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Pathophysiology I > Injury and Trauma of Musculoskeletal Structures > Flashcards

Injury and Trauma of Musculoskeletal Structures Flashcards

1
Q

What is a contusion?

A

A bruise.

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2
Q

What is the difference between a contusion and a hematoma?

A

A contusion causes blood vessel/cell damage. A hematoma is a localized hemorrhage that puts pressure on local nerves.

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3
Q

What is the similarity between a contusion and a hematoma?

A

The skin remains intact.

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4
Q

What is the difference in colour between a contusion and a hematoma?

A

Contusion is usually blue, black, or yellow. Hematoma is red because of hemorrhage.

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5
Q

What is a strain?

A

A partial tear of a muscle or tendon.

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6
Q

Where are the most common locations of strains?

A

Back, cervical spine, elbow, and shoulder. In sports: hip, hamstring, quadriceps.

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7
Q

Why does age increase risk for strains?

A

Collagen fibres become less elastic with aging.

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8
Q

What are the manifestations of a strain?

A

Pain, increasing with stretching. Stiffness, swelling. Sometimes no obvious signs unless inflamed.

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9
Q

What is a sprain?

A

Tearing or rupture of supporting ligament or capsule surrounding a joint.

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10
Q

What are manifestations of a sprain?

A

Pain, rapid swelling that limits movement, discoloration.

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11
Q

What is the difference between a sprain and a strain?

A

Sprain is a complete tear of ligament, while strain is partial tear. Sprains take longer to heal than strains.

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12
Q

What is the treatment for sprains and strains?

A

RICE - rest, ice, compression, elevation (immobilization)

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13
Q

Describe the healing process of sprains and strains.

A

Capillaries bring oxygen and nutrients. Fibroblasts produce collagen. Collagen bundles strengthen over time.

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14
Q

What are some complications that can occur from improper sprain/strain healing?

A

Contraction can pull healing apart, resulting in lengthened position upon final healing. Adhesions.

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15
Q

What is a dislocation?

A

Abnormal displacement of articulating surfaces of a joint.

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16
Q

What is the difference between dislocation and sublaxation?

A

Sublaxation is only a partial dislocation. There is still some contact between the articulating surfaces of the joint.

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17
Q

What are the three causes of joint dislocation?

A

Congenital, traumatic, and pathologic.

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18
Q

What is a pathologic dislocation?

A

A dislocation that occurs as a complication of another pathological condition eg. infection, rheumatoid arthritis, neuromuscular disease, etc.

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19
Q

Which joint is most commonly dislocated in an MVA?

A

Hip.

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20
Q

Which joints are most commonly dislocated as sports injuries?

A

Shoulder, knee

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21
Q

Which joints are most commonly dislocated due to a fall?

A

Wrist, ankle.

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22
Q

What are the manifestations of a dislocation?

A

Pain, deformity, and limited movement.

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23
Q

How is a joint dislocation treated?

A

Manipulation. Surgical repair. Immobilization. Physiotherapy. The dislocation may spontaneously correct itself as well.

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24
Q

What is a common shoulder injury that occurs in children?

A

Fractured clavicle

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25
Q

How is a fractured clavicle treated?

A

Usually not needing surgery. Immobilize with sling.

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26
Q

What is the function of the rotator cuff?

A

Stabilizes the humoral head against the glenoid

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27
Q

Why are shoulder joints inherently unstable?

A

They have a huge range of motion and a shallow socket.

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28
Q

What are four general causes of rotator cuff injury?

A

Direct blow or stretch. Excessive use. Altered blood supply to tendons. Age-related degeneration.

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29
Q

What are some common conditions that result from a rotator cuff injury?

A

Tendinitis, subacromial bursitis, partial/complete tears.

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30
Q

What are some manifestations of rotator cuff injuries?

A

Pain, tenderness, difficulty abducting and rotating arm, muscle atrophy.

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31
Q

How is a shoulder or rotator cuff injury diagnosed?

A

Assessment of active and passive range of motion. History of injury (important!), MRI, arthroscopic examination.

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32
Q

What is the treatment for shoulder and rotator cuff injuries?

A

Anti-inflammatories, corticosteroids (oral or injected), physiotherapy, surgical repair.

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33
Q

What are the most serious knee injuries?

A

Knee ligamentous injuries.

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34
Q

Which is the most common knee ligament injury?

A

ALC rupture/tear

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35
Q

What are the manifestations of an ALC rupture or tear?

A

“pop” or tearing sensation, sudden pain, loss of weight-bearing, hemorrhage causes swelling.

36
Q

What are manifestations of a meniscus tear?

A

Pain, especially on hyperflexion and hyperextension. Edema. Instability. Locking due to a loose fragment

37
Q

What is a complication that can occur as a result of a meniscus tear?

A

Osteoarthritic changes limiting movement.

38
Q

What are manifestations of patellar sublaxation and dislocation?

A

Weakness, swelling, crepitus, stiffness, loss of range of motion.

39
Q

What is crepitus?

A

a grating sound or sensation produced by friction between bone and cartilage or the fractured parts of a bone.

40
Q

What is chondromalacia patellae?

A

Inflammation of the underside of the patella.

41
Q

What causes chrondomalacia patella?

A

Knee overuse in older adult, sports.

42
Q

What is the most common cause of anterior knee pain?

A

Patellofemoral Pain Syndrome

43
Q

What causes Patellofemoral Pain Syndrome?

A

Imbalance of forces controlling patella movement. Contact of posterior surface of patella with femur. Running, jumping, sitting.

