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N1115 - Trans. to Associates > Exam 3 - Chpt 37 Musculo. Trauma > Flashcards

Exam 3 - Chpt 37 Musculo. Trauma Flashcards

1
Q

soft tissue injury produced by blunt force

A

contusion

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2
Q

contusion s/sx

A

pain
swelling
discoloration (ecchymosis)

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3
Q

pull muscle injury to the musculotendinous joint

A

strain

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4
Q

strain s/sx

A 
pain
edema
muscle spasm
ecchymosis
loss of function
--graded 1st, 2nd, 3rd degree
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5
Q

injury to ligaments and supporting muscle fiber around a joint

A

sprain

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6
Q

sprain s/sx

A

joint tenderness
painful movement
edema
disability, pain increases during the first 2-3 hours

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7
Q

articular surfaces of the joint are not in contact

A

dislocation

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8
Q

when is a dislocation an emergency

A

pain
changes in contour, axis, length of limb
loss of mobility

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9
Q

RICE

A

rest
ice
compression
elevation

  • immobilization
  • anti-inflammatory meds
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10
Q

2 types of factures

A

open, closed

-no break in the skin

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11
Q

open fractures are aka

A

compound/complex fractures

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12
Q

open/compound/complex fractures extend to the ___

A

bone

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13
Q

how many grades of open/compound/complex fractures are there?

A

3

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14
Q

grade 1 open/compound/complex fracture

A

1cm long, clean wound

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15
Q

grade 2 open/compound/complex fracture

A

large wound without extensive damage

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16
Q

grade 3 open/compound/complex fracture

A

high contaminated
extensive soft tissue injury

–may have amputation

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17
Q

intra-articular fracture extends into the ___ ___

A

joint surface

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18
Q

s/sx of fracture

A 
acute pain
loss of function
deformity
shortening of extremity
crepitus
local swelling, discoloration
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19
Q

Dx a fracture

A

symptoms
pt reports injury to the area
radiography

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20
Q

fracture emergency management

A

immobilize
splinting
assess neuro before, after splinting

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21
Q

emergency management for an open fracture

A

cover with a sterile dressing to prevent contamination

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22
Q

restoration of the fracture fragments to anatomic alignment and positioning

A

fracture reduction

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23
Q

medical management of fractures

A

fracture reduction
closed: manipulation, manual traction
open: internal fixation
immobilization

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24
Q

factors that affect fracture healing

A 
inadequate immobilization
inadequate blood supply
multiple trauma
extensive bone loss
infection
poor adherence to Rx restrictions
malignancy
older age
some disease process
-RA
certain meds
-corticosteroids
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25
Q

early complications of fractures

A

shock (hypovolemic)
fat embolism
compartment syndrome
VTE, PE

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26
Q

hypovolemic shock is common with which fracture

A

pelvis

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27
Q

fat embolism is common with which fracture

A

long bone

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28
Q

delayed fracture complications

A

delayed union, malunion, and nonunion
avascular necrosis of bone
complex regional pain syndrome (CRPS)
heterotrophic ossification

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29
Q

prolongation of expected healing time for a fracture

A

delayed union

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30
Q

death of a tissue secondary to poor perfusion and hypoexmia

A

avascular necrosis

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31
Q

rehab r/t clavicle fracture

A

strap, sling

exercise elbow, wrist, fingers ASAP

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32
Q

how soon after a clavicle fracture can you elevate the arm above the shoulder

A

6 weeks

33
Q

rehab r/t humeral neck, shaft fracture

A

slings, bracing

activity limitations until adequate period of immobilization

34
Q

what to monitor for regularly with elbow fractures

A

neurovascular

35
Q

how long to limit elbow movement after immobilization and healing for nondisplaced, casted

