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PathoPharm > lewis ch 62 MS trauma and orthopedic surgery > Flashcards

lewis ch 62 MS trauma and orthopedic surgery Flashcards

1
Q

injury to ligaments around a joint

A

sprain

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2
Q

degree of sprain: few fiber tears; mild

tenderness and swelling

A

1st degree

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3
Q

degree of sprain: partial disruption of

tissue; increased swelling and tenderness

A

2nd degree

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4
Q

degree of sprain: complete tear with

moderate to severe swelling

A

3rd degree

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5
Q

excessive stretching of muscle and fascia, may involve tendon

A

strain

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6
Q

degree of strain: mild or slightly pulled

A

1st degree

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7
Q

degree of strain: moderately torn muscle

A

2nd degree

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8
Q

degree of sprain: severely torn or ruptured muscle

A

3rd degree

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9
Q

S+S sprains/strains (4)

A
  • pain
  • edema
  • decreased function
  • bruising
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10
Q

3 possible complications sprains/strains

A
  • avulsion fracture
  • subluxation or dislocation
  • hemarthrosis
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11
Q

bleeding in the joint

A

hemarthrosis

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12
Q

ligament pulls loose a fragment of bone

A

avulsion fracture

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13
Q

acute care for sprains/strains

A

Rest
Ice (24-48 hours, 20 mins at time)
Compress
Elevate above heart

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14
Q

complete displacement or separation of the articular surfaces of the joint

A

dislocation

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15
Q

partial of incomplete displacement of the joint surface; symptoms less severe

A

subluxation

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16
Q

S+S dislocation/subluxation (5)

A
  • deformity
  • pain
  • tenderness
  • loss of function
  • swelling
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17
Q

potential complications (3) of dislocation/subluxation

A

intraarticular fracture
avascular necrosis
compartment syndrome

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18
Q

common upper extremity dislocations (3)

A

thumb
elbow
shoulder

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19
Q

common lower extremity dislocations (2)

A

hip

knee cap

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20
Q

people at risk for repetitive strain injuries (6)

A
  • musicians
  • dancers, gymnasts
  • athletes
  • weightlifters
  • swimmers
  • people who use keyboard computers
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21
Q

injury caused by compression of median nerve, associated with activities that require continuous wrist movement

A

carpal tunnel syndrome

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22
Q

risk factors carpal tunnel syndrome (5)

A
  • diabetes
  • peripheral vascular disease
  • rheumatoid arthritis
  • pregnancy
  • premenstrual period
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23
Q

S+S carpal tunnel syndrome/repetitive strain injuries (5)

A
  • impaired sensation
  • pain
  • numbness
  • weakness
  • clumsiness
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24
Q

phalens sign

A

Phalen’s maneuver is positive when flexing the wrist to 90 degrees for 1 minute elicits symptoms in the median nerve distribution

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25
tinels sign
Tinel's sign is positive when tapping over the carpal tunnel elicits symptoms in the distribution of the median nerve
26
two tests to confirm carpal tunnel syndrome/repetitive strain injury
phalens sign and tinels sign
27
late stages S+S carpal tunnel syndrome/repetitive strain injuries
- atrophy - recurrent pain - dysfunction of hand
28
causes bursitis (5)
- repeated/excessive trauma - friction - gout - rheumatoid arthritis - infection
29
S+S bursitis (4)
- warmth - pain - swelling - limited ROM
30
causes primary and secondary fractures
primary: traumatic injury secondary: disease process (cancer, osteoporosis)
31
5 classifications fractures based on fracture line
- linear - oblique - transverse - longitudinal - spiral
32
7 types of fractures
- transverse - spiral - greenstick - comminuted - oblique - pathologic - stress
33
S+S fractures (5)
- edema and swelling - pain and tenderness - muscle spasm - bruising - loss of function
34
multistage fracture healing (6 stages)
1. fracture hematoma 2. granulation tissue 3. callus formation 4. ossification 5. consolidation 6. remodeling
35
factors influencing healing of fractures (7)
- smoking - displacement and site of fracture - infection - immobilization - age - poor nutrition - blood supply
36
7 complications fracture healing
- angulation - delayed union - malunion - myositis ossificans - nonunion - pseudoarthrosis - refracture
37
complication: fracture heals in abnormal position in relation to midline of structure
angulation
38
complication: fracture healing progresses more slowly than expected
delayed union
39
complication: fracture heals in expected time but in unsatisfactory position. may cause deformity or dysunion
delayed union
40
complication: deposition of calcium in muscle tissue at site of significant blunt muscle trauma or repeated muscle injury
myositis ossificans
41
complication: fracture does not heal despite treatment. no xray evidence of callus formation
nonunion
42
complication: type of nonunion occurring at fracture site in which a false joint is formed with abnormal movement at site
pseudoarthrosis
43
complication: new fracture occurs at original fracture site
refracture
44
Pulling force applied to injured or diseased | body part or extremity; attains realignment
traction
45
two types traction
skin traction | skeletal traction
46
ex skin traction
bucks traction for femur fracture
47
how often should you assess 5 Ps and pressure points for person with skin traction
q2-3 hours
48
how much weight can skin traction support
5-10 pounds
49
how much weight can skeletal traction support
5-45 pounds
50
when are external fixations used (4)
- extensive soft tissue damage - congenital bone defects - nonunion/malunion - limb lengthening
51
Surgical realignment of bony fragments using devices such as pins, plates, intramedullary rods, and bioabsorbable screws
internal fixation
52
3 central and peripheral muscle relaxant drugs
- carisoprodol (soma) - cyclobenzaprine (flexeril) - methocarbamol (robaxin)
53
bone penetrating antibiotic drug
cephalosporins
54
immediate attention required for what 2 things (complication of fractures)
- open fracture with severe blood loss | - fractures that damage vital organs
55
3 direct complications of fractures
- bone infection - bone nonunion/malunion - avascular necrosis
56
5 indirect complications of fractures
- compartment syndrome - venous thromboembolism - fat embolism - rhabdomyolysis - hypovolemic shock
57
Swelling and increased pressure within a | limited space
compartment syndrome
58
2 causes compartment syndrome
-Decreased compartment size from restrictive dressings, splints, casts, excessive traction, or premature closure of fascia -Increased compartment contents due to bleeding, inflammation, edema, or IV infiltration
59
six Ps that are S+S of compartment syndrome
``` Pain (out of proportion to injury) Pressure Paresthesia Pallor Paralysis Pulselessness ```
60
how can you accurately diagnose compartment syndrome
regular neurovascular assessments
61
what should you avoid if compartment syndrome is suspected (2)
- ice/compression | - elevation above heart
62
2 causes fat embolism syndrome
trauma | sepsis
63
S+S fat embolism syndrome (appear within 24-28 hours of injury) (5)
- chest pain - tachypnea, tachycardia - cyanosis - hypoxemia - petechiae
64
how to prevent fat embolism syndrome
reposition the patient as little as possible before the bones are immobilized
65
Syndrome caused by the breakdown of damaged | skeletal muscle
rhabdomyolysis
66
what does rhabdomyolysis cause
obstruction of renal tubules
67
2 complications joint surgery
infection | VTE
68
common organisms of infection from joint surgery
gram positive strep and staph
69
3 prophylactic measures to to prevent infection from joint surgery
- self contained OR suites - laminar airflow - antibiotics
70
what 2 anticoagulants and 2 nursing interventions can be used to treat/prevent VTE
warfarin and lovenox | early ambulation, SCDs

PathoPharm (42 decks)

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