44
Q

What are the manifestations of Patellofemoral Pain Syndrome?

A

Pain, weakness. (Absence of edema).

45
Q

Why is a hip dislocation a medical emergency?

A

It disrupts the blood and nerve supply to the leg, which can cause avascular necrosis.

46
Q

What is avascular necrosis?

A

Interruption of blood supply resulting in necrosis of bone tissue, and collapse.

47
Q

What are the risk factors for osteoporosis? (There are 9 of them)

A

Age. Women. Physical inactivity. Alcohol excess. Psychotropic medications. Institutionalization. Visual impairments. Polypharmacy. Osteoporosis.

48
Q

What are the three common sites of hip fracture?

A

Neck, intertrochanteric, subtrochanteric

49
Q

What are the surgical options for treating hip fracture?

A

Total hip replacement, Hemi-arthroplasty, Open reduction internal fixation, Revision.

50
Q

What are the two causes of fractures?

A

Sudden injury and/or stress fractures.

51
Q

What is a pathologic fracture?

A

Bone weakened by previous disease or tumor.

52
Q

How are fractures classified?

A

Position on bone, degree of communication with outside environment, degree of break, character of fracture pieces, direction of break.

53
Q

What are the different fracture classifications according to the position on the bone?

A

Proximal/midshaft/distal. Head/neck. Near prominence (malleolus).

54
Q

What are the different fracture classifications according to the degree of communication with the outside environment?

A

Open/compound. Closed.

55
Q

What is a greenstick fracture?

A

Partial break that occurs with young, soft, immature bone.

56
Q

What are the classifications of fractures according to the character of fracture pieces?

A

Comminuted. Compression. Impacted. Butterfly. Avulsion.

57
Q

What is a comminuted fracture?

A

A fracture with multiple pieces.

58
Q

What is a compression fracture?

A

Crushing of 2 bones.

59
Q

What is an impacted fracture?

A

Fragments wedged together.

60
Q

What is a butterfly fracture?

A

Triangular bone piece. Typically occurs on long bones.

61
Q

What is an avulsion fracture?

A

When the tendon or ligament tears off a piece of the bone.

62
Q

What are the classifications of fractures according to direction of the break?

A

Transverse, oblique, spiral, twist/torque

63
Q

What are the manifestations of fractures?

A

Pain/tenderness, swelling, loss of function/mobility, deformity, crepitus, blood loss, nerve function impairment or loss.

64
Q

How is a fracture diagnosed?

A

Assessment and X-ray

65
Q

How is a fracture treated?

A

Reduction (closed or open). Immobilization. Preservation and restoration of function. Physiotherapy.

66
Q

What are some examples of immobilization devices for fractures?

A

Splint, cast, external fixation devices, traction.

67
Q

What are the stages of bone healing?

A

Hematoma formation. Fibrocartilagnous callus formation. Bony callus formation. Remodeling.

68
Q

What occurs during the “hematoma formation” stage of bone healing?

A

Bone tissue/blood vessel rupture. A fibrin network (clot) forms. This provides a foundation for inflammatory cells.

69
Q

How long does the “hematoma formation” stage of bone healing take?

A

1-2 days.

70
Q

What occurs during the “fibrocartilaginous callus formation” stage of bone healing?

A

Fibroblasts begin repair.

71
Q

How long does the “fibrocartilaginous callus formation” stage of bone healing take?

A

2-3 weeks

72
Q

What occurs during the “bony callus formation” stage of bone healing?

A

Osteoblasts form, and calcium salts deposit. Cartilage converts to bony callus.

73
Q

When does the “bony callus formation” stage of bone healing begin?

A

3-4 weeks after injury.

74
Q

How long does the “bony callus formation” stage of bone healing take?

A

Months

75
Q

What is another word for “bony callus formation”?

A

Ossification

76
Q

What occurs during the “remodeling” stage of bone healing?

A

Dead cells are removed. Compact bone replaces spongy bone.

77
Q

Name three complications of bone healing.

A

Delayed union, malunion, nonunion.

78
Q

What is delayed union in bone healing?

A

Failure to heal in usual time, but eventually does.

79
Q

What are fracture blisters?

A

Epidermal necrosis due to fluid separating the epidermis from the dermis.

80
Q

Why should the blisters remain intact?

A

High chance of infection if blisters are broken.

81
Q

What is compartment syndrome?

A

Increased intraosseus pressure within a limited space due to decreased size, increased volume of contents, or both.

82
Q

What four things determine the amount of pressure during compartment syndrome?

A

Duration, metabolic rate, vascular tone, and local blood pressure.

83
Q

What is the result of increased pressure in compartment syndrome?

A

Compression of blood vessels and nerves. This can lead to ischemia, necrosis, paresthesis, and paralysis.

84
Q

What are the manifestations of compartment syndrome?

A

Severe pain, senstion change (burning, tingling, loss of senstion), diminished reflexes, loss of motor function, decrease or loss of peripheral pulses.

85
Q

What are the six P’s that indicate compartment syndrome?

A

Pain, pulselessness, paralysis, paresthesia, polar, palor

86
Q

What is fat embolism syndrome?

A

Fat droplets from bone and adipose tissue circulate through venous system in the body.

87
Q

What are the manifestations of fat embolism syndrome?

A

Respiratory failure (dyspnea, pallor, cyanosis, angina, tachycardia, diaphoresis). Cerebral dysfunction (mentation/behavioural changes, focal deficits, encephalopathy, seizures). Skin/mucosa petechiae (rash 2-3 days post event).

Pathophysiology I (5 decks)

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