Musculoskeletal A&C

Question 1

Important history taking questions

Answer 1

how have symptoms changed overtime - could they move straight after the incident

weight bearing after incident

loss of function

paraesthesia - pins and needles

medications

Question 2

Examination Points - Look

Answer 2

Compare sides of the body - remember abnormalities may be normal for the patient

swelling, loss of function. irregularity, pain, deformity, unnatural movement, crepitus, tenderness and symmetry

Question 2

Examination Points - Feel

Answer 2

pain, pallor, paraesthesia, pulses, paralysis, perishing cold, capillary refill, distracting injuries and distal pulses

above and below joints

sensation above and below, compare sides

Question 2

8 Types of Fracture

Answer 2

Closed - no puncture of skin
Open- skin punctured or large wound that goes down to bone
Transverse- single break into two parts
Spiral - twisting force
Comminuted - more than 2 pieces
Impacted - broken bones are forced into each other
Greenstick - incomplete, often seen in children
Oblique - broken diagonally

Question 3

Neck of Femur fracture overview

Answer 3

common in over 65s
10% mortality rate at one month and 30% at one year - due to reduced movement, surgery and reduced confidence

Symptoms = pain, shortening on one side, rotation of foot on injured side, inability to stand or rotate the leg

Question 4

What are sprains?

Answer 4

injury to ligaments - partial or complete tears

Question 5

Management of sprains

Answer 5

ice, compression and elevation

Question 6

What are strains?

Answer 6

injuries to muscles - partial or complete tears
Grade 1 - bruised, sore
Grade 2 - partial tear
Grade 3 - complete tear

Question 7

Management of strains

Answer 7

ice, compression and elevation

Question 8

Musculoskeletal Treatments (7)

Answer 8

Reduction of pain - splinting, positioning, medication

Control of bleeding - pressure, gauze

triangular bandages

box splints - arm/leg fractures

Vacuum splints

Pelvic splints

Traction splints

Question 9

Step by step on using the Kendrick Traction Device

Answer 9

1. check pulse and sedation of patient
2. secure ankle hitch (red section is short, yellow is long)
3. thigh strap (blue) - holes on outside
4. traction pole - black line level with foot
5. elastic knee strap (yellow)
6. yellow loop from ankle hitch at the end of traction device and pull the red loop until tight
7. elastic thigh trap
8. elastic ankle strap
9. check pulse

traffic light system: thigh strap (red), knee (yellow), ankle (green)