Data Trace Editor – Discussion: – muscle contraction is initiated w/ release of ionic calcium, from terminal cisternae into the sarcoplasm; – complexing of calcium by troponin shifts the protein conformations in thin filament & allows formation of crossbridges between actin & myosin, which then moves the actin molecule up long axis of the myosin filament; … Read more
– See: Extra-articular Thumb Metacarpal Fractures – Discussion: – interosseous muscles & intrinsically strong carpometacarpal capsular and interosseous ligaments provide intrinsic stability to extra-articular fractures at the metacarpal bases; – mechanism of frx of little CMC: – stability of CMC joint derives from articulation w/ carpal … Read more
– See: MP joint injuries – Discussion: – often badly comminuted; – consider a short period of splinting followed by early active motion; – this may mold the articular surface by using the soft tissue sleeve; – early motion will also prevent joint stiffness, but loos of … Read more
– carpometacarpal fracture dislocation – dislocation of MP joint: – complex dislocations of the MP joint – simple dislocations of the MP joint – thumb MP joint dislocation – metacarpal head frx – metacarpal neck fracture – metacarpal shaft fractures – MP joint locking – rheumatoid arthritis: MP joint – MP joint arthroplasty – MP … Read more
– See: metacarpal frx menu – Discussion: – frxs through neck & shaft of metacarpals usually angulate w/ apex dorsal, displacing the metacarpal head into the palm; – ring and little neck frx: (see boxer’s frx); – corresponding CMC joints are mobile (in contrast to 1st & 2nd CMC) w/ flexion extension arc of between … Read more
– Adult: 50-150mg PO/IM/SQ q3-4hr prn Pain; (75mg IM Demerol =10mg Morphine) 1-2 mg/kg/dose PO/IM/IV (including Peds q 6 hr) – PO: peak effect at 2 hrs; – IM/IV: onset at 2-5 min; Peak at 1 hr; lasts 2-3 hrs. – IV administration must be slow in diluted solution; – Peds: 1 mg/kg/dose IV/IM q2-4hr; 1.0-1.5 mg/kg/dose … Read more
– Discussion: – for evaluation of both the patella and trochlea surfaces of femur; – disadvantages: – this view does not necessarily predict which patients will show functional improvements w/ surgical realignment; – as pointed out by O’Neil (1997) some patients … Read more
– See ABG – See Diff Dx: Anion Gap / Non Anion Gap – By definition: primary decrease HCO3 concentration. – Simple Met acidosis, Stimulates Ventilation, Decreasing pCO2 – Base Deficit: – indicator of blood loss, resuscitation, and mortality in trauma patients, and it is a more sensitive marker of hypovolemia than vital signs; … Read more
– See ABG AG: Endogenous; AG: Exogenous Lactic Acid Aspirin Hypovolemia ketoacidosis Methanol DKA Starv. Uremia Renal Failure Rhabdomyolysis – elevated CK, myoglobin ETOH Ethylene glycol Hyperaliment Dialysis Buffer TPN
See ABG – Definition: primary increase HCO3. – Must distinguish: Compensatory HCO3 incr vs. Primary Resp Acid – the Resp response to Met. Alk may vary: pCO2 incr approx 0.6 : 1 HCO3. HCO3: 24 26 28 30 32 34 36 38 40 pCO2: 40.0 41.2 42.4 43.6 44.8 46.0 47.2 48.4 49.6 * if … Read more