Muscular Skeletal

Question 1

What are the P’s of musculoskeletal Assessment

Answer 1

• Pain or tenderness
• Pallor (pale skin or poor cap refill)
• Paraesthesia (sensation, pins and needles)
• Pulse (diminished or absent)
• Paralysis (inability to move)
• Pressure

Question 2

What is splinting able to achieve?

Answer 2

• Immobilize
• Reduce swelling
• Relieve pain
• Prevent contamination of open wound
• Simplifies transport of a patient

Question 3

What is the splinting treatment process?

Answer 3

• Splint joints and bone ends above and below the injury
• Immobilize open and closed fractures in the same manner
• Cover open fracturs to minimize contamination
• Check the P’s
• Immobilize a long bone extremity in a straight position that can be splinted easily.
• Immobilize a dislocation in a position of comfort and ensure vascular supply
• Immobilize joint as found
• Apply cold compress to reduce swelling and pain
• Elevate the extremity if possible

Question 4

What factors can affect musculoskeletal trauma

Answer 4

• Age
• Prior damage
• Osteophyte formation

Question 5

What is a fracture?

Answer 5

• A break in the continuity of the bone or cartilage

- When the stress placed on the area exceeds the tensile or compressive strength of the bones.

Question 6

Types of Incomplete Fractures

Answer 6

• Incomplete fractures can be broken into the following
  o Greenstick
   Break occurs in the periosteum on one side of the bone while bowing/buckling on the other side. This is common in children
  o Torus
   Bucking of the cortex
  o Bowing
   Bending of the bone

Question 7

When is a fracture considered complicated?

Answer 7

• When the fractures involve damage to muscle, tissue, organs, nerves and blood vessels.

Question 8

What is the grading of open or compound fractures?

Answer 8

-	Grade 1
o	Wound is <1cm in puncture
-	Grade 2
o	Wound up to 5cm long with no contamination crush or necrosis
-	Grade 3
o	Large laceration with associated contamination or crush
-	Grade 4
o	Total or near amputation

Question 9

List the 7 types of fractures

Answer 9

-	Comminute
o	Multiple bone fragments
-	Linear
o	Parallel to long axis
-	Oblique
o	45 degrees to the long axes
-	Spiral
o	Spiral caused by twisting motion
-	Pathological
o	Occurs at the point of weakness due to an underlying pathology
-	Stress
o	Micro fractures
-	Epiphyseal
o	Break that involves the epiphyseal plate

Question 10

What are the four stages of fracture healing?

Answer 10

• 1 – Hematoma formation
• 2 – Fibrocartilaginous callus formation
• 3 – Bony callus formation
• 4 – Bone remodelling

Question 11

What are complications of fractures?

Answer 11

• Arterial injury
• Nerve injury
• Compartment syndrome
• Fat embolism