Chapter 42 - Ortho Flashcards
Function of osteoblasts?
Synthesize nonmineralized bone cortex
Function of osteoclasts?
Reabsorb bone
What are the stages of bone healing?
Inflammation, soft callus formation, mineralization of the callus, removal of the callus
Where does cartilage receive nutrients from?
Synovial fluid
What is shared by Salter-Harris fractures type III, IV, V? Treatment?
Cross the epiphyseal plate and can affect the growth plate of the bone
ORIF
What is the treatment for Salter-Harris type I and II?
Closed reduction
What are the fractures associated with AVN?
Scaphoid, femoral neck, talus
What are fractures associated with nonunion?
Clavicle, 5th metatarsal fracture (Jones’ fracture)
What are the fractures associated with compartment syndrome?
Supracondylar humerus and tibia
What is the biggest risk factor for nonunion?
Smoking
Obturator nerve does what?
Hip adduction
Superior gluteal nerve does what?
Hip abduction
Inferior gluteal nerve does what?
Hip extension
Femoral nerve does what?
Knee extension
What herniates with lumbar disc herniation?
Nucleus pulposus
What is the result of L3 nerve compression?
Weak hip flexion
What is the result of L4 nerve compression?
Weak knee extension; weak patellar reflex
What is the result of L5 nerve compression?
Weak dorsiflexion (foot drop), dec. sensation in big toe web space
What is the result of S1 nerve compression?
Weak plantar flexion, weak Achilles reflex; decreased sensation in lateral foot
Motor innervation from ulnar nerve? Sensory? Result of injury?
Motor: intrinsic musculature of hand, finger abduction, wrist flexion
Sensory: all of 5th and 1/2 of 4th fingers, back of hand
Injury: Claw hand
Motor innervation from median nerve? Sensory? Result of injury?
Motor: Thumb apposition, thumb abduction, finger flexors
Sensory: most of palm and 1st 3 1/2 fingers on palmar side
Injury: carpal tunnel syndrome
Motor innervation from radial nerve? Sensory?
Wrist extension, finger extension, thumb extension, triceps (no hand muscles)
Sensory: 1st 3 1/2 fingers on dorsal side
Motor innervation from musculocutaneous nerve?
Biceps, brachialis, coracobrachialis
Motor innervation from axillary nerve?
Deltoid (abduction)
C1-4 nerve compression causes what?
Neck and scalp pain
C5 nerve compression causes what?
Weak deltoid and biceps (weak bicep reflex)
C6 nerve compression causes what?
Weak deltoid and biceps, weak wrist extensors (weak biceps and brachioradialis reflex)
C7 nerve compression causes what?
Weak triceps
C8 nerve compression causes what?
Weak triceps, weak intrinsic muscles of hand and wrist flexion
Treatment of cervical fracture?
Sling
Risk of vascular impingement
What structure injury is associated with anterior shoulder dislocation? Posterior? Treatment?
Anterior: axillary nerve injury
Posterior (seizures, electrocution): axillary artery injury
Closed reduction for both
Treatment of acromioclavicular separation? Risk of injury to what?
Sling
Brachial plexus and subclavian vessel injury
Treatment for scapular fracture?
Sling unless glenoid fossa involvement, then need internal fixation
Treatment for midshaft humeral fracture?
Sling
Treatment for supracondylar humeral fracture?
Adults: internal fixation
Children: closed reduction, internal fixation if severe
What is Monteggia fracture? Treatment?
Proximal ulnar fracture and radial head dislocation
ORIF
What is Colles fracture? Treatment?
Fall on outstretched hand, distal radius
Closed reduction