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Musculoskeletal TRAUMA Flashcards

1
Q

Strain

A

stretching or tearing of a muscle or tendon

muscle to bone

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2
Q

Sprain

A

stretching or tearing of a ligament

bone to bone

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3
Q

Contusion

A

injury to soft tissue that results in a hematoma

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4
Q

1st Degree Strain

A
  • mild edema, pain, and muscle spasms
  • ROM NOT affected
  • may last 3-5 days
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5
Q

2nd Degree Strain

A
  • Moderate
  • Edema/bruising
  • Pain/muscle spasms
  • Loss of strength
  • 2-3 weeks
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6
Q

3rd Degree Strain

A
  • Complete Tearing
  • Internal bleeding w/ bruising
  • Severe pain, edema, muscle spasms
  • Complete loss of function
  • May need surgery
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7
Q

1st Degree Sprain

A
  • stretching or minimal tearing
  • edema/mild discomfort
  • function unaffected
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8
Q

2nd Degree Sprain

A
  • Moderate incomplete tearing
  • Edema, redness, pain w/ moving
  • Discomfort evident w/ weight bearing
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9
Q

3rd Degree Sprain

A
  • Complete tearing
  • Ambulation not possible
  • Severe pain, redness, edema
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10
Q

Diagnostic Tests for Strains/Sprains

A
  • X-rays
  • CT Scans
  • MRI
  • Ultrasounds
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11
Q

Treatment for 1st-2nd Degree

A 
R- rest
I- ice (30 mins 5x a day)
C- compression 
E- elevate
NSAID's 
Splinting
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12
Q

3rd Degree Treatment

A

Surgery

  • Arthroscopic
  • Reconstructive
  • Recovery is 4-6 weeks of immobilization and therapy
  • Percocet/Norco
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13
Q

Complications of Sprains and Strains

A
  • Joint instability
  • Higher Risk for repeated injury
  • Bursitis/ Tendonitis
  • Limited Mobility
  • Compartment Syndrome
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14
Q

Joint Dislocation

A

Articular surfaces of bone are no longer aligned

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15
Q

5 Types of Dislocation

A
  • Total or Partial
  • Congenital
  • Spontaneous
  • Traumatic
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16
Q

S/S of Dislocation

A
  • Abnormal appearance of joint
  • Shortening of affected limb
  • Loss of normal mobility
  • Confirmed w/ x-ray
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17
Q

Treatment for Dislocation

A
  • Immediate immobilization
  • Reduction ASAP
  • Re-immobilize
  • Neurovascular checks q 1-2 hours
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18
Q

When can the patient begin to move their extremity again after dislocation?

A

-Begin slowly progressing movement IF joint is stable

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19
Q

When may surgery be necessary?

A

If no stability can be attained

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20
Q

When is treatment considered emergent for a dislocation?

A

When it is traumatic and is to prevent Avascular Necrosis

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21
Q

Fractures

A

A disruption or break in the continuity of a bone

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22
Q

What might cause an elderly person’s bones to fracture?

A
  • Weakened bones secondary to osteoporosis
  • Loss of bone density due to aging
  • Falls
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23
Q

What are the most common causes of fractures for teens-young adults?

A
  • Motor vehicle accidents

- Sports injuries

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24
Q

Where do fractures in young children often occur?

