Intro to Orthopedic Injury Flashcards

Ex I

1
Q

What are the three types of primary injury?

A

Direct: trauma at point of impact (contusion)
Indirect: force from trauma is transmitted to tissue (shoulder dislocated by falling on hand)
Overuse: acute repetitive friction or chronic repetitive microtrauma

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2
Q

What’s the difference between primary and secondary injury?

A

Primary: Injury caused directly by trauma
Secondary: Additional injury due to primary injury

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3
Q

What are the two types of secondary injury?

A

Enzymatic (enzymes released from damaged cells cause further local damage) and ischemic (loss of blood flow leads to local hypoxia and cell death)

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4
Q

What are three physiological problems caused by ischemia?

A

Hypoxia, inadequate nutrients, inadequate waste removal

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5
Q

Tension

A

A force that pulls tissues

Muscle-tendon issues like sprain and cramp

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6
Q

Compression

A

Forceful blow to tissues

Contusion, fracture

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7
Q

Shearing

A

Force move parallel to tissues

vertebral disc injuries

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8
Q

Torsion

A

Twisting or turning force

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9
Q

Bending

A

Horizontal force causing tissue to bend or strain

spiral or greenstick fracture

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10
Q

Stretching

A

Elongation of tissues, especially ligaments

Strain, sprain

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11
Q

What structures respond to the different forces?

A

Tendons and ligaments resist tension
Bones resist compression
Intervertebral discs resist tension, compression, shearing, and torsion

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12
Q

Bruise/contusion

A

Compression that causes hemorrhage under the skin

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13
Q

Muscle cramps

A

acute painful involuntary muscle contraction

caused by dehydration or electrolyte imbalance

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14
Q

Muscle spasm

A

reflex muscle contraction caused by acute trauma

serves to protect an area

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15
Q

Muscle hypertonicity

A

increased activity of an otherwise normal muscle

muscle tone is increased with no patent pathology

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16
Q

Muscle spasticity

A

increased muscle tone at rest
increased resistance to passive stretch, exaggerated DTRs, possible clonus
Result of upper motor neuron lesion

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17
Q

Sprain

A

stretching or tearing damage to a ligament and possibly associated tissues

18
Q

Sprain grading

A

1 (0-20%) Minimal pain and loss of function, retains stability
2 (20-75%): moderate pain, loss of function, swelling, and instability
3 (>75%): extremely painful, major loss of function, severe instability. surgery indicated.

19
Q

What causes a sprain, and what are some examples?

A
End range loading
sudden load (whiplash)
direct blow (lateral force to knee)
repetitive overload (typing)
sustained postural overload (long hours at workstation)
20
Q

Clinical impression of sprain

A

Decreased active and passive range of motion with pain
No pain on isometric contraction
local tenderness, edema, bruising
Joint instability

21
Q

Strain

A

acute stretch or tear in muscle or tendon

22
Q

strain grading

A

1: 50% severe tear, loss of function, palpable, surgery indicated

23
Q

what causes strain, examples?

A
sudden contraction (most likely)
sudden stretch
repetitive contraction
sustained postural load
blow to muscle
24
Q

clinical impression of strain

A

isometric contraction is most provocative of pain and weakness
decreased active rom with pain
normal passive rom without pain

25
Q

Acute synovitis

A

inflammation of synovial membrane

26
Q

dislocation

A

complete separation b/t two articulating bones

27
Q

subluxation

A

incomplete separation b/t two articulating bones

28
Q

separation

A

increase in joint space between articulating surfaces

29
Q

osteochondrosis

A

intra-articular

degenerative changes in epiphysis or apophysis

30
Q

osteochondritis dessicans:

A

intra-articular

avascular degeneration of articular cartilage

31
Q

apophysitis

A

intra-articular

inflammation of tendon-bone junctions

32
Q

traumatic arthritis:

A

intra-articular

inflammation causing thickness of synovium of a joint, resulting in crepitus (grating)

33
Q

bursitis

A

extra-articular

inflammation of bursa

34
Q

capsulitis

A

extra-articular

inflammation of joint capsule

35
Q

paratenonitis

not a typo

A

extra-articular

inflammation of the outside of a tendon or its sheath

36
Q

tendinosis

A

extra-articular

degeneration of collagen matrix of a tendon

37
Q

burner

A

irritation and pain from nerve traction

38
Q

neuritis

A

inflammation of nerve cells

39
Q

sciatica

A

stretch of sciatic nerve

40
Q

carpal tunnel syndrome

A

compression of the median nerve

41
Q

mortons neuroma

A

tumor of a neuron in the foot

42
Q

What are the stages of nerve injury?

A

neuropraxia: loss of conduction due to disruption of myelin sheath
axonotmesis: disruption of axon but not CT
neurotmesis: severing of nerve including myelin sheath, neuron, and CT