Musculoskeletal Disorders Flashcards
what is a fracture? patho? CM?
Break in continuity of bone, epiphyseal plate, or cartilaginous joint surface
Pathogenesis
-Periosteum & blood vessels disrupted
-Hematoma formed -> Inflammatory reaction
-Site invaded by osteoclasts & osteoblasts
-Avascular bone replaced by living bone via resorption & bone deposition.
-Callus formation creates new bone at edges of periosteum.
-Remodeling is replacement of mature lamellar bone.
Clinical Manifestations
-Unnatural alignment
-Swelling
-Muscle spasm
-Tenderness, pain
-Impaired sensation
Treatment—stabilization.
what are complications in bone healing? etiology? tx?
Delayed healing can include:
-Delayed union: 3mo-1yr bone tenderness
-Malunion: Improper alignment
-Nonunion: Not healed in 4-6 mo.
Etiologies: Non-approximated fragments, infection, smoking, malnutrition, poor circulation
Tx: Bone graft, internal/external fixation, electrical bone stimulation, or a mixture of these
what is fat embolism syndrome? CM
-Cause of pulmonary insufficiency
-Most common with Fx of pelvis, tibia, femur, ribs
-Fat globule released into circulation -> lodge in small blood vessels of lungs, kidneys, brain, and other organs
Clinical Manifestations: Change in LOC; restless, agitated, confusion, stupor (near unconsciousness), dyspnea, increased resp rate, tachycardia, Fever, petechial skin rash, crackles
what is compartment syndrome? etiology? CM?
D/t trauma to soft tissue caused by impact
Etiologies: decreased compartment size, increased compartment content, or externally applied pressure
-Edema causes increase in pressure in compartment; pressure reduces capillary flow; muscle & nerves become ischemic
Manifestations: pain, paresthesia, pale skin, and diminished pulse
what are dislocations and subluxations?
Dislocation: Complete separation of joint articulating surfaces
Subluxation: Partial separation
-Considerable amt. of tissue damage occurs with both
-Evaluation for fx is necessary
what are sprains and strains? Patho? CM?
Strain: Tear in tendon
Sprain: Tear in ligament
Pathogenesis:
-Inflammation, granulation tissue, collagen formation
Clinical Manifestations
-Pain
-Soft tissue swelling
what are the types of soft tissue injuries?
Types:
Contractile tissue: Is involved in cxn of muscle & includes not only muscle but tendon & bony insertion.
Inert tissue: Has no ability to contract or relax.
what is blunt trauma?
Can cause bleeding into the muscle belly; may lead to inability to contract the muscle; may coagulate and calcify; results in myositis ossificans
Calcification prevents normal & strong contraction of muscle involved
what are joint capsule injuries?
Joint capsule: stabilizes synovial joint.
-Injury in joint causes scarring in capsule.
-Thick capsule prevents full ROM.
-Synovial fluid unable to flow through cartilage, causing compression & distention.
-“frozen shoulder”
what are injuries to fasciae and bursae?
Fasciae: Connective tissues arranged in sheaths that envelop muscles.
Bursae: Pockets of connective tissue lined with synovium in areas between muscles or between tendon & bone.
Injuries cause pain & restriction of movement of M/S system
what are injuries to tendons?
Tendinitis: From infection, direct injury or repetitive motion
-Stress on tendon greater than fibers can tolerate
Categorized by severity of injury
Grade I: minute tear
Grade II: Large tear
Grade III: total rupture
what are injuries to ligaments?
Ligaments: Connect bone to bone.
-Loading exceeds physiologic range of motion (ROM).
-Classified as mild, moderate, severe.
Symptoms: Pain with wt. bearing & acute swelling.
Tx: Depends on degree of tear; surgical restoration of ligament continuity may be required in severe injury.
what is osteomyelitis? etiology? patho?
Severe infection of bone & local tissue
-Staphylococcus aureus most common pathogen
Etiologies: Bacteremia (systemic infxn), burns, sinus disease, trauma, malignant tumor necrosis, periodontal infection or an infected pressure ulcer. Direct infection from open fx, penetrating wounds, surgical contamination, insertion of prosthesis, metal plates, or screws
Pathogenesis:
-Bacterial growth causes bone destruction & abscess formation
-From abscess cavity pus spreads into medulla of bone
-Necrotic bone becomes trapped
-Sinuses develop in bone & allow pus to escape outside of bone
what is infectious arthritis? CM? tx?
Joint infection most often d/t bacteria via bloodstream
Clinical Manifestations: D/t localized infection & systemic manifestation of inflammation-warm swollen joint
Tx: Abx over 4-6 wks with therapeutic joint aspiration, arthroscopy or surgical drainage
Joint Prosthesis Infection
-Bacterial arthritis
-Staphylococcus epidermidis is common agent
-Removal of prosthesis followed by IV abx tx for 4-6 wks.
-Prosthesis may be replaced when wound cultures show no growth.
what is scoliosis?
Lateral curvature of spine causes S- or C-shaped spinal column
Functional: Resolves when pt. bends to affected side
Structural: Fails to correct itself on forced bending against curvature & has vertebral rotation
Tx: Bracing, exercises, or surgical interventions with spinal alignment, fusion, & internal fixation
