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Questions and Answers
What is compartment syndrome?
What is compartment syndrome?
A condition in which increased pressure within a limited space compromises the circulation and function of the tissues within that space.
What are the four compartments found in the lower leg?
What are the four compartments found in the lower leg?
What are two factors that can increase compartment pressure?
What are two factors that can increase compartment pressure?
What are some causes of compartment syndrome?
What are some causes of compartment syndrome?
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Muscle damage is reversible if it occurs within 6-8 hours.
Muscle damage is reversible if it occurs within 6-8 hours.
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What are the 5 Ps of compartment syndrome?
What are the 5 Ps of compartment syndrome?
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What is the normal tissue pressure? What is the absolute pressure to diagnose CS?
What is the normal tissue pressure? What is the absolute pressure to diagnose CS?
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What is the treatment for compartment syndrome?
What is the treatment for compartment syndrome?
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The fascia should be cut on both sides of the leg during a fasciotomy.
The fascia should be cut on both sides of the leg during a fasciotomy.
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What are two signs of compartment syndrome that should be investigated urgently?
What are two signs of compartment syndrome that should be investigated urgently?
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What is the absolute pressure threshold for diagnosing compartment syndrome?
What is the absolute pressure threshold for diagnosing compartment syndrome?
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Which of the following is NOT a principle of fasciotomy?
Which of the following is NOT a principle of fasciotomy?
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What should be done as soon as compartment syndrome is clinically evident?
What should be done as soon as compartment syndrome is clinically evident?
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Which of the following is an indication for performing a fasciotomy?
Which of the following is an indication for performing a fasciotomy?
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What should NOT be done when diagnosing compartment syndrome?
What should NOT be done when diagnosing compartment syndrome?
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What can lead to irreversible muscle changes in compartment syndrome?
What can lead to irreversible muscle changes in compartment syndrome?
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Which of the following symptoms indicate a late stage of compartment syndrome?
Which of the following symptoms indicate a late stage of compartment syndrome?
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Which condition is NOT typically associated with the etiology of compartment syndrome?
Which condition is NOT typically associated with the etiology of compartment syndrome?
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What is the primary method for diagnosing compartment syndrome?
What is the primary method for diagnosing compartment syndrome?
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Which of the following is NOT one of the 5 Ps used for diagnosing compartment syndrome?
Which of the following is NOT one of the 5 Ps used for diagnosing compartment syndrome?
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Which situation could potentially increase compartment pressure due to compartment content?
Which situation could potentially increase compartment pressure due to compartment content?
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What is the role of a special catheter in the context of compartment syndrome?
What is the role of a special catheter in the context of compartment syndrome?
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Which of the following factors can compromise tissue function within a compartment?
Which of the following factors can compromise tissue function within a compartment?
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What is formed when AMP is deaminated by AMP deaminase?
What is formed when AMP is deaminated by AMP deaminase?
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Which energy system is predominantly used during high intensity activities lasting no longer than 10 seconds?
Which energy system is predominantly used during high intensity activities lasting no longer than 10 seconds?
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What is the primary characteristic of the anaerobic glycolysis system?
What is the primary characteristic of the anaerobic glycolysis system?
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Which process occurs when blood lactate is removed through gluconeogenesis?
Which process occurs when blood lactate is removed through gluconeogenesis?
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What is the predominant energy system utilized for activities exceeding 2-3 minutes?
What is the predominant energy system utilized for activities exceeding 2-3 minutes?
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What is the primary function of creatine in muscles?
What is the primary function of creatine in muscles?
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Where does the synthesis of creatine begin in the human body?
Where does the synthesis of creatine begin in the human body?
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Which enzyme is responsible for the conversion of creatine into phosphocreatine?
Which enzyme is responsible for the conversion of creatine into phosphocreatine?
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What happens to creatinine once it is formed in the body?
What happens to creatinine once it is formed in the body?
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How do levels of creatinine in urine correlate with body muscle mass?
How do levels of creatinine in urine correlate with body muscle mass?
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Which of the following conditions is creatine kinase (CK) elevated in?
Which of the following conditions is creatine kinase (CK) elevated in?
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Which isoenzyme of creatine kinase is primarily found in the heart muscle?
Which isoenzyme of creatine kinase is primarily found in the heart muscle?
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During exercise, what compounds does ATP degrade into?