A

Growth plates

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25
Complete Fracture
Bones break into 2 or more parts and may involve displacement
26
Incomplete Fracture
Break does not go all the way through the bone
27
Oblique Fracture
Break runs across the bone diagonally
28
Comminuted Fracture
Produces bone fragments - may have missing pieces - hardest to heal
29
Impacted Fractures
Ends of the bones are driven into each other | -often w/ falls
30
Closed (Simple) Fracture
Does NOT break the skin
31
Open (Compound) Fracture
Bone protrudes through the skin
32
Stress Fractures
Repeated bone trauma | -Athletes
33
Compression Fracture
Compression of vertebrae | -May be pathological (osteoporosis)
34
Avulsion Fracture
tendon/ligament is pulled away and takes the bone w/ it
35
Depression Pattern Fracture
Inward fracture from blunt force trauma
36
Green stick Fracture
One side is broken and the other is bent | -Children
37
Spiral Fracture
Twisting of the bone | -Child abuse
38
S/S of a Fracture
- Pain - Loss of Function - Deformity - Shortening - Crepitus - Swelling - Discoloration
39
What are the non-surgical treatments for a fracture?
- Immobilization (splints/casts) - Pain Meds - Closed Reduction
40
What pain meds are used for fractures?
Narcotics: Percocet, Norco NSAIDs: Motrin, Advil, Aleve
41
Closed Reduction
Bones are realigned through manual manipulation and traction while the patient is under conscious sedation - Cast/splint used for immobilization - X-rays used to verify realignment
42
Surgical Treatment for Fractures
- Open reduction w/ internal fixation - Closed reduction w/ internal fixation - Open reduction w/ external fixation
43
Open Reduction w/ Internal Fixation
Plates, screws, and rods are used internally to stabilize the fracture
44
Closed Reduction w/ Internal Fixation
Bones aligned manually, but small incisions are made to place plates and screws
45
Open Reduction w/ External Fixation
Rods and pins create a frame externally to support the fracture
46
What should be done for an Open Fracture?
- Irrigation and debridement of wounds - Reduction and stabilization - Antibiotics w/in 6 hours of trauma - Sterile dressing/wound VAC/debridement - Closure w/ patients skin or secondary intention
47
Reactions to Internal Fixations
May be the result of mechanical or material failure, allergic reaction, or device corrosion -causes pain and decreased mobility
48
How can you treat a reaction to internal fixation devices?
Removal may be possible if bone strength and functioning can be adequately maintained -Must treat infection 1st
49
Reactions to External Fixation Devices
Infection typically common w/ pins and pin sights - Erythema - Drainage - Warmth of infected extremity - Fever - Increased WBC's
50
Treatment and Prevention for reactions to external fixation devices
Pin care and antibiotics
51
Complex Regional Pain Syndrome
Constant intense limb pain associated w/ limb fractures
52
S/S of Complex Regional Pain Syndrome
* *Severe burning pain - Swelling - Excessive sensitivity (hyperesthesia) - Discoloration - Limited ROM
53
What should be done for a patient w/ Complex Regional Pain?
- Avoid prolonged contact w/ affected extremity - Vitamin C supplements - Early Mobilization - Elevation - Physical Therapy - Pain reduction
54
What medications can be used fir Complex Regional Pain?
- NSAIDs - Corticosteroids - Nerve blocks - Muscle relaxants - Opioids
55
Fat Embolism
usually occurs when there is trauma to a long bone or the PELVIS - A piece of fat from the marrow breaks away and obstructs smaller vessels - multiple fractures, CRUSH injuries, ortho surgery, pelvic/long bone fractures
56
S/S of Fat Embolisms
- Disorientation - Agitation - Acute HA - Hypoxia - Tachypnea - Tachycardia - Dyspnea/crackles/wheezing - Petechia
57
How are fat embolisms diagnosed?
CT San of lungs and Cerebral MRI
58
What can happen if a fat embolism is NOT treated?
- pulmonary edema - heart failure - stroke - death
59
Prevention and Treatment of Fat Embolism
- Immediate immobilization - Minimal manipulation and support - Strict fluid and electrolyte balance - Respiratory support - Corticosteroids - Vasopressors
60
Delayed Union
prolonged healing/realignment
61
Malunion
fractures do not heal in correct alignment causing deformities
62
Nonunion
Fractures do NOT heal - Internal fixations - Bone grafting - Electrical bone stimulation
63
Treatment for the Unions
- Smoking cessation - Limit alcohol - Proper nutrition - Avoid NSAID's
64
Venous Thromboemboli VTE
clots develop in the large vessels of the extremities | -can break away and move to the lungs resulting in pulmonary embolism
65
What should you monitor for w/ VTE?
- sudden SOB and chest pain - restlessness - tachypnea - tachycardia - acute persistent cough - blood-tinged sputum
66
What can prevent/treat VTE?
