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Clin Med IV Exam 1 > General Principles of Orthopedics > Flashcards

General Principles of Orthopedics Flashcards

1
Q

Cortical bone

A
  • “Hard” outer surface
  • Provides skeletal support
  • Site of attachment for tendon & ligaments
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2
Q

Cancellous Bone

A
  • “spongy”/trabecular bone found at ends of long bones, pelvis, ribs, skull & vertebrae
  • porous
  • Includes red & yellow bone marrow
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3
Q

Where is Cancellous Bone found?

A 
Long bones
Pelvis
Ribs
Skull
Vertebrae
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4
Q

Where is red bone marrow found?

A

Adults–axial skeleton

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5
Q

Where is yellow bone marrow found?

A

Adults–appendicular skeleton

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6
Q

Metaphysis

A

Transition zone

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7
Q

Diaphysis

A

Shaft

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8
Q

Epiphysis

A

Location of growth plate

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9
Q

Tendon

A

Connect muscle to bone

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10
Q

Ligaments

A

Attach bone to bone

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11
Q

Parts of axial skeleton

A 
Bones of head and trunkk
Skull
Ossicles of middle ear
Hyoid bone
Rib cage
Sternum & vertebral column
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12
Q

Parts of appendicular skeleton

A 
Pectoral girdles (clavicle and scapulae)
Arms and forearms
Hands
Pelvis
Thighs/leg
Feet/ankles
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13
Q

Bone Remodeling Cycle

A
  1. Resorption
  2. Reversal
  3. Formation
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14
Q

What is key for diagnosis of fx/msck injury?

A

HISTORY

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15
Q

Acute & Chronic duration

A

Acute <6 wks

Chronic >6wks

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16
Q

Traumatic vs Atraumatic

A 
Traumatic = acute; injury related
Atraumatic = degenerative; overuse
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17
Q

How do fracture lines appear on imaging?

A

BLACKER, more sharply angles & jagged than other lucencies in bone

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18
Q

What other structures can mimic an acute fx on imaging?

A

Sesamoid bones
Accessory ossicles
Unhealed fx

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19
Q

Definition Fracture

A

Loss of continuity of structure of bone

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20
Q

Closed fx

A

fx not exposed to environment

**ALL FX HAVE SOME DEGREE OF SOFT TISSUE INJURY

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21
Q

Open fx

A

break in skin & underlying soft tissue

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22
Q

What is the length of time recommended for surgical tx of open fx?

A

6hrs

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23
Q

Fracture Healing Phases

A
  1. Inflammatory phase (hematoma and granulation tissue form)
  2. Reparative phase (callus formation)
  3. Bone remodeling (final phase of healing)
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24
Q

What healing phase is a hematoma and granulation tissue seen in?

A

Inflammatory phase

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25
Q

What healing phase is a callus seen in?

A

Reparative phase

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26
Q

What healing phase shows compact bone replacing spongy bone

A

Bone remodeling–final phase

27
Q

Delayed union?

A

fx taking longer to heal than usually required

28
Q

Malunion?

A

fx is healing in mechanically & cosmetically UNACCEPTABLE way

29
Q

Nonunion?

A

Fx will most likely NOT heal

30
Q

Principle of splinting

A
  • Immobilize affected extremity/area
  • Prevent further injury
  • Pain control
31
Q

Rules of immobilization

A
  • MUST immobilize joint above & below injury
  • Wrap from distal to proximal to minimize tapping of blood distal to injury
  • Eval distal circulation, motor function & sensation BEFORE & AFTER splinting
32
Q

Length of splinting

A

Temporary

1-5 days

33
Q

What do you always want to evaluate BEFORE & AFTER splintign?

A

circulation
motor function
sensation

34
Q

Casting principles

A
  • Maintain position to provide bone healing
  • prevent displacement of fx
  • protect from further injury
35
Q

Length of cast

A

4-6wks

usually change at 3wks if no movement of fx

36
Q

Would you put an unstable wrist fx in a short arm cast?

A

NO.
Unstable wrist fx –> LONG ARM CAST
Stable wrist fx –> SHORT arm cast

37
Q

What fx goes in a long arm cast?

A

Forarm fx

Unstable wrist fx

38
Q

What fx goes into a spica cast?

A

Scaphoid fx

Radial styloid fx

39
Q

What fx goes into a long leg cast?

A

Tib/fib fx

Quad tendon repair

40
Q

What fx goes into a short leg cast?

A

Anything below the knee

Foot, ankle, achille’s, Sever’s syndrome

41
Q

What is a closed reduction?

A
  • reduce bone to near anatomic position
  • “recreate the fracture” to align
  • must be STABLE fx
  • no incision in the skin
42
Q

ORIF (open reduction internal fixation)?

A
  • Reduce and hold unstable fx
  • Acts as internal splint
  • Allows for correction of deformity
  • requires surgery
43
Q

Would you use an ORIF for a stable fx?

A

NO. used for UNSTABLE fx

44
Q

What do ORIF IM Rod prevent?

A

anterior/posterior movement of bone

45
Q

What do ORIF IM screws prevent?

A

prevent bone from rotating around rod

46
Q

When would you do an Ex-Fix?

A
  • when major non-lifesaving procedures must be avoided
  • bridge to definitive internal fixation
  • if pt in OR for life-saving procedure, should be applied in concert
47
Q

What type of injury MSCK injury involves stretching/tearing of ligaments?

A

Sprain (most common in ankle)

48
Q

Mechanism of injury of sprain

A

inversion

eversion

49
Q

What type MSCK injury involve injury to muscle or muscle and tendon?

A

Strain

50
Q

Mechanism of injury of strain?

A

overextension
over stretching
muscle over use

51
Q

Sx strain

A

Pain
muscle spasms/weakness
swelling
cramping

52
Q

Tx Sprain/Strain

A 
RICE (rest, ice, compression, elevation)
Splinting
NSAID
Early ROM
PT
53
Q

What do you want to evaluate before & after a reduction?

A

neurovascular status

54
Q

How do you describe a fx fragment in a relation to another fragment?

A

describe the relationship of the DISTAL fx fragment relative to the PROXIMAL fragment

55
Q

Tendonitis

A

Inflammation/irritation of tendon
causes pain & tenderness at or just outside of joint

Most common: shoulders, elbows, wrists, knees

56
Q

Tx tendonitis

A 
Rest
Ice cube massages
BRACE
NSAIDs (naproxen)
PT
Cortisone (not 1st line)
57
Q

Tendon Rupture–Contributions

A

Steroid injection into tendon
Fluoroquinolone
Body habitus
Trauma

58
Q

Tx Tendon Rupture

A 
Splint/immobilize
Ice
NSAIDs
Repair/reconstruction
Early ROM
PT
59
Q

Ligament Rupture

A

Common sport injury (skiing, soccer, football)

Results from VALGUS stress or direct fall onto joint

60
Q

Valgus stress or varus stress for ligament rupture?

A

VALGUS stress

61
Q

1st line ortho pain mgmt?

A

ACETAMINOPHEN

350-650mg q4-6hrs

62
Q

Can you get topical analgesics OTC for othro pain mgmt?

A

No. Prescription only

63
Q

What should you warn pt about when using NSAIDs?

When should they expect it to work?

A
  • Take w/ food
  • Analgesic effect seen within 1-2hrs
  • Anti-inflammatory effect after 2-4wks of continuous use

Clin Med IV Exam 1 (9 decks)

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