intro to orthopedic injury Flashcards
What is a primary injury?
injury that results directly from the initial, immediate trauma associated with a particular mechanism of insult
What does direct or extrinsic injury mean?
trauma that occurs at apoint of impact where the foce meets the body
What does indirect of intrinsic injury mean?
a force meets the body in such a way that energy is transmitted to another part of the body.
Example of an indirect/intrinsic injury?
dislocated shoulder from falling on outstreatched hand.
What can cause an overuse injury?
acute repetitive friction or chronic repetitive microtrauma
What is a secondary injury?
additional injury that is a result of the primay injury
What are the two types of secondary injury?
secondary enzymatic and secondary hypotoxic
What does a short term secondary injury result from?
sequelae of injury if not managed properly.
What does short term secondary injury affect?
uninjured cells on periphery of primary lesion.
What does long term secondary injury lead to?
degenerative conditons, increases quanity of tissue damage and healing time
What is secondary enxymatic injury
when lysosomes release enzymes damaging surrounding cells causing cell death
What is secondary hypoxic/eschemic injury?
failure of vasculature to supply enough blood maybe from vascular and inflammatory changes that cause hypoxia.
What type of metabolism can happen in hypoxic injury?
a shift to anaerobic metabolism occures eventually leading to inability to produce enough ATP.
What happens to cells subject to hypoxic injury?
less atp means failure of ion pumps then swelling and cell death! Very importaint
What three physiological problems does ischemia cause?
hypoxia, inadequate supply of nutrients and inadequate removal of waste
what could cause ischemia?
damaged blood vessesl, clotting, inflammation, pressure, pain, swelling of injured cells.
What is tension?
a force that pulls tissues, tendon injuries.
Compression
forcefull blow to tissues
Example of compression injury?
contusion, fracture
Example of a tension injury
strain, cramp
What is shearing injury
force that moves parallel to the tissues
Example of shearing injury?
vertebral disk injury
What is torsion?
twisting or turning force, ends twist in opposite directions
What is bending injury?
horizontal force causing the tissue to bend or strain like in a spiral or greenstick fracture
What is a stretching injury?
elongation of tissue and ligaments like in a sprain and strain.
Difference between tension and stretch injury?
stretch injury tissute gets to long, in tension injury the tissue just gets pulled without elongation.
What resistes tensile (tenson) forces?
tendons
What resists compressive forces?
bones
What do ligaments resist?
tensile force, just like tendons
What five forces do discs resist?
tension, compression, shear and torsion.
What is a bruise?
compression that causes bleeding under skin
What is a contusion?
acute compression causeing hemorrhage of muscle tissue
What is muscle cramp?
acute involuntary muscle contraction caused by dehydration or electrylyte imbalance.
What is a muscle spasm?
reflex muscle contraction caused by acute trauma, it guards area.
Muscle hypertonicity is what?
increased activity in normal tissue so it has greater tonicity, it can cause imbalances
Muscle spasticity?
increase muscle tone at rest.
what can result from an upper motor neuron lesion?
muscle spasticity.
characterization of muscle spasticity?
increased resistance to passive stretch, exaggerated deep tendon relfex/clonus
What is a sprain?
stretchin or tearing damage to ligament with a good chance of other tissues being torn.
what are the three grades of sprain?
Grade 1 - mimimal with stability, Grade 2 - moderated with moderate stability, Grade 3 with extream pain and sever instability, needs surgery.
what would cause a sprain?
sudden load, direct bload, repetitive overload, sustained postural overload.
Which direction would be more difficult to move in
Movement in direction that would stretch ligament is painful.
Would isometric muscle cause pain for a prain?
No pain for isometric contraction.
Strain is what?
acute stretch, tear or rip in muscle or tendon
What are the grades of a strain?
Grades one through three rateing the tear, and function loss from mimimal to severe.
What would cause a strain?
sudden contraction, or stretch. Blow to muscle, conttusion or deep bruise
what is the difference between sprain and strain with active and passive range of motion?
Sprain (strecthing) has painful active and passive motion, Strain (tearing) has painfull active motion but painless passive motion.
Types of synovial joint injury?
acute synovitis, dislocation, subluxation, separation, intra-articular injury, extra articular injury
Acute synovitis is ?
inflammation of synovial membrane
Dislocation
complete separation between two articulating bones
subluxation
incomplete separation between two articulation bones, (not a full dislocation
Separation
increase in joint space between articulation surfaces.
Intra-articular injury examples?
osteochondrosis, osteochrondritis dissecans, apophysitis, traumatic arthritis
Extra-articular injury example?
bursitis, capsulitis, paratenonitis, tendonosis
Exampes of perepheral nerve injury
burner, neuritis, sciatica, carpal tunnel, mortions neuroma
what are the three stages of nerve injury?
neuropraxia, axontemesis, neurotmesis
Neuropraxia
transient physiological block that is caused by ischemia from pressure or stretch of nerve with no degeneration.
Aconotmesis
internal architecture of the nerve is preserved by axons are so badly damaged, + wallerian degeneration
Neurotmesis
structue of nerve is destroyed by cutting, secere scarring or prolonged severe compression
