CHP 38: ORTHOPAEDIC TRAUMA Flashcards
components of the axial skeleton
vertebral column, skull, ribs, and sternum
components of the appendicular skeleton
pectoral and pelvic girdles and upper/lower extremity bones
what does the shoulder girdle consist of
scapula and clavicle
what is a FOOSH
fall on outstretched hand
supination vs pronation
supination: palms up
pronation: palms down
where does most hand function come from
forearm muscles
what allows the foot to be positioned away from the body for balance and strength
thigh
what bone supports 90% of the upper body’s weight
tibia
when does skeletal injuries result
when tissues are impacted by forces that exceed tissues’ physiologic limitations
at what age do bones decrease in density
35y/o
when does bone density decrease in women
post menopause
what is a significant decrease in bone density called
osteoporosis
what is FRAX
fracture risk assessment tool used to evaluate pt’s 10-year probability of fracture
what type of injury is indirect force
falling from height and landing on feet, causing pelvic fractures
what is indirect injury
force strikes one region of body and is transferred to area away from point of impact
what do twisting injuries result in
fractures, sprains, and dislocations
what are fatigue fractures also called
stress fractures
what is a fracture
break in the continuity of a bone
what is new bone called
osteoid
3 ways a fracture may be classified
direction of fracture line, number of fractures on bone, or number of cortices (outer layers of bone) involved
open vs closed fracture
open: break in overlying skin allows fracture to communicate with outside environment
closed: skin over fracture site remains intact
what is a linear fracture
parallel to long axis of the bone
what is a transverse fracture
straight across bone at right angles
what is an oblique fracture
angled across the bone
what is a spiral fracture
encircles the bone
what is an impacted fracture
end of one bone becomes wedged into another bone
what is a pathologic fracture
erosive destruction of bone or abnormal overgrowth of bone
what is a comminuted fracture
more than two fracture fragments in one area of the bone
what is a segmental fracture
more than two fracture fragments occurring in different parts of the bone
what is a complete fracture
break through both cortices
what is an incomplete fracture
break through one cortex
where do greenstick fractures usually occur
tibia or radius in children
what is a depression fracture
blunt trauma to a flat bone (skull) causing bone to be pushed inward
what fracture is caused by sudden jerking of a body part
avulsion fracture
what is the most reliable signs of a fracture
deformity
what is the primary symptom of a fracture
pain localized to fracture site
what is a “knocked-down shoulder” indicative of
clavicle fracture on the side to which the head is leaning
what is subluxation
partial dislocation of a joint
what is diastasis
ligaments holding two bones in fixed position are disrupted and the space between them increases
principal symptoms of dislocation
pain or feeling of pressure over involved joint and loss of motion
sprains vs strains
sprains: ligaments
strains: muscle or tendon
what are the 6 P’s of musculoskeletal assessment
pain, paralysis, paresthesia, pulselessness, pallor, pressure
general treatment of sprains and strains
RICES - rest, ice, compression, elevation, splinting
which fracture site has the highest potential for blood loss
pelvis
when to use ice for treating injuries
initial 48 hours
when should heat therapy be avoided in injuries
48-72 hours
what must be splinted for fractures
bone ends and the two adjacent joints
what must be splinted for dislocations
entire length of bone above and below dislocated joint
how far should the traction splint extend beyond the foot
6-10 inches
what is devascularization
loss of blood flow to body part when blood vessels are damaged from musculoskeletal injury
what is fascia
inelastic membrane surrounding groups of muscles
what is compartment syndrome
pressure too high in limb, preventing blood flow to that area, leading to muscle ischemia and death
first S/S of compartment syndrome
searing or burning pain to involved compartment out of proportion to the injury
what is Crush syndrome
prolonged compression force impairs muscle metabolism and circulation, causing tissues to become ischemic and necrotic, releases harmful products
what time frame do muscle cells begin to die from compression
4-6 hours
how is cytotoxicity caused
production of oxygen free radicals
typical finding in cytotoxicity
tea-colored urine
S/S of DVT
swelling of extremity, discomfort that worsened with use, warmth and erythema of extremity
fat embolism S/S
12-72 hours within injury - tachycardia, dyspnea, fever, petechiae, AMS
