MSK 1 Flashcards
What are the 2 types of bone and what is the purpose of each?
Cortical: provides structural support and attachment points for muscles
Cancellous: “soft” interior where vascular supply is situated; site of RBC production
Which type of bone is where RBCs are produced?
Cancellous
What are the 3 main parts of a long bone?
(1) diaphysis
(2) epiphysis
(3) metaphysis
Which part of a long bone is also known as the shaft and provides skeletal support?
Diaphysis
Which part of a long bone is a common site of muscle attachment?
Diaphysis
Which part of a long bone is the ossification center?
Epiphysis
Tendons attach ___ to ___.
Tendons attach muscle to bone.
Ligaments attach ___ to ___.
Ligaments attach bone to bone
What are 4 examples of acute musculoskeletal complaints?
(1) Fractures
(2) Dislocations
(3) Ligament strains/sprains
(4) Septic joints
What are 3 examples of chronic musculoskeletal complaints?
(1) Overuse syndromes (tendonitis)
(2) Osteoarthritis
(3) Osteomyelitis
Define direct, indirect, and twisting forces.
Direct: a direct blow
Indirect: force impacts one end of limb and damage is transmitted to a distant point
Twisting: one part of extremity stationary while the rest twists
What 5 things would you look for on musculoskeletal physical exam?
(1) Swelling
(2) Deformity
(3) Neurovascular status
(4) Pain with palpation
(5) Painful/decreased ROM
What are 3 special tests to assess joints on PE and what is the usefulness of each?
Provocative tests: recreate mechanism of injury to reproduce the pt’s pain
Stress tests: apply load to test ligament stability
Functional testing: useful to assess injury severity and ADLs
What is the initial test of choice following skeletal trauma?
X-ray
What 4 things does an x-ray evaluate?
(1) Cortical integrity
(2) Articular surface congruity
(3) Joint space
(4) Lesions
What is a CT scan used in?
Trauma to identify and characterize injury pattern/severity
A CT scan is better than x-ray in what 3 things?
(1) identifying subtle fractures (2) visualizing articular extension of fracture
(3) assessing for the presence of articular step-off/gap
What are MRIs primarily used for? What additional 2 things are MRIs useful for?
Soft tissue eval; diagnosing occult fractures and when there is a concern for associated ligament or articular cartilage injury
What is an ultrasound used for and what are 2 injury examples for ultrasound use?
Used in trauma setting to assess soft tissue injury; (1) Achilles’ tendon rupture (2) Quad tendon rupture
What 2 fractures is a bone scan most commonly used for?
Occult and stress fractures
What are the ABCs of reading an x-ray?
Alignment (long axes of bones), adequacy (of views and image quality) Bones (lucent lines, deformities) Cartilage (joint space, defects) Soft tissues (swelling, effusion)
Define fracture. And list 2 additional things that may be affected by fractures.
Fracture: loss of continuity of the structure of a bone
(1) Sharp fragments may injure surrounding tissue
(2) Arteries and veins that run throughout the bones may tear or rupture and bleed
Differentiate open fracture from closed fracture.
Open: break in skin w/underlying soft tissue injury
Closed: fracture is not exposed to environment, no break in skin
In what amount of time after an open fracture should surgical tx be at least started?
6 hours