[216B] Tissue Integrity: Trauma Flashcards
VO2 max is measured in _/__ and determines what 3 things?
L/min
- Circulation capacity
- Lung capacity
- O2 delivery to muscles
During activity, the SNS stimulates which gland secretion?
Adrenal
With adrenal gland hormone secretion during activity, vaso____ occurs in high output organs (ie. brain)
dilation
CO ____ with activity to match demand
increases
What are 3 byproducts of aerobic metabolism using pyruvate and how are they excreted?
- CO2 (exhaled)
- H2O (diaphoresis)
- Heat (warm/flushed)
Anaerobic metabolism occurs when demand ____ supply
exceeds
What is a byproduct of anaerobic metabolism?
Lactate
What are 4 categories of causes of fatigue?
- Physiologic
- Psychologic
- Pathologic
- Unknown
Physiologic fatigue is inadequate ___ to generate muscle activity, whereas psychologic is inadequate ___ ability
ATP, CNS
What is the most common unknown cause of fatigue?
Chronic fatigue syndrome
What are 3 characteristics of acute fatigue?
- Sudden onset
- Clear cause
- Rest –> recovery
What are 5 characteristics of chronic fatigue?
- Unclear onset + causality
- Rest -x-> recovery
- Accumulates
- Interferes with ADLs
- Causes other pathologies
Chronic fatigue syndrome has an ____ onset, ____ duration, and ____ symptomology
insidious, long, non-specific
What are 4 diagnostic s&s of chronic fatigue syndrome?
- Chronic fatigue >6 months with effect on ADLs
- Post-exercise malaise
- Unrefreshing rest/sleep
- Cognitive or orthostatic effects
What are 3 txs for chronic fatigue syndrome?
- CBT (cognitive behavioral therapy)
- Team approach
- Management of associated pathologies
MSK system is __% of body mass and includes what 3 things?
70%
- Bones
- Cartilage
- Soft tissue in joints, ligaments, tendons + muscle
What is the difference between a ligament and a tendon?
Ligaments: connect bone to bone
Tendons: connect muscle to bone
How does color of bone marrow change with growth and development?
Kids: red
Adults: yellow
Acute fractures are caused by ____ ____ whereas chronic fractures are caused by ____
sudden force, overuse
Contusions, dislocations and sprains may occur due to ____ fractures
acute
Tendon strains may occur due to ____ fractures
chronic
What are 6 s&s of fractures?
- Severe pain (initial numbness aka local shock)
- Inflammation
- Hematoma
- Deformity
- Loss of function
- Injury to surrounding area
What are the 3 types of unstable fractures?
- Oblique (diagonal)
- Spiral (torsion)
- Comminuted (fragmented)
What is the difference between an open/compound fracture and a closed/simple fracture?
Open breaks through skin whereas closed doesn’t
What is the difference between a compression fracture and an impacted fracture?
Compression: 2 bones crushed together
Impacted: fracture fragments crushed together
Describe a greenstick fracture and what demographic is at most risk
- One side of bone is broken, the other side is bent
- Peds, because their bones are bendy
Describe an avulsed fracture
Fragment of bone is pulled away from tendon/attachment
Epiphyseal fractures occur in what demographic? Why?
Children, cause they’re still growing
Which types of epiphyseal fractures impacts growth?
3-5
What are the 6 txs for all fractures?
- Pain management
- Inflammation management
- Complication management
- Immobilization
- Reduction
- Restoration of function
What are the 3 main categories of medications for tx of fractures?
- Analgesics
- Anti-inflammatories
- Anesthesia
What are 4 types of anesthesia?
- Local
- Nerve block
- Spinal
- General
What is reduction?
Restoration of alignment
What are 2 methods of reduction for closed fractures?
- External traction (pulls)
- External fixation (stabilizes)
What are 2 methods of reduction for open fractures?
- Surgical reduction
- Internal fixation
Immobilization maintains ____
alignment
What are 3 methods for restoration of function?
- Rehabilitation exercises
- Physiotherapy
- Occupational therapy
What are 4 hormones important for bone healing?
- Vitamin D
- Calcitonin
- Thyroid hormone
- Growth hormone
What is the function of osteoblasts?
Synthesis of bone
What are the 4 stages of bone healing?
- Hematoma (inflammation + coagulation)
- Granulation tissue (angiogenesis)
- Callus formation (soft -> hard; differentiation of MSCs)
- Remodeling
What are MSCs?
Mesenchymal stem cells, precursor for bones and cartilage
Meniscus, tendons & ligaments heal ____
slowly
Healing of long bones can take up to _ months
6
Healing of stress fractures can take up to _ weeks
4
What are 8 complications of fractures?
