WorksheetsMRSC5014 -Trauma
Total questions: 28
Worksheet time: 15mins
Trauma Radiography - Best Practice
True or false
Currently, there is no available evidence suggesting the use of MRI in the setting of acute trauma.
TRUE
FALSE
Which finding during the “D” assessment most strongly suggests increased intracranial pressure?
Unequal pupils
Normal blood pressure
Regular breathing
Warm, dry skin
Pelvic X-rays in trauma can be omitted if FAST is negative.
True
False
Trauma Radiography - Best Practice
True or false
A c-spine collar must never be removed, but pelvic binders can be removed provided you have another radiographer present to assist.
TRUE
FALSE
Trauma Radiography - Best Practice
The E-FAST Scan is used for what?
To visualise free fluid in the body and pneumothorax in the anterior pleura
To assess the mechanical instability of the pelvis
To identify foreign bodies in the abdomen and pelvic locations
As a substitute to whole body CT as it is more sensitive and specific.
Trauma Radiography - Best Practice
The Advanced Trauma Life Support (ATLS) guidelines recommend a rapid primary clinical survey of the ABCDEs and a trauma series of plain radiographs + focused assessment with sonography in trauma US.
What are the plain radiographs recommended and why?
Chest XR - detecting major pneumothorax and major haemothorax
Abdomen XR - to rule out any free fluid or air
Pelvic XR - concern for occult pelvic injury or mechanically unstable pelvis
Lateral C-spine XR - rule out atlanto-occipital dislocation or other severely displaced c-spine fracture
In a hemodynamically unstable trauma patient with a positive FAST, the next step is usually:
DMSA renal scan
MRI of the abdomen
Exploratory laparotomy
Whole-body CT scan
When a patient utters incomprehensible sounds without forming words, what verbal score is assigned on the Glasgow Coma Scale?
1
2
3
4
What do each of the letters stand for in ABCDE?
Ambulant, Breathing & ventilation, Circulation, Defibrillator, External Assistance
Airway, Breathing & ventilation, Circulation & haemorrhage control, Disability/Deficit, Environment
Airway, Breathing & ventilation, Consciousness level, Danger, Environment
Airway, Breathing & ventilation, Cervical spine clearance, Disability/Deficit, Environment
Under the “C” (Circulation & Haemorrhage Control) step, which finding is not a direct sign of hypovolemic shock?
Hyperthermia
Delayed capillary refill
Hypotension
Tachycardia
The “E” (Exposure & Environmental Control) step includes all the following except:
Removing clothing to inspect for hidden injuries
Maintaining normothermia with warming blankets
Protecting patient dignity with appropriate covering
Full immobilisation of limbs
In the “D” (Disability) evaluation, which GCS score necessitates immediate airway protection?
12
9
8
15
A patient flexes their arm withdraws from painful stimuli. What motor response score does this represent on the Glasgow Coma Scale?
3
4
5
6
Which of the following correctly identifies the non‐contrast components of a whole‐body CT (WBCT) trauma protocol in a stabilised patient?
CT C‐spine and CT Head
CT Chest (arterial phase) and AbdoPelvis (portal venous phase)
CT C‐spine and CT Chest (arterial phase)
CT Head and AbdoPelvis (portal venous phase)
Which type of blast injury is caused by missiles or debris propelled by the explosion?
Primary
Secondary
Tertiary
Quaternary
Trauma is best defined as a sudden, unexpected, dramatic event that results in injury. Which element is not part of this definition?
Sudden onset
Anticipated event
Forceful impact
Potential long-term disability
Chemical burns fall under which trauma category?
Blunt force
Penetrating
Explosive
Thermal
When adapting a foot X-ray for a supine trauma patient, the tube should be angled:
Steep cranially to foreshorten metatarsals
Always at 45° caudally
Perpendicular to the sole of the foot
In line with the tibial shaft
For AP tibia/fibula in a supine patient with limited rotation, the best adaptation is:
Use ultrasound instead
Traditional PA projection
Angle the beam
Medial-lateral projection only
In mass-casualty scenarios, FAST is especially useful as a:
Replacement for CT scanning
Triage tool to identify unstable patients
Method to evaluate cortical scarring
Definitive diagnostic tool
According to best-practice guidelines, image quality in trauma radiography:
Is the sole responsibility of the radiologist
Can be compromised if the patient is unstable
Should never be sacrificed for speed
Is secondary to radiation dose reduction
A 52-year-old male motorcyclist is brought into the resuscitation bay after a high-speed collision. He’s hypotensive (BP 85/50), tachycardic, and has a distended, tender abdomen. His C-spine is immobilised and he remains supine on the trolley. A FAST exam is positive.
Which is the most appropriate next step in imaging management?
Pelvic binder removal and repeat FAST
Whole-body CT trauma series with IV contrast
Direct transfer to operating theatre for laparotomy
Supine AP chest X-ray then pelvic X-ray
A 28-year-old construction worker falls from scaffolding. He’s alert, haemodynamically stable, but complains of neck pain. He remains in his cervical collar and cannot extend his neck. You need a lateral C-spine view.
Which radiographic adaptation is most suitable?
Standard lateral C-spine in erect position
AP supine C-spine with increased tube angle
Horizontal beam lateral (HBL) C-spine on trolley
Odontoid peg view with the collar removed
A 65-year-old woman presents after a simple trip-and-fall at home. She has pain and swelling in her left mid-foot. She cannot dorsiflex her ankle or flex her knee.
To assess for a Lisfranc injury, which approach yields the most diagnostic foot series?
AP/oblique/medial-lateral foot in seated position
AP and lateral foot (HBL) with beam angled to arch
45° plantarflexed AP foot plus standard lateral
Tunnel view (plantodorsal) without modification
A 40-year-old intubated patient with suspected pneumothorax arrives from the field. He remains supine, and portable CXR is requested.
What marker and view combination should be used to ensure proper interpretation?
“AP” marker on upright PA chest
“Supine” marker on AP supine CXR
“HBL” marker on horizontal beam lateral CXR
“Erect” marker on semi-erect AP CXR
A 50-year-old male arrives with pelvic pain after a crush injury. He's hypotensive; pelvic binder is in place. Portable AP pelvis shows an “open-book” pattern.
What is the most critical next imaging decision?
Remove binder and obtain AP pelvis off the trolley
Proceed directly to the operating room for stabilization
Order contrast-enhanced CT abdomen/pelvis before surgery
Perform an E-FAST study to look for intra-abdominal fluid
A 17-year-old with a GCS of 6 following a skateboard accident presents with unequal pupils and hypotension. He’s intubated and has cervical immobilisation.
Which imaging pathway aligns with ATLS and local trauma protocols?
Immediate WBCT series (head to pelvis)
Plain films only—lateral C-spine, chest, pelvis
FAST exam then MRI head if negative
Skull X-ray followed by lumbar spine CT
A hemodynamically stable 45-year-old has multiple facial lacerations after an assault. He complains of jaw pain and mild malocclusion.
Which imaging strategy is most appropriate to assess suspected mandibular fractures?
Panoramic dental film alone
CT maxillofacial series with 3D reconstructions
AP and lateral skull X-rays only
Oblique mandible projections on mobile machine
