CSTR STUDY GUIDE 2024 WITH
COMPLETE SOLUTION
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
-uncal 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-Nonfocal 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
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
-Facial Diagnostics and Procedures - -CT scan, MRI scan, X rays, ORIF,
Enucleation or removal of the eyeball.
-Neck Structures - -• Pharynx
• Larynx
• Epiglottis
• Thyroid Cartilage
• Cricoid Cartilage
• Trachea
• Esophagus
• Vertebrae
• Carotid Arteries: common, internal,external
• Vertebral artery
• Jugular vein
• Vagus 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 - -• Atlanto-occipital Dissociation - C 1 is
associated.
• Jefferson's fracture of C1
• Hangman's fracture of C-2