Common compartment syndrome exam questions for medical finals, OSCEs and MRCP PACES
Question 1. Compartments
How many compartments are in the leg?
- There are four compartments: anterior, lateral and both deep and superficial posterior.
How many compartments are in the forearm?
- There are three compartments: superficial volar, deep volar and dorsal.
Question 3. Define chronic compartment syndrome
What is chronic compartment syndrome?
- This has focused on acute compartment syndrome as it is a true medical emergency. Chronic compartment syndrome is a chronic exertional syndrome often induced by exercise. It is most commonly in the anterior compartment of the leg in athletes. To diagnose it the resting pressure in the compartment should exceed 15mmHg, exceed 30mmHg on exercising and have prolonged pressure elevation after stopping exercise.
Where else can you get compartment syndrome?
- It is most often seen in the leg, followed by the forearm. It can also affect the hand and foot and rarely the upper arm or thigh.
What is typical about the pain of compartment syndrome?
- It is typically out of proportion to the procedure or amount of analgesia that the patient has had.
Question 4. 6 P’s of compartment syndrome
What are the 6 P’s of compartment syndrome?
- Pain, pallor, pressure, paraesthesiae, paralysis and pulselessness.
Question 5. Treatment
What is the simplest treatment you can perform for a suspected compartment syndrome?
- Remove tight dressings or plaster and elevate to the level of the heart.
What are the key diagnostic criteria and definitive treatment of compartment syndrome?
- A compartment pressure measurement exceeding 30mmHg then compartment syndrome seems likely. If this exceeds 40mmHg or rises to within 20mmHg of the patient’s diastolic blood pressure (i.e. above 50 for a patient with a diastolic pressure of 70), the definitive treatment of urgent fasciotomy is indicated.