- Vascular damage (bleeding, hypovolemic shock)
- Infection
- Associated injuries
- Fat Embolism Syndrome (FES)
- Thromboembolism
- Compartment syndrome
- Complex Regional Syndrome (CRPS)
- Fracture blisters
Pneumothorax means ____ in the ____ space of the lungs
air, pleural
Traumatic tension pneumothorax leads to an ____ of pressure within the pleural space, which can cause what to collapse?
increase, lungs
What are 5 s&s of tension pneumothorax?
- SOB
- Cyanosis
- Decreased O2 sat.
- Tracheal shift
- Cardiogenic shock
- Hypoxemia
What are 3 txs for tension pneumothorax?
- O2
- One-way valve seal
- Chest tube
Hemothorax means ____ in the ____ space of the lungs
blood, pleural
Fat Embolism Syndrome (FES) is ____ or ____ ____ tissue in circulation
Adipose, bone marrow
FES occurs due to what type of bone fracture?
Long
What are 11 s&s of FES?
- Pulmonary embolism
- CVA
- Skin rash
- Chest pain
- SOB
- Decreased O2 sat
- Cyanosis
- Pallor
- Change in LOC
- Seizure
- Diffuse rash on upper body
What are 3 txs for FES?
- Prophylaxis is best
- Oxygenation
- Glucocorticoids
Thromboembolisms (DVT or PE) are due to:
Low mobility with injuries
What are 3 prophylactic txs for thromboembolisms?
- Anticoagulants
- Compression devices
- Early ambulation
What are 2 examples of anticoagulants?
- Heparin
- Enoxaprin
Acute compartment syndrome is ____ pressure within a body compartment due to ____, causing ____ volume
high, inflammation, increased
What is the etiology of acute compartment syndrome?
- Post injury
- Common with immobilization devices
What are the 5 s&s of acute compartment syndrome?
- Swelling
- Worsening pain
- Loss of sensation
- Loss of motor function
- Loss of reflexes
How do you treat acute compartment syndrome?
Relieve pressure + elevate immediately
What is Complex Regional Pain Syndrome (CRPS)?
Higher pain than injury warrants
What are some characteristics of pain in CRPS?
- Severe
- Burning
- Aching
- Elicited by low stimulus
What are some physiologic changes as a s&s of CRPS?
Skin: shiny, thin, eczema
Tissue: muscle wasting
What is the etiology of CRPS?
Inadequate pain management for initial acute pain
What are 3 txs for CRPS?
- Prophylaxis with adequate pain management
- Physiotherapy for mobilization
- Chronic paint treatment
What are lacerations?
Integumentary tearing
What are 4 things to assess for lacerations?
- Size
- Depth
- Deformity
- Contusion (bruise)
What are 2 txs for lacerations?
- Asepsis
- Closure
What are the 3 aspects of asepsis tx for lacerations?
- Cleansing wound (irrigation)
- Decontamination (debridement, antimicrobials)
- Prevention (vaccination)
Contusions are a ____ tissue injury, where the skin is ____ and there is ____ hemorrhage
soft, intact, local
Large hemorrhage can lead a contusion developing into a:
hematoma
What are 3 txs for contusions?
- Control inflammation
- Aspiration with a needle
- NSAIDs
Compresses for contusions should be what temperature immediately?
Cold
Strains are a ____ overload of what 2 types of complexes?
mechanical, muscle or muscle-tendon
What are 3 s&s of strain?
- Inflammation
- Pain
- Increased pain with aggravating activity
What are some common strains?
- Lower back
- Joints (elbows + shoulders)
- Feet
- C spine
What are 5 txs for sprains?
- Compression (cold or warm)
- NSAIDs
- Rest
- Rehabilitation
- Prophylaxis (stretching)
Sprains are a ____ overload of a ____
mechanical, joint
What are 4 s&s of sprains?
- Pain
- Inflammation
- Contusion
- Decreased function
What is the tx of sprains similar to?
Strains, but may require surery
What are some common sprains?
- Ankle (inversion)
- Knee
- Elbow
- Wrist
What is the difference between a dislocation and subluxation?
Dislocation is a complete joint displacement, whereas subluxation is incomplete
What are 3 causes of dislocations?
- Direct force (traumatic)
- Congenital (hip at birth)
- Pathologic (arthritis)
What type of joint is most common for dislocations?
Ball + socket (ie. shoulder)
What is a potential complication for dislocations?
Nerve/blood vessel injury
What are 3 txs for dislocation?
- Assess level of injury
- Manual closed reduction maneuvers
- Analgesia