During exercise, what compounds does ATP degrade into?
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What is the primary function of muscles in the human body?
What is the primary function of muscles in the human body?
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Which type of muscle fibers are best suited for activities requiring endurance?
Which type of muscle fibers are best suited for activities requiring endurance?
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What characterizes fast-twitch type IIb muscle fibers?
What characterizes fast-twitch type IIb muscle fibers?
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What role do mitochondria play in skeletal muscle fibers?
What role do mitochondria play in skeletal muscle fibers?
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Which characteristic is associated with cardiac muscle?
Which characteristic is associated with cardiac muscle?
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Which components are commonly found in the sarcoplasm of muscle cells?
Which components are commonly found in the sarcoplasm of muscle cells?
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Which type of muscle is primarily responsible for controlling movements of the skeleton?
Which type of muscle is primarily responsible for controlling movements of the skeleton?
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Which function is NOT associated with muscle metabolism?
Which function is NOT associated with muscle metabolism?
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Study Notes
Compartment Syndrome
- A condition where increased pressure in a confined space reduces blood flow and tissue function.
- Anterior compartment syndrome is a type, where high pressure in the front of the leg impairs circulation to muscles, nerves, and distal circulation.
- The lower leg has 4 compartments: Lateral, Anterior, Superficial Posterior, and Deep Posterior.
Etiology/Pathophysiology
- Compartment Size: Localized external pressure (tight dressings, casts), or fascial defects can cause this.
- Compartment Content: Bleeding (hematoma from fractures or vascular injury), increased capillary permeability (trauma, burns, snake bites).
Etiology
- Fractures
- Blunt trauma
- Tight casts or dressings
- Fascial defects
- Burns/electrical injuries
- Hemophilia/coagulation disorders.
- Snake bites
- Arterial injuries
Tissue Survival
- Muscle: Reversible changes under 3-4 hours, irreversible damage after 6-8 hours (muscle death).
- Nerve: Reversible changes (neuropraxia) within 2-4 hours; irreversible changes after 8 hours.
Diagnosis (5 P's)
- Pain: disproportionately intense compared to the injury, often in the calf muscles.
- Pallor: pale skin colour.
- Paresthesia/Hypoesthesia: decreased or absent sensation.
- Pulselessness: absent pulse.
- Paralysis: muscle weakness or inability to move.
Clinical Evaluation
- Pain is the most crucial sign, especially if disproportionate to the injury.
- Pain on passive stretching and palpation of the affected compartment are reliable indicators.
- Other signs (pallor, pulselessness, paralysis, paresthesia) typically appear later and shouldn't delay treatment.
Measuring Compartment Pressure
- A catheter measures pressure inside the compartment.
- Normal tissue pressure: 0-4 mm Hg (up to 10 mm Hg during exertion).
- Compartment syndrome diagnosis: pressure above 30 mm Hg.
General Management
- Remove tight bandages/casts.
- Maintain the limb at the level of the heart (to improve blood flow to the area).
- Administer supplemental oxygen.
- Perform fasciotomy promptly to prevent irreversible muscle and nerve damage.
Surgical Treatment
- Fasciotomy: incision into the skin, subcutaneous tissue, and deep fascia to relieve pressure.
Indications for Fasciotomy
- Pressure within 15–20 mm Hg.
- Rising pressure inside the compartment.
- Significant tissue injury.
- 6 hours of complete limb ischemia.
- Injuries with a high risk for compartment syndrome (fractures or severe blunt trauma).
Fasciotomy Principles
- Prompt diagnosis is crucial (early detection).
- Long incisions are made on both sides of the affected limb (skin, subcutaneous tissue, and deep fascia).
- Release all fascial compartments.
- Preserve neurovascular structures.
- Maintain the wound and administer antibiotics.
- Close the skin or cover with a skin graft within 7–10 days.
Summary
- High suspicion for compartment syndrome.
- Treat quickly upon suspicion.
- If clinically apparent, do not measure compartment pressure.
- Fasciotomy is the only treatment to prevent permanent damage and should be performed promptly.
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Description
This quiz explores the condition of compartment syndrome, focusing on its etiology, pathophysiology, and effects on muscle and nerve survival. Learn about different types, causes, and how increased pressure in confined spaces affects blood flow and tissue function. Test your knowledge on a critical medical topic.
