Musculoskeletal

Question 1

types of fractures: closed/simple

Answer 1

skin intact

Question 2

open/compound fracture

Answer 2

skin broken from within during trauma or without during surgical intervention

Question 3

complete fracture

Answer 3

entire width of bone is broken

Question 4

incomplete fracture

Answer 4

not entire width of bone

Question 5

stable/nondisplaced fracture

Answer 5

maintain anatomical alignment

Question 6

unstable/displaced

Answer 6

don’t maintain anatomical alignment

Question 7

transverse fracture

Answer 7

A transverse fracture is when the fracture line is perpendicular to the shaft (long part) of the bone.

Question 8

oblique fracture

Answer 8

An oblique fracture is when the break is on an angle through the bone.

Question 9

Spiral fracture

Answer 9

A spiral fracture is a bone fracture that occurs when a long bone is broken by a twisting force. It usually takes a combination of surgery, rest, and physical therapy to recover from spiral fractures

Question 10

comminuted fracture

Answer 10

One kind is a comminuted fracture. This injury happens when your bone breaks into three or more pieces. Fractures can be open or closed.

Question 11

segmental fracture

Answer 11

They happen when one of your bones is broken in at least two places, leaving a segment of your bone totally separated by the breaks.

Question 12

Avulsed fracture

Answer 12

An avulsion fracture is an injury to the bone in a location where a tendon or ligament attaches to the bone. When an avulsion fracture occurs, the tendon or ligament pulls off a piece of the bone.

Question 13

impacted fracture

Answer 13

An impacted fracture occurs when the broken ends of the bone are jammed together by the force of the injury.

Question 14

Torus fracture

Answer 14

It is a common occurrence following a fall, as the wrist absorbs most of the impact and compresses the bony cortex on one side and remains intact on the other, creating a bulging effect

Question 15

greenstick fracture

Answer 15

A greenstick fracture occurs when a bone bends and cracks, instead of breaking completely into separate pieces. The fracture looks similar to what happens when you try to break a small, “green” branch on a tree. Most greenstick fractures occur in children younger than 10 years of age.

Question 16

what is closed reduction?

Answer 16

nonsurgical manipulation, manual traction; uses general or local anesthesia. Used to set bone back into correct placement.

Question 17

What is open reduction?

Answer 17

surgical correction of bone alignment; may include fixation (wire, screws, pins, plates, rods, nails)

Question 18

Two types of traction for setting bone?

Answer 18

skin traction (weight to tape attached to skin around damaged body part) and skeletal traction (pins/wires surgically inserted into bone)

Question 19

complications of casts:

Answer 19

impaired circulation, imapired neurological function (movement and sensation), infection, compartment syndrome; venous thrombosis, fat embolism

Question 20

Cast care

Answer 20

• protect skin prior to applying
• cast may produce heat in drying
• with wet casts, never use fingertips (indentation)
• elevate extremities during initial period; assess for complications
• explain to the patient: no sharp objects underneath; elevate cast during first stages to prevent edema; clean cast; skin at edges; waterproof around perineal; skin care!

Question 21

Compartment syndrome

Answer 21

compression of structures in closed compartments (either natural structures of body or within a cast)

Question 22

compartment syndrome is indicated by:

Answer 22

dramatic increase in pain, loss of sensation or movement, pain with passive motion, and pulselessness

6 Ps: paresthesia, pain, pressure, pallor, paralysis, pulselessness

Question 23

Treatment of compartment syndrome

Answer 23

DON’T elevate extremity above the heart; DON’T apply ice; DO remove or loosen band or cast; if due to internal tissue compartment, fasciotomy may be performed

Question 24

3 types of hip fractures

Answer 24

femoral neck, intertrochanteric, subtrochanteric

Question 25

S&S of hip fractures

Answer 25

shortened and externally rotated hip; deformity along lateral side; ecchymosis and tissue trauma; muscle spasm, pain, tenderness in region

Question 26

treatment of hip fracture

Answer 26

prior to surgery, skeletal or skin traction; surgical intervention = internal fixation or total hip arthroplasty (open reduction and pin most common)

Question 27

post op care of hip fractures

Answer 27

assess fr CMS and edema; maintain alignment; avoid hip flexion >90 degrees avoid adduction and internal rotation

Question 28

Hip fracture complications

Answer 28

DVT, ulcers, delirium

Question 29

total knee arthroplasty postoperative

Answer 29

CMS, 6 Ps, positioning, passive ROM

Question 30

Disk herniation S&S:

Answer 30

pain radiating down buttock and below knee; reflexes decreased or absent; paresthesia or muscle weakness in legs, feet, or toes; positive straight leg test

Question 31

For a disk herniation, spinal surgery is indicated if:

Answer 31

problem does not respond to conservative treatment, pt has consistent pain, or has persistent neurological deficit

Question 32

Kyphoplasty

Answer 32

Kyphoplasty is a minimally invasive surgery used to treat a spinal compression fracture. Spinal compression fractures occur primarily in spinal vertebrae that have been weakened by osteoporosis.

Question 33

Kyphoplasty postoperative care:

Answer 33

no lifting/twisting/bending; shower, don’t bathe; walk (including stairs); take antiinflam. And pain meds

Question 34

clinical indications of amputation

Answer 34

circulatory impairment due to peripheral vascular disorders; traumatic and thermal injuries; malignant tumors; uncontrolled/widespread infection; congenital disorders

Question 35

Care of the limb after amputation

Answer 35

• Daily skin care helps prevent infections, sores, other problems slowing healing
• Wash and check limb daily
• Massage skin to help scar from attaching to tissue below
• Wash limb every evening with mild soap and warm water; rinse well and pat dry; DO NOT SOAK
• Check skin on all sides with mirror

Question 36

Define CMS

Answer 36

Circulation, motion, sensation