intro to orthopedic injury Flashcards
- Primary Injury
Direct/ extrinsic
Indirect/intrinsic
Overuse
Secondary Injury
enzymatic
hypoxic
short term and long term
Ischemia Causes:
- Damaged blood vessels
- Hemostasis/clotting
- Inflammation induced hemoconcentration
- Thicker blood does not flow as well
- Increased extravascular pressure from expanding hematoma
- Pain induced muscle spasm
- Swelling of injured cells
Ischemia results in
- Hypoxia
- Inadequate supply of nutrients (glucose)
- Inadequate removal of waste
- Mechanisms of Injury:
Tension (tendons/ligaments) Compression (bone) Torsion (twisitjg) Shearing (parallel, vertebrae resist all of the above) Bending (greenstick, spiral fracture) Stretching (strain, sprain)
Common injuries
Bruise Contusion cramp, spasm muscle hypertonicity, spacticity sprain
spasm
a reflex muscle contraction caused by acute trauma; serves to protect or guard an area
muscle hypertonicity
increased activity of normal muscle. - No nerve or muscle pathology but resting tone is greater than normal
May cause muscle imbalance with an inhibited/weak antagonist muscle
muscle spacticity
- increase in muscle tone at rest
- Increased resistance to passive stretch, exaggerated deep tendon reflexes and possibly clonus
- Result of an Upper Motor Neuron Lesion
Sprain grading
ligament damage-Grade 1 (0-20%) - minimal pain and loss of function, little or no swelling, and no abnormal motion when tested; stability of the joint is intact
-Grade 2 (20-75%) - moderate pain, loss of function and swelling; moderate joint instability present
-Grade 3 (>75%) - extremely painful with a major loss of function, tenderness, swelling and severe instability; surgical repair is probably indicated
NO ISOMETRIC PAIN
Strain grading
an acute stretch, tear or rip in the muscle or tendon
- Grade 1 (50%) - severe tearing with pain, loss of muscle function and a palpable deformity; surgical repair is probably indicated
- *often caused by sudden contraction
- **ISOMETRIC CAUSES PAIN
Synovial Joint Injury:
- Acute Synovitis - inflammation of the synovial membrane
- Dislocation - a complete separation b/t two articulating bones
- Subluxation - an incomplete separation b/t two articulating bones
- Separation - an increase in joint space b/t articulating surfaces
-Intra-articular joiny injury
- Osteochondrosis - degenerative changes of bone epiphysis or apophysis
- Osteochondritis dissecans - avascular degeneration of articular cartilage
- Apophysitis - inflammation of the tendon-bone junctions
- Traumatic arthritis - inflammation causing thickness of the synovium of a joint and resulting in creptitis and grating
-Extra-articular injury
- Bursitis - inflammation of bursa
- Capsulitis - inflammation of joint capsule
- Paratenonitis - inflammation of the outside of a tendon or its sheath
- Tendinosis - degeneration of the collagen matrix or a tendon
- Peripheral Nerve Injury:
- Burner - irritation and pain from nerve traction or stretching
- Neuritis - inflammation of nerve cells
- Sciatica - stretch of sciatic nerve
- Carpal Tunnel Syndrome - compression of median nerve
- Mortons Neuroma - tumor of a neuron in the foot