- Early ambulation - ROM daily - Prophylactic anticoagulants
67
Hypovolemia/Hypovolemic Shock
Secondary to blood loss that may occur - pelvic, femur, and open fractures - agitation, confusion, low urine output, clammy hands, hypotension, tachycardia, tachypnea, weak pulse
68
How to treat Hypovolemia/Hypovolemic Shock
- Rapid stabilization - Transfusion of PRBC's - Pain meds
69
Disseminated Intravascular Coagulation (DIC)
- Clotting proteins in the blood are consumed leading to widespread hemorrhaging * *Plasma Transfusions - Clotting proteins become abnormally active resulting in widespread clots * *Anti-coagulants
70
Avascular Necrosis
bone loses its blood supply and dies
71
5 P's for Neurovascular Assessment
``` Pain Pulse Pallor Paresthesia Paralysis ```
72
Compartment Syndrome
Swelling w/in a limited space, such as muscle compartment or cast that does not easily expand - Compresses blood vessels, compromising circulation, and nerves affecting motor function - Damage can be irreversible and permanent after only 3 hours
73
Late S/S of Compartment Syndrome
- Loss of sensation - Cool skin - Weak pulse - Paresthesia - Decreased mobility - Sudden increase in pain
74
Treatment for Compartment Syndrome
CALL PROVIDOR ASAP - loosen or remove bandage - Bi-valve cast - Fasciotomy
75
Fasciotomy
a surgical procedure where the fascia is cut to relieve tension or pressure -closed surgically or w/ wound vac
76
Pressure Ulcers
- Assess for drainage/foul odor - Remove bandage - Bi-valve cast or cut window
77
Disuse Syndrome
Muscle Atrophy - loss of size and strength in a muscle that has been inactive for a long period of time - muscle contraction exercises, fist squeezes, PT
78
Buck's Traction
Used for immobilization of femur and hip fractures prior to surgical repair - Free hanging weights - Extremity remains in proper alignment - Check for slipping
79
Skeletal Traction
Used to maintain alignment/prevent limb shortening - tibia, femur, and cervical fractures - attached directly to the bone - Weights attached to rods
80
External Fixator
- used to maintain alignment and immobilization in stable, complicated fractures - pins and screws are inserted directly in the bone and secured w/ metal frame - clamps used to change tension
81
Traction Care
- Assess weights and ropes q 2 hours - Ensure proper alignment - Feet remain in neutral position - Inspect for pressure ulcers - Apply to trapeze - Pressure mattress - Pin care - Inspect pin sites daily
82
Joint Replacement
A surgical procedure in which parts of an arthritic or damaged joint are removed and replaced w/ a metal, plastic, or ceramic device (prosthesis) -Knees, hips, shoulders
83
Diagnosis of need for Joint Replacement
-Observation/Assessment Deformity, limitations, pain -X-ray/MRI
84
Conservative treatment for joint injury
- Exercise - Weight loss - NSAID's (stop 1 week before surgery) - Joint Supplements
85
Surgery for Joint Replacement
- May be total or partial | - Prosthetic device may be cemented or uncemented
86
Cemented
Glue or cement is used to attach the new device to the healthy bone -Older adults that are less active
87
Uncemented
A hole is drilled into the healthy bone to attach the new device - younger adults - high levels of activity, better movement, easier to revise
88
Total Hip Replacement (Arthroplasty)
involves removal of the ball and socket as well as the neck of the femur
89
Partial Hip Replacement (Hemi-Arthroplasty)
involves the removal of the ball as well as the neck of the femur, but NOT the socket
90
Joint Replacement Post Op Education
- Hemovac drain - May need blood transfusions (autologous) - Usually closed w/ staples - Island dressing - Continuous passive motion machine - Partial weight bearing w/ slow progression to full
91
Total Joint Knee Precautions
- Do not pivot or twist | - Do not kneel or squat
92
Total Joint Hip Precautions
- Avoid flexion beyond 90 degrees - Do not pivot or twist - Do not cross legs - Do not elevate HOB more than 60 degrees
93
Complications of Joint Replacement
- Bleeding/hypovolemia - Orthostatic hypotension - Wound infection - Dislocation - DVT - Pulmonary embolism
94
S/S Hip dislocation
- pain and swelling - acute groin pain - shortening of affected leg - abnormal rotation - Popping sound
95
Amputation
Removal of body part - performed at the lowest point w/ highest chance of successful healing - Conserve as much as possible
96
Complications of Amputation
- Hemorrhage - Infection - Skin breakdown
97
Phantom Limb Pain
Sensation that an amputated body part is still attached, numbness, tingling, and burning sensations manifest from the removed limb
98
Treatment for Phantom Limb Pain
- Antidepressants - Anticonvulsants - Mirror technique - Validate pain and encourage to touch amputation - Exercise limb

Nursing (21 decks)

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