CSTR Health Study Guide Exam Questions with Verified Answers- Latest Update 2024, Exams of Health sciences

Download CSTR Health Study Guide Exam Questions with Verified Answers- Latest Update 2024 and more Exams Health sciences in PDF only on Docsity! CSTR Health Study Guide Exam Questions with Verified Answers- Latest Update 2024 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) Brain Hematomas - ✅✅✅EPH, SAH, SDH, IPH, ICH uncial herniation, transtentorial - ✅✅✅(cerebellum) - code ICD- 10 - cord contusion = AIS code of 140202.5 = 5 squared = 25 ISS score. Meninges - ✅✅✅three protective membranes that surround the brain and spinal cord dura mater, arachnoid, and pia mater Intracranial Injuries-Focal injuries - ✅✅✅picked up on CT scan. Contusion, epidural hematoma, subdural hematoma, subarachnoid hematoma, intracerebral/intraparenchymal hemorrhage Intracranial Injuries-Nonlocal Head Injuries - ✅✅✅concussions, shear injury, diffuse axonal injury (DAI), anoxic brain injury (ABI) - these go down to the cellular level. Cranial Nerves and Functions - ✅✅✅I. Olfactory- smell II. Optic - Vision III. oculomotor - Pupil, some extraocular movement • Vertebrae • Carotid Arteries: common, internal, external • Vertebral artery • Jugular vein • Valgus Nerve • Phrenic Nerve Neck Injury Indicators - ✅✅✅• 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 - ✅✅✅• Cricothyroidotomy - needle through a catheter • 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 Cervical Vertebra Injuries - ✅✅✅• Atlanta-occipital Dissociation - C 1 is associated. • Jefferson's fracture of C1 • Hangman's fracture of C-2 • Axis or Odontoid-dens Fracture of C-2 Thoracic Spine - ✅✅✅• Contains 12 vertebrae • 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 cardiac massage defibrillation pericardial window median sternotomy cross- clamp aorta Thoracic Injuries - ✅✅✅• 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. • Diaphragmatic rupture • 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 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 • Pedestrian hit by MV • Machinery Abdominal Injury Indicators - ✅✅✅• Distended Abdomen • Rigidity • Guarding • Rebound • Short of Breath • Bruising • Seatbelt Sign • Quadrant pain • Dehiscence • Evisceration - bowel is exposed to the outside world. • Umbilical Bruising • Tenderness • Absence of Bowel Sounds • Nausea/Vomiting Abdominal trauma Diagnostics & Procedures - ✅✅✅• FAST exam • Ct Scan • X Ray • Diagnostic Peritoneal Lavage (DPL) - to rule out intra- abdominal bleeding using a needle. • Foley Catheter • Suprapubic Catheter • IVP - intravenous pyelogram • Cystotomy • RUG - retrograde urethrogram- contrast dye is inserted through the urethra • Laparoscopy- viewing the abdomen through a scope • Exploratory laparotomy - making an incision into the abdomen surgically and exploring. • Resection- for example of the colon. Lower Extremity Bones - ✅✅✅• Femur • Patella • Tibia • Fibula • Calcaneus • Talus/Navicular • Cuneiform/Cuboid • Metatarsals • Phalanges Lower Extremity Arteries - ✅✅✅• External Iliac • Femoral • Popliteal • Dorsally Pedis • Posterior Tibial Lower Extremity Nerves - ✅✅✅• Sciatic • Anterior Tibial • 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 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 site to another on the body, or from another person, without bringing its own blood supply with it. Tangential excision (burns) - Tangential excision - ✅✅✅involves surgical removal of successive layers of the burn wound down to viable dermis. Sutures/Staples - ✅✅✅medical device used to hold body tissues together after an injury or surgery Escarotomy - ✅✅✅a surgical incision into necrotic (or devitalized dead tissue) tissue resulting from a severe burn. Burns Depth and Degree - ✅✅✅• First Degree - involves the outer layer of the skin. Dry, red, blanches, tender. • Second Degree - Hyperemic, moist, blister, painful. Superficial partial thickness - upper dermis, Deep partial thickness - deeper dermis. • Third Degree - Dry, leather appearance, eschar. Color varies from to red to brown to black. Not painful. 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 o Four General Types 1. Grafts and Prostheses 2. Implants 3. Simple or Mechanical Appliance 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) GCS = 11(0.9368) + SBP = 78(0.7326) + RR =22(0.2908) = 10.3048 + 57.1428 +6.3976 + 73.845 normal AIS components-Numerical Identifier - ✅✅✅7 Digit Unique Numerical Identifier- •Pre Dot Code - 6 digits to the left of the decimal point • AIS Severity Number - a single digit to the right of the decimal point • Injury Description - text • References - to AIS 98 and FCI AIS components-Breakdown - ✅✅✅• Body Region (1st Number) • Type of Anatomic Structure (2nd Number) • Specific Anatomic Structure (3rd - 4th) • Level (5th-6th) • Decimal • AIS Severity Number = 3 AIS Severity Code - ✅✅✅0- None 1-Minor 2-Moderate 3-Serious 4-Severe 5-Critical 6-Maximum 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. (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. • Being knowledgeable of reimbursement issues, what documentation to look for. • Work hand in hand with physicians as a respected team member related to documentation issues • Leave prompters on the chart for needed documentation. • Face to face meetings to discuss documentation needs on a weekly basis. • Educational presentations for residents • Coding validations with medical records for reimbursement comparisons. • Reliable, validated data within the Trauma Registry. • Concurrent trauma Registry. • Dedicated person for the Trauma Registry. Registry Operations -Staffing ACS recommendation - ✅✅✅one registrar per 500-750 patients per year Registry Operations -Definition of a current registry - ✅✅✅80% or records are abstracted and closed within 60 days of Discharge. 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 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. xiphoid process - ✅✅✅lower, narrow portion of the sternum AIS Injury Scale-How many body regions? - ✅✅✅6 ACS recommendations what % of patients for data validation? - ✅✅✅5%-10% subluxation - ✅✅✅partial dislocation of a joint comminuted fracture - ✅✅✅fracture in which the bone is splintered or crushed Pt with AIS value of 6 has an ISS of? - ✅✅✅75 cystic duct - ✅✅✅carries bile to and from the gallbladder ICD-10-CM classification - ✅✅✅arranges dx and injuries into groups 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