ✅✅✅• Used in the ED and trauma registries for outcome evaluation. • Based on the first set of vital signs in the FIRST facility • Ranges from 0.0000 - 7.8408 • Normal : 7.8408 (weighted formula) • Formula: RTS = 0.9368(GCS) + 0.7326(SBP) + 0.2908(RR)  9-Unknown  ISS Calculations - ✅✅✅the sum of the squares of the highest AIS from the three (3) most severely injured ISS body regions. A2 +B2+C2 = ISS  AIS components- ( ) - ✅✅✅contains synonyms for a specific type of injury/provide a definition for the injury description  AIS components- { } - ✅✅✅contain inclusionary or exclusionary information/ contain organ injury scale grade  AIS components-Boxed Bold Type - ✅✅✅contains directives  AIS components- ; semicolon - ✅✅✅separate injury descriptors that are comparable in severity  AIS components-Italics - ✅✅✅used for proper name anatomical structures or injuries, and for OIS grades  ISS Range - ✅✅✅1-75  ISS Purpose - ✅✅✅to reflect severity of multi-organ injury in the same body region.  TRISS - ✅✅✅determines the probability of survival from the ISS, RTS, and the patient's age.  >0.50 = probability of Survival  <0.50 = Probability of Death  PS Components - ✅✅✅• Age • Mechanism (Blunt vs. Penetrating) • RTS (Evaluation) • ISS  TRISS Chart - ✅✅✅• PRE Chart  W Score Example: - ✅✅✅Total patients = 784, those with POS (probability of survival) 693  Total deaths = 24 Sum of POS = 634.531  (Total # pts with POS - deaths) - (POS sum)  (Total # pts with POS)/100  (693-24)- (634.531)  (693)/100  =669 - 634.531  6.93  = 34.469 divided by 6.93  = 4.97 unexpected survivors /100 patients  Data validation - ✅✅✅is the process of ensuring that a program operates on clean, correct, and useful data. • A routine check for correctness, meaningfulness, and security of data that are input to the system database. • A process to prove or disprove accuracy. • Elimination of erroneous values. • Identify y suspicious or invalid cases, variables, and data values.  IRR registry frequency and percent - ✅✅✅The data in the registry should be evaluated monthly and not all data elements need to be validated each time. The ACS suggests 5- 10% of records  The Trauma Registrar's Role - ✅✅✅• Daily review of all trauma charts- new and in-house patients.  contusion - ✅✅✅bruise  Pie Chart/Graph - ✅✅✅used to show parts of a whole  ISS of 84 - ✅✅✅represents miscalculation  infammation - ✅✅✅localized pain, swelling, heat and redness  ISS range - ✅✅✅1-75  temporal lobe - ✅✅✅Cerebrum-An area on each hemisphere of the cerebral cortex near the temples that is the primary receiving area for auditory information  Diagnostic Peritoneal Lavage - ✅✅✅Abdomen-instillation of lactated Ringer's or normal saline solution into the abdominal cavity to detect red blood cells, white blood cells, bile, bacteria, amylase, or gastrointestinal contents  Trimalleolar fracture - ✅✅✅ankle fx  Primary reason for trauma registry - ✅✅✅Quality Improvement  Inflammation suffix - ✅✅✅-itis  AIS body regions combines for ISS body region 1 - ✅✅✅Head and Neck  Orbital floor fracture - ✅✅✅Blow out fracture  Cricothyroidotomy - ✅✅✅establish airway  revised trauma score (RTS) - ✅✅✅Glasgow Coma Scale  Systolic blood pressure  Medial - ✅✅✅Toward the mid line of the body  Lateral - ✅✅✅Away from the mid line of the body  supine - ✅✅✅lying on the back  prone - ✅✅✅lying face down  Burn Scoring - ✅✅✅the rule of nines  intertrochanteric fracture - ✅✅✅Fracture at the proximal end of the femur  ICD-10-CM Solid Organ Injury, 5th digit represents - ✅✅✅Organ Injured (Body Part Injured)  ICD-10-CM Code Structure - ✅✅✅3- 7 Characters: 1st Character: Always alpha (A-Z, except u). 2nd Character: Always numeric. 3rd-7th Characters: Alpha or numeric. First 3 characters: Category. 4th-6th Characters: Describe etiology, anatomic site, severity, and such. 7th Character: Added information for obstetrics, injuries, external causes or injury and such.  duodenum - ✅✅✅first part of the small intestine  LOC assigned an AIS code must be corroborated by? - ✅✅✅EMS  hyoid bone - ✅✅✅U-shaped bone at the base of the tongue that supports the tongue and its muscles.  pie chart - ✅✅✅a chart that shows the relationship of a part to a whole  bar graph - ✅✅✅a graph that uses vertical or horizontal bars to show comparisons among two or more items  Scattergram - ✅✅✅Used to plot correlations where each pair of values is plotted against each other to see if there is a relationship between them.  line graph - ✅✅✅A graph that uses line segments to show changes that occur over time  histogram - ✅✅✅a bar graph depicting a frequency distribution  lumbar vertebrae - ✅✅✅L1-L5  cervical vertebrae - ✅✅✅7, C1-C7, first set of seven bones, forming the neck  Thoracic Vertebrae (T1-T12) - ✅✅✅the 12 bones of the vertebral column (midspine)  sacral spine - ✅✅✅S1-S5 (back wall of the pelvis)  Coccyx Vertebrae - ✅✅✅4 vertebrae that make up the tail bone  M score - ✅✅✅Characterizes case mix  Based on ISS compared to the MTOS  Score Ranges:  0.0-0.87 = Dissimilarity to MTOS  .88-1.0 = Similarity to MTOS  Mode - ✅✅✅The value that occurs most frequently in a given data set.  Y92.1 - ✅✅✅Institutional (Non- private) residence  Y92.2 - ✅✅✅School, Other Institutional and Public Administrative  Y92.3 - ✅✅✅Sports and athletic area  Y92.4 - ✅✅✅Street, Highway, other paved road  Y92.5 - ✅✅✅Trade and service area  Y92.6 - ✅✅✅Industrial construction area  Y92.7 - ✅✅✅Farm  Y92.8 - ✅✅✅Other places  Y92.9 - ✅✅✅Unspecified  < - ✅✅✅Less Than  - ✅✅✅Greater Than