It's so MESSy
A 57 year old female presents with an open tibial and fibular fracture s/p MVC and is hypotensive at 86/58. After 1L of LR, her repeat BP is 102/70. How many points does she score for the shock category of the MESS score?
+1
A fracture of which bone of the lower extremity is most likely to lead to compartment syndrome?
Tibia
Initial test for determining vascular injury in a lower extremity
ABI
Name the ideal timing for tendon repair
Within 24 hours or after 2 weeks
Name the resident that allowed Sung Lee to shave off his beard after ABSITE 2019.
Christ Porter
What age range qualifies as +2 points in the MESS score?
>50 years old
Name the injury, including vector, shown here:
(Powerpoint slide 2)
Left posterior hip dislocation
A 34 year old female falls off of a ladder and has a left ankle dislocation. After reducing it, which x-rays will you order?
Left tib/fib
Left ankle
Left footName the innervation of the dorsal interossei muscles of the hand
Ulnar nerve
This resident’s artwork has been featured in a medical textbook for breast anatomy
Aaron Arroyave
What MESS score is associated with a low likelihood of limb salvage?
greater than or equal to 7
What nerve is most commonly injured during a 4 compartment fasciotomy and which incision is it associated with?
Peroneal (Fibular) nerve, during lateral incision for anterior compartment
What value for ABI is considered abnormal and requires angiography evaluation?
<0.9
How many zones are in the extensor surface of the forearm?
9
Name the resident who has a pet rabbit, which is actually potty trained.
Lauren Grimsley
Calculate the MESS score:
A 63 year old male presents s/p ATV collision with a left open femur fracture. His vitals are: HR of 115, BP of 82/48, RR of 16 and O2 sat of 98% on 4L NC. He receives 1L of LR and improves to HR of 102 and BP of 98/66. His femur fracture has dirt and gravel present deep within the wound. His femoral pulse is palpable, but his DP and PT pulses are only dopplerable and his left foot is cool to the touch.
9 pts
Limb ischemia: +2
Shock: +1
Age: +2
Mechanism: +4
Why does a pelvic binder help reduce hemorrhage from an open book pelvic fracture?
Reduces the volume of the truncated cone of the pelvis V=1/3*π*h*(r12+r22+(r1+r2)) by reducing the radii of r1 and r2.
Name the injury mechanism associated with this type of vascular injury
Posterior dislocation of knee, popliteal artery injury
What type of suture is used to repair tendons?
Braided, permanent suture
Name the resident who once danced and camped out for a year's worth of Chick-Fil-A.
John Mark McLain
Which hospital in King County first published on the MESS score in 1990?
Harborview Medical Center
Name 2 different ways to obtain compartment pressures
Stryker needle
Arterial line placement into compartment
Wick catheter
Slit catheter
Which type of pelvic fractures are most likely to lead to arterial bleeding and possible IR embolization?
Anterior-posterior compression fractures
Name the function and innervation of the lumbricals of the hand
Function: flex MCP and extend DIP and PIP joints (upstroke in writing)
Innervation: Half by median nerve and half by ulnar nerve
Name all of the couples in the residency
Renee Do and Andrew Antill
Elle Gregory and Andrew Hodge
Megan Johnson and George Lodeiro
Paul Rothenberg and Rebecca Norcini
Megan Shepherd and Alex Funkhouser