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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
Q

tinels sign

A

Tinel’s sign is positive when tapping over the
carpal tunnel elicits symptoms in the distribution of the
median nerve

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26
Q

two tests to confirm carpal tunnel syndrome/repetitive strain injury

A

phalens sign and tinels sign

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27
Q

late stages S+S carpal tunnel syndrome/repetitive strain injuries

A
  • atrophy
  • recurrent pain
  • dysfunction of hand
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28
Q

causes bursitis (5)

A
  • repeated/excessive trauma
  • friction
  • gout
  • rheumatoid arthritis
  • infection
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29
Q

S+S bursitis (4)

A
  • warmth
  • pain
  • swelling
  • limited ROM
30
Q

causes primary and secondary fractures

A

primary: traumatic injury
secondary: disease process (cancer, osteoporosis)

31
Q

5 classifications fractures based on fracture line

A
  • linear
  • oblique
  • transverse
  • longitudinal
  • spiral
32
Q

7 types of fractures

A
  • transverse
  • spiral
  • greenstick
  • comminuted
  • oblique
  • pathologic
  • stress
33
Q

S+S fractures (5)

A
  • edema and swelling
  • pain and tenderness
  • muscle spasm
  • bruising
  • loss of function
34
Q

multistage fracture healing (6 stages)

A
  1. fracture hematoma
  2. granulation tissue
  3. callus formation
  4. ossification
  5. consolidation
  6. remodeling
35
Q

factors influencing healing of fractures (7)

A
  • smoking
  • displacement and site of fracture
  • infection
  • immobilization
  • age
  • poor nutrition
  • blood supply
36
Q

7 complications fracture healing

A
  • angulation
  • delayed union
  • malunion
  • myositis ossificans
  • nonunion
  • pseudoarthrosis
  • refracture
37
Q

complication: fracture heals in abnormal position in relation to midline of structure

A

angulation

38
Q

complication: fracture healing progresses more slowly than expected

A

delayed union

39
Q

complication: fracture heals in expected time but in unsatisfactory position. may cause deformity or dysunion

A

delayed union

40
Q

complication: deposition of calcium in muscle tissue at site of significant blunt muscle trauma or repeated muscle injury

A

myositis ossificans

41
Q

complication: fracture does not heal despite treatment. no xray evidence of callus formation

A

nonunion

42
Q

complication: type of nonunion occurring at fracture site in which a false joint is formed with abnormal movement at site

A

pseudoarthrosis

43
Q

complication: new fracture occurs at original fracture site

A

refracture

44
Q

Pulling force applied to injured or diseased

body part or extremity; attains realignment

A

traction

45
Q

two types traction

A

skin traction

skeletal traction

46
Q

ex skin traction

A

bucks traction for femur fracture

47
Q

how often should you assess 5 Ps and pressure points for person with skin traction

A

q2-3 hours

48
Q

how much weight can skin traction support

A

5-10 pounds

49
Q

how much weight can skeletal traction support

A

5-45 pounds

50
Q

when are external fixations used (4)

A
  • extensive soft tissue damage
  • congenital bone defects
  • nonunion/malunion
  • limb lengthening
51
Q

Surgical realignment of bony fragments using
devices such as pins, plates, intramedullary rods,
and bioabsorbable screws

A

internal fixation

52
Q

3 central and peripheral muscle relaxant drugs

A
  • carisoprodol (soma)
  • cyclobenzaprine (flexeril)
  • methocarbamol (robaxin)
53
Q

bone penetrating antibiotic drug

A

cephalosporins

54
Q

immediate attention required for what 2 things (complication of fractures)

A
  • open fracture with severe blood loss

- fractures that damage vital organs

55
Q

3 direct complications of fractures

A
  • bone infection
  • bone nonunion/malunion
  • avascular necrosis
56
Q

5 indirect complications of fractures

A
  • compartment syndrome
  • venous thromboembolism
  • fat embolism
  • rhabdomyolysis
  • hypovolemic shock
57
Q

Swelling and increased pressure within a

limited space

A

compartment syndrome

58
Q

2 causes compartment syndrome

A

-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
Q

six Ps that are S+S of compartment syndrome

A 
Pain (out of proportion to injury)
Pressure
Paresthesia
Pallor
Paralysis
Pulselessness
60
Q

how can you accurately diagnose compartment syndrome

A

regular neurovascular assessments

61
Q

what should you avoid if compartment syndrome is suspected (2)

A
  • ice/compression

- elevation above heart

62
Q

2 causes fat embolism syndrome

A

trauma

sepsis

63
Q

S+S fat embolism syndrome (appear within 24-28 hours of injury) (5)

A
  • chest pain
  • tachypnea, tachycardia
  • cyanosis
  • hypoxemia
  • petechiae
64
Q

how to prevent fat embolism syndrome

A

reposition the patient as little as possible before the bones are immobilized

65
Q

Syndrome caused by the breakdown of damaged

skeletal muscle

A

rhabdomyolysis

66
Q

what does rhabdomyolysis cause

A

obstruction of renal tubules

67
Q

2 complications joint surgery

A

infection

VTE

68
Q

common organisms of infection from joint surgery

A

gram positive strep and staph

69
Q

3 prophylactic measures to to prevent infection from joint surgery

A
  • self contained OR suites
  • laminar airflow
  • antibiotics
70
Q

what 2 anticoagulants and 2 nursing interventions can be used to treat/prevent VTE

A

warfarin and lovenox

early ambulation, SCDs

PathoPharm (42 decks)

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