A

4-6 weeks

36
Q

how long to limit elbow movement after internal fixation

A

about 1 weeks

37
Q

rehab r/t radial, ular, wrist, and hand fractures

A

early rehab exercises

active ROM for fingers, shoulder

38
Q

rehab r/t pelvic fracture

A

depends on fracture and associated injuries
stable fractures are tx’d within a few days of bed rest, symptom management
early immobilization reduces problems r/t mobility

39
Q

rehab r/t hip fracture

A

sx is usually done to fixate

care is similar to THA

40
Q

rehab r/t femoral shaft fractures

A

low leg, foot, hip exercises to preserve function, improve circulation
early ambulation
PT, weight bearing as Rx
active, passive knee exercises ASAP to prevent restriction of knee movement

41
Q

technique used with dressing changes

A

aseptic

42
Q

rigid, external immobilizing device

A

cast

43
Q

cast materials

A

nonplaster (fiber glass)

plaster of Paris

44
Q

uses for cast

A

immobilize a reduced fracture
correct a deformity
apply uniform pressure to soft tissue
support, stable weak joints

45
Q

when are contoured splints of plaster or pliable thermoplastic materials used

A

rigid immobilization not required
anticipated swelling
special skin care required

46
Q

braces (orthoses) are used for

A

support
control movement
prevent additional injury

47
Q

6 P’s of neurovascular changes

A 
pain
poikilothermia (cool to touch)
pallor
pulselessness
paresthesia
paralysis
48
Q

occurs from increased pressure in a confined space; compromises blood flow

A

compartment syndrome

49
Q

what is the early indicator of compartment syndrome

A

pain

50
Q

compartment syndrome treatment

A

notify physician

  • cast may be removed
  • emergency fasciotomy may be necessary
51
Q

pt will c/o this with a cast pressure ulcer

A

painful “hot spot” and tightness

52
Q

muscle atrophy and loss of strength

A

disuse syndrome

53
Q

disuse syndrome treatment

A

isometric exercises

muscle setting exercises

54
Q

what is used to relieve cast itching

A

hair dryer on cool setting

55
Q

application of pulling force to a part of the body

A

traction

56
Q

purpose of traction

A

reduce muscle spasms
reduce, align, immobilize
reduce deformity
increase space between opposing forces

–used short term

57
Q

all tractions are applied in how many directions?

A

2

58
Q

the lines of pull are aka

A

vectors of force

59
Q

types of skin traction

A

buck extension
cervical head
pelvic

60
Q

musculoskeletal traction is

A

skeletal traction

61
Q

how often to inspect the skin if pt is in traction

A

TID

62
Q

how often to assess pressure points with traction

A

q8h

63
Q

TKA and THA are commonly performed d/t

A

obesity

64
Q

how to reposition a pt after a THA

A

log roll

65
Q

methods to prevent dislocation of THA

A

correct positioning using splint, wedge, pillows

keep abduction with turning, adduction when transferring

66
Q

limit flexing the hip less than __ degrees

A

90

67
Q

should the legs cross midline of the body after a THA

A

No

68
Q

how soon do pts ambulate after THA

A

POD1

69
Q

THA are at risk for infection up to ___ months

A

24

70
Q

neuro checks how often with TKA

A

q2-4h

71
Q

acute rehab for TKA

A

1-2 weeks

total: 6 weeks recovery

72
Q

orthopedic preop assessment

A 
routine preop assessment
hydration status
med hx
knowledge
support, coping
possible infection
--ask about colds, dental problems, UTI, infections within 1-2 weeks
73
Q

what baseline needs to be obtained prior to sx

A

pain

74
Q

when should a foley be removed

A

POD1

75
Q

when should you assess for voiding

A

4 hours after foley has been removed

76
Q

a fever within 24 hours post op is indicative of

A

PNA

77
Q

a fever 48-72 hours post op is indicative of

A

UTI

78
Q

a fever 72 hours post op is indicative of

A

wound infection

79
Q

large amounts of ___ should not be given to orthopedic pts are on bedrest

A

milk

d/t hypercalcemia

N1115 - Trans. to Associates (21 decks)

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