Intro to Ortho & Rheum Flashcards
What is orthopedics?
The study of the musculoskeletal system: bones, ligaments, joints, muscles, tendons, nerves
What is rheumatology?
A sub-specialty of internal medicine and pediatrics devoted to the diagnosis and therapy of rheumatic disease
Functions of the musculoskeletal system.
- movement
- structural support
- protection of organs
- storage of minerals
- hematopoiesis
Epiphysis
End portion of the bone, typically no marrow, made of cancellous (spongy) bone.
Metaphysis
Wider portion of bone between diaphysis and epiphysis.
Physis
Zone of growth aka growth plate
Diaphysis
Long portion of the bone (shaft). Contains the medullary canal - site of erythropoiesis
Osteocytes
the living unit of bone
Osteoblasts
help build bone tissue. when over produced, create bone spurs.
Osteoclasts
break down bone tissue
Articular cartilage
facilitates smooth movement between two bones. found at joint spaces
Periosteum
found on the outside of all bones, except at joint articulation. has pain receptors and provides nurishment to bone through blood supply
Diarthrodial (synovial) joint
joints are freely mobile.
- ball and socket joints (hip and shoulder)
- hinge joints (elbow)
- condyloid (knee)
- saddle (thumb)
- pivot (radius/ulna articulation)
Amphiarthrodial (fibrocartilaginous) joint
joints allow some movement
- costosternal, symphysis pubis, acromioclavicular
Synarthrodial Joints
no movement
- cranial sutures
Flexion
bending of a joint or shortening of a flexor muscle
Extension
straightening of a joint or shortening of an extensor muscle
Pronation
rotating palm downward or feet rotating inward
Supination
rotating palm upward or feet rotating outward
Abduction
move away from the midline
Adduction
move toward the midline
Inversion
move inward
Eversion
move outward
Varus (bowlegged)
distal extremity is ‘inward’
Valgus (knock-kneed)
distal extremity is ‘outward’
Plane of the Human Body
- Sagittal Plane: divides the body in half vertically
- Coronal Plane: divides the body from front to back
- Transverse (axial) plane: divides the body into top and bottom
Fracture
disruption of the cortex of bone resulting in cracking, splintering, or bisecting. characterized by whether they are open/closed, the bone involved, type of fracture, displacement, and location of fracture
Dislocation
Occurs when the joint between two bones separates, usually from excessive tension to or disruption of supporting ligaments
Sprain
Stretching of ligaments from excessive force. Grade 1 partial tear but stable, Grade 2 partial tear with some instability, Grade 3 involves complete tear with joint opening when stressed
Strain
stretching or partial tearing of the muscle-tendon unit from excessive force
Transverse Fracture
perpendicular to the long axis of the bone
Oblique Fracture
Diagonal to the long axis of the bone
Spiral Fracture
caused by a twisting injury
Greenstick Fracture
fracture through one cortex
Torus Fracture
buckling of the cortex
Avulsion Fracture
caused by a tendon or ligament pulling a piece of bone off
Stress Fracture
caused by a non-traumatic, cumulative overload of a bone
Comminuted Fracture
“crushed” commonly seen in conjunction with other fracture types
Open Fracture
bone exposed through skin
Segmental Fracture
free floating segment of bone. butterfly fragment. concerned with blood supply
Salter-Harris I
Fracture through the physis
Salter-Harris II
Fracture through the physis with extension to the metaphysis
Salter-Harris III
Fracture through the physis with extension to the epiphysis
Salter-Harris IV
Fracture through the metaphysis, physis, and epiphysis
Salter-Harris V
Crush injury to the physis
Compartment Syndrome
- Elevated pressure in a closed muscle compartment
- Due to injury, commonly crushing compartment. also ischemia or anoxia
- Most common in anterior tibia and volar forearm
- Normal pressure ~120mmHg. Compartment pressure ~30mmHg
- Emergent fasciotomy indicated
Seven P’s of Compartment Syndrome
Pain, pallor, paresthesias, paresis, poikilothermia, pressure, pulselessness
Tendonitis/Synovitis/Tenosynovitis
- Painful inflammation of a tendon and/or the synovial tissue around then tendon
- Associated with overuse injuries or acute injuries
- Common in shoulder (cuff), elbow (epicondylitis), wrist, knee (patellar), ankle (achilles)
Bursitis
inflammation of the bursa due to overuse injuries or local trauma. common around the shoulder (subacromial bursa), hip (greater trochanteric bursitis), elbow (alecranon bursitis), and knee (prepatellar and pes anserine bursitis)
Corticosteroid Injections
mainstay in treatment of many musculoskeletal conditions. thought to cause a decrease in inflammation of synovial tissue. can also be used in extra-atricular areas like bursae, tendon sheathes, epidural space. Minimal systemic response
