++
Chapter 49. Acute Compartment Syndrome of the Limb: Implications for Regional Anesthesia
++
++
++
In which anatomic location does acute compartment syndrome (ACS) occur most often?
++
++
++
++
++
++
++
++
++
+
++
B is correct. ACS is most common in the lower leg and forearm. Upper leg muscles are at a lower risk for injury than are the smaller muscles of the lower leg, because the muscles of the thigh can dissipate the large forces of direct trauma.
++
++
++
What is the only objective and accurate test to diagnose acute compartment syndrome?
++
++
++
A. Arterial duplex of the affected limb
++
++
B. Elevated serum creatinine kinase
++
++
C. Computed tomography angiography of the affected limb
++
++
D. Direct compartment pressure measurement in the suspected compartment
+
++
D is correct. Changes in compartment pressures can precede the clinical signs of compartment syndrome. Compartment pressure measurement is the only objective and accurate test to diagnose and record compartment syndrome.
++
++
++
From which compartmental pressure in a normotensive patient is emergent intervention indicated?
++
++
++
++
++
++
++
++
++
+
++
C is correct. Compartmental pressures greater than 30 mm Hg require emergent intervention because ischemia is imminent.
++
++
++
Which of the following is a possible factor leading to compartment syndrome?
++
++
++
A. Tight circumferential dressings
++
++
++
++
C. Reperfusion after prolonged periods of ischemia
++
++
+
++
A, B, and C are all possible factors, so option D is correct. See Table 49–1 for factors leading to compartment syndrome.
++