Lecture 2-4 (Trauma)

Question 1

What is the outer layer of bone called

Answer 1

cortex

Question 2

What is the end of bones called?

Answer 2

metaphyseal

Question 3

dense and strong in the shaft area

Answer 3

cortex

Question 4

cortex is thinner, and bone underneath is not dense or strong?

Answer 4

metaphyseal area

Question 5

Bone underneath thin cortical shell

Answer 5

cancellous bone

Question 6

2/3 blood supply to diaphysis

Answer 6

internal (endosteal)

Question 7

1/3 blood supply to diaphysis

Answer 7

external (periosteal)

Question 8

Metaphyseal blood supply

Answer 8

endosteal and periosteal vessels and soft tissues

Question 9

What happens when breaks or fractures occur?

Answer 9

soft tissue and muscle damage, blood supply disruption

Question 10

What breaks under very little deformation

Answer 10

bones

Question 11

Mother Nature Cast

Answer 11

Indirect bone healing

Question 12

Compressing the fracture fragments together

Answer 12

Direct bone healing

Question 13

No callus can be seen on xray

Answer 13

direct bone healing

Question 14

Callus forms in the area of the fracture

Answer 14

indirect bone healing

Question 15

Most dislocations of the shoulder are…!

Answer 15

anterior

Question 16

What are shoulder dislocations caused by?

Answer 16

abduction
extension
external rotation

Question 17

What is at risk in a shoulder dislocation?

Answer 17

axillary nerve
(scratch deltoid)

Question 18

What is the key to any reduction?

Answer 18

relaxation and muscle fatigue

Question 19

How to reduce a shoulder dislocation?

Answer 19

pre and post reduction NV exam

Question 20

What is the txt for shoulder dislocation?

Answer 20

sling for 1-2wks, w/ gentle progressive ROM exercises and thxp

Question 21

What two muscles are involved in shoulder dislocations?

Answer 21

subscapularis

biceps

Question 22

T/F Posterior dislocations are rare

Answer 22

TRUE!!! (5%)

Question 23

What is MOST common cause for a posterior shoulder dislocation!!?

Answer 23

seizure

electric shock

Question 24

What is the most common physical exam finding for a posterior shoulder dislocation

Answer 24

shoulder locked in internal rotation

Question 25

What is a Bankart lesion?

Answer 25

injury of anterior (inferior) glenoid labrum of the shoulder

Question 26

“Coffee cup on a plate” and humerus slides off

Answer 26

Bankart lesion

Question 27

Humerus head slides out and bangs into the glenoid rim, causing a indentation

Answer 27

Hill- Sachs lesion

Question 28

cortical depression in the posterolateral head of the humerus bone

Answer 28

Hill-Sachs lesion

Question 29

Often the result of a fall on an outstretched hand

Answer 29

Glenoid fracture

Question 30

When are glenoid fractures repaired?

Answer 30

greater than 25 percent of the joint surface

Question 31

Where are most clavicle fractures seen?

Answer 31

middle 1/3 (80%)

Question 32

What is the most common cause for clavicle fractures?

Answer 32

Traffic accidents (70%) (seat-belt)

Question 33

Txt for anterior proximal 1/3 clavicle fracture?

Answer 33

exclusively NON OP

Rec CT scan to check neuro and SC joint

Question 34

Txt for middle 1/3 clavicle fracture?

Answer 34

mostly NON-OP

Question 35

Txt for distal 1/3 clavicle fracture?

Answer 35

mostly non-op BUT controversial (SURGERY)

mostly likely NON-UNION

Question 36

2% clavicle fracture?

Answer 36

proximal 1/3

Question 37

Associated w/ direct trauma (bat, crowbar)

Answer 37

Scapula fracture

Question 38

Txt for scapula fracture?

Answer 38

managed non-op

Question 39

Part of the scapula most commonly fractured?

Answer 39

body and spine

Question 40

What is comminution?

Answer 40

bone broken into a million little pieces

Question 41

Operative indication of a scapula fracture?

Answer 41

• Significant displacement of the glenoid cavity
• Significant displacement of the glenoid neck
• Comminution
• Very very rare to require fixation