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MedPsych Exam 3 > Fractures > Flashcards

Fractures Flashcards

1
Q

what are common consequences of fracture injuries?

A

(Low Mortality, High Morbidity)
Physical Suffering
Mental Distress
Loss of Time

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2
Q

why are fractures more likely to happen to the elderly?

A

Decreasing coordination causes falls

Weakened bones more susceptible to injuries

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3
Q

what is the OT definition for fracture?

A

A severe soft tissue injury with an underlying bony defect

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4
Q

what is direct trauma?

A

bone fractures at the point of contact (application) of the force

i.e. fracture of femur at point of contact with moving car

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5
Q

what is indirect trauma?

A

bone fractures at a distance from point of contact (application) of the force

i.e. fracture of clavicle from fall on outstretched hand

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6
Q

what are ways that bone pathology can cause fracture?

A
  1. Pathological fx. caused by disease of bone
  2. Pathological fx. caused by metastasis of a tumor
  3. Force is not sufficient to break normal bone but weakened bone is susceptible to even slight stress
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7
Q

if there is no evidence that force was applied to fracture a bone, what should be investigated?

A

1) did the fracture occur through normal or abnormal bone

2) is there normal or decreased amount of bone present

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8
Q

what are stress fractures?

A

Bone is subjected to repetitive forces
very common and easy to tx
not life threatening

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9
Q

what are common sites of stress fracture?

A 
Tibia**
Metatarsals
Navicular
Femur
Fibula
Calcaneus
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10
Q

what are common causes of stress fxs?

A 
Training errors (too much, often, soon, fast)
Equipment errors (shoe support important)
Other factors (bone health, nutritional intake, collagen disorders)
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11
Q

what are different sites (anatomical location) for fractures?

A

Diaphysis, metaphysis, epiphysis, intra-articular, fracture dislocation

Upper, middle, lower

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12
Q

what are the levels of extent for fractures?

A

Complete: one side of bone to other
Incomplete: one side remains intact

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13
Q

what is an example of incomplete fx? who do they affect?

A

Greenstick, Buckle, Crack

Usually in children due to “softer” nature of bone
Bone “bends” on one side, breaks on the other

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14
Q

what is configuration?

A

pattern of fx on x-ray

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15
Q

what is transverse configuration?

A

one side to bone to the other

Direct trauma

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16
Q

what is oblique configuration?

A

lies oblique on bone

Indirect trauma

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17
Q

what is spiral configuration?

A

bone is twisted on long axis

Indirect trauma

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18
Q

what is comminuted configuration?

A

more than 1 fx. line, more than 2 fragments

Indirect or direct

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19
Q

what is impacted configuration?

A

fragments are driven into each other, remain locked

direct trauma

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20
Q

what is crush configuration?

A

usually involves cancellous bone from
direct or indirect trauma
(i.e. calcaneum from landing on heels from height)

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21
Q

what is avulsion configuration?

A

excessive stress applied to tendon or ligament that, as it rips off bone, pulls off piece of bone

22
Q

what are relationships of fx fragments to each other?

A

Non-displaced vs. Displaced

23
Q

what are types of displaced fxs?

A

Angulation
Rotated
Partial displacement
Overlap/overriding

24
Q

what are the 3 factors that affect fx stability?

A 
1. Direction of line of fx. 
  Stable: transverse, greenstick. Impacted
  Unstable: spiral, oblique, comminuted
2. Forces applied by muscle pull
3. Integrity of ligaments
25
Q

what are the Relationships of fx. fragments to their external environment?

A

closed (skin intact) vs. open

26
Q

what can cause an open fx?

A

Fx. Fragment has penetrated skin from within

Sharp object has penetrated skin to fx. bone from without

27
Q

what are fx complication classification?

A

Un-complicated (immobilized, short rehab)

Complicated (Local, systemic)

28
Q

what is primary fx shock?

A

occurs immediately
Vaso-constricting nerves are inhibited
Peripheral blood vessels dilate, BP drops, pt. becomes pale, faint
Spontaneous recovery in few mins

29
Q

what is secondary fx shock?

A

brought on by hemorrhage
common in long bone fxs.
Reduction of blood volume
Skin pale, cold, moist, heart beats faster Recovery with blood transfusion

30
Q

what are fx associated injuries?

A
  1. ischemia
  2. visceral injuries
  3. joints
  4. nerves
  5. muscles
31
Q

what are 4 signs of ischemia?

A

Temperature

4 “Ps”: paresthesia, pallor, pain, paralysis

32
Q

how do visceral injuries after fx occur?

A

fractured bone goes into organ

Bladder, spleen, pleurae

33
Q

what are the symptoms of fracture?

A 
Tenderness/pain over bone
Swelling
Deformity (Visible, Palpable)
Loss of function 
Visible bruising
34
Q

how does rate of healing vary?

A

Rate varies by age (quicker in children)

Cancellous heals faster then cortical bone

35
Q

what are some requirements for fx healing?

A

Slight movement at fx. Site

Uninterrupted blood supply

36
Q

what is stage 1 of healing?

A

Hematoma forms
Bone ends bleed
Periosteum is stripped, varies in length
Surrounding soft tissue may be damaged

37
Q

what is stage 2 of healing?

A

Acute inflammation
Cell division
Cell proliferation seen within periosteum

38
Q

what is stage 3 of healing?

A

Callus formation
Dead bone is reabsorbed
Immature woven bone is laid down

39
Q

what is stage 4 of healing?

A

bony callus formation

40
Q

what is stage 5 of healing?

A

Remodeling
Medullary cavity restored
Bone returns to normal shape

41
Q

what are the 3 principles of tx of fx?

A
  1. reduction of fx
  2. immobilization
  3. rehab
42
Q

how do you immobilize the healing fx?

A

maintain position of fx fragment
Prevent movement across fx site
Joint above & below usually immobilized

43
Q

what is reduction?

A

restore bone parts to normal alignment

44
Q

what is the difference btwn closed and open reduction?

A

Closed = Manual manipulation, no surgery
(Held with cast, splint, sling, fracture brace)

Open = surgery when fracture cant be held together by other means
(after Failed closed reduction, To avoid long bed rest)

45
Q

what is the difference btwn external and internal methods of immobilization?

A

External Methods
(Plaster/fiberglass cast, Traction, External fixation)
Internal Methods
(Plates, screws, Intramedullary rods, K-wires)

46
Q

what are methods of open reduction?

A

Open reduction internal fixation (ORIF)
External fixation
Combination
Joint arthroplasty

47
Q

what does exercise promote?

A

edema absorption

48
Q

what does exercise prevent?

A

Org. of blood clots
Loss of elasticity of muscle
Formation of unnecessary scar in muscle

49
Q

what does exercise maintain?

A

Movements in joints not immobilized
Strength by isometric exercise
circulation

50
Q

what are different types of orthopedic technologies that help with bone healing and growth?

A

Continuous Passive Motion (CPM)
Electrical Bone Growth Stimulator
Limb Lengthening (Illizoroff Technique)

MedPsych Exam 3 (7 decks)

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