Intro to Orthopedics Lecture Powerpoint Flashcards
Osteoarthritis differs from rheumatoid arthritis in that it commonly affects this joint, while it is spared in rheumatoid arthritis
DIPs
X ray findings consistent with osteoarthritis (3)
- Narrowing of joint space (RA has preserved joint space)
- subchondral sclerosis
- osteophytes
Orthopedics definition
Branch of medicine concerned with acute, chronic, traumatic, and overuse injuries and other disorders of the musculoskeletal system
Articulation definition
Joint or junction between any 2 bones or cartilages
Genu varum vs genu valgum
Varum is outward bowing knees (collapsing of the joint space medially and gapping of it laterally either traumatic or degenerative) then test with valgus stress test to see if repairable with bracing or LCL integrity test via varus stress testing, valgum is inward bowing of the knees (loss of joint space laterally and expansion medially) that can be tested with varus stress test to see if repairable with bracing or MCL integrity test via valgum stress testing
Epiphyseal plate (physis) definition
Growth plate, open in children allowing them to grow, sealed off in adults
3 compartments of the knee
- medial
- lateral
- patellofemoral compartment (front of knee space between patella and femur)
Osteoarthritis can occur in any of these 3
Sprain vs strain
Stretching or tearing of the ligaments supporting an articulation (includes capsules ligaments are located within as well), vs stretching or tearing of a musculotendinous unit
Tendonitis definition
Inflammation/irritation of a tendon most commonly due to overuse
Tendinosis (chronic tendonitis) definition
Degenerative condition affecting the tendon, commonly associated with micro tears that can be seen only on MRI (not x ray)
Shoulder dislocation vs shoulder separation
Dislocation refers to glenohumeral joint (humerous head in the glenoid fossa pops out most often anterior), vs separation refers to acromial clavicular joint (clavicle not aligned with acromion, clavicle pops up creating characteristic bony step off)
Osteoarthritis/degenerative joint disease
Mechanical wearing of articular surfaces with loss of articular cartilage collapsing of joint space and new bone growth (osteophytes) and hardening (sclerosis) of bone, either primary (unknown cause) or secondary (to injury)
Angulation of fracture
Condition where fracture fragments are not anatomically aligned, fracture fragments are at an angle to one another in comparison to anatomical alignment, described by direction that apex is pointing relative to long axis of bone in anatomical position (ex - volar angulation in a colles fracture)
Displacement/translation of fractures
When fracture fragments/dislocations are not axially aligned, describe direction of placement based on DISTAL fragment relative to proximal (ex - dorsal displacement in a colles fracture)
Rotation of fractures
Condition in which fracture fragments are rotated relative to each other, described according to the direction in which the distal fragment is rotated relative to proximal portion, very important in the digits
Reduce/reduction
To restore a fracture or dislocation to correct positioning/alignment, either closed (manipulation of joints thru skin) or open (surgical procedure)
External fixation/fixator or “ex-fix” definition
External device that has pins entering the skin into the bone proximal and distal to the fracture site with metal bars connecting to adjust the length and tension in order to realign properly in the process of reducing a bone
ORIF definition
Open reduction, internal fixation, involves making incision thru skin, identifying fracture and placing it into proper alignment, and placing a fixator device (plates, screws, rods, etc)
Volar vs dorsum of wrist
Volar is the anterior surface in anatomical position and dorsum is the posterior surface
If the distal fragment of a bone moves medial relative to the proximal fragment, we call it ___ displacement
medial displacement
What should be rechecked following any and all orthopedic procedures and treatments?
Neurovascular status - you don’t want to be the cause of why they lose a limb!
Splint definition
External fixation to support body parts or structures, noncircumferential as it immobilizes but allows for swelling** and easy removal, want to put on a splint in the acute stage of an injury
Cast definition
Form for a body part in a stiff mold made of bandage and hardening material (plaster more flexible and fiberglass less flexible but more supportive), circumferential for fixation of extremity, do not want to put on in presence of any swelling for fear of compartment syndrome or shrinkage resulting in loose cast, used in the long term
3 layers of splinting and casting materials
1) stockinette (cotton, tubular, sock like material)
2) undercast padding (cotton or gore-tex [skip the 1st step in this case - can get wet])
3) Casting tape/splint material
Position of function
Positioning for most splints/casts as it preserves normal lay of extremity and provides least tension on fracture fragments (body going limp)
Position of rehabilitation
Positioning for some casts/splints as it maintains reduction while preserving functional balances and preventing contractures/adhesions
Where should adequate cotton padding be used especially in a cast?
How do we smooth over plaster/fiberglass?
What temp water is used?
- at bony prominances and edges of cast
- Gloved palm, no fingers
- Cool to room temp, not hot, the resin activation is already warm
