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NSG 2202 > Musculoskeletal Trauma/Test 4 > Flashcards

Musculoskeletal Trauma/Test 4 Flashcards

1
Q

Musculoskeletal Trauma Definition:

A

a complete or partial interruption of osseous tissue

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2
Q

Musculoskeletal Trauma usually occurs….

A

as a result of a blow to the body, a fall or accident.

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3
Q

Musculoskeletal incidence is highest among

A

15-30 year olds and women over 65 (osteoporosis)

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4
Q

Humerus fractures are

A

common among young and middle aged adults

  • elderly d/t neuromuscular instability
  • People in high risk occupations
  • Disease processes; cancer renal failure, chronic degenerative disease
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5
Q

Stable trauma:

A

aligned

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6
Q

Unstable trauma:

A

displaced

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7
Q

Diagnostic tests:

A

Xray
MRI
CT Scan

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8
Q

Pt history indicates…

A

a mechanism of injury associated with:

  • Immediate localized pain
  • decreased function
  • Inability to bear weight or used affected part
  • guarding
  • may or may not be accompanied by obvious bone deformity.
  • excessive motion
  • crepitus (do not attempt to elicit this sign)
  • soft tissue edema
  • inflammatory changes
  • ecchymosis
  • sensory changes
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9
Q

Process of Bone Healing:

A

Immobilization and proper re-allignment of bone fragments must occur

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10
Q

Factors that impede bone healing:

A
  • Age-hormones
  • Medications- steroids, anticoagulants
  • Metabolic disorders or diseases-diabetes, cancer, malnutrition, immunodeficiency, osteoporosis
  • inadequate blood supply
  • site and extent or soft tissue injury
  • Infection
  • Excess motion of the fracture fragments
  • Excessive edema at the tx site
  • Bone necrosis
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11
Q

Peripheral Neurovascular Assessment Neuro:

A
  • Sensation
  • Movement
  • pain
  • paresthesia
  • paresis/palsy
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12
Q

Peripheral Neurovascular Assessment Vascular:

A
  • Color
  • Temperature
  • Edema
  • Capillary refill
  • Peripheral pulse
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13
Q

Physiological splintage

A

*Guarding, muscle spasm, and avoidance of use

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14
Q

External orthopedic splinting

A

*Casts, plaster splints, and braces

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15
Q

Internal fixation:

A

*Screws, plates or rods to hold opposing ends together

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16
Q

Fracture reduction: Closed reduction-

A
  • Manual manipulation (non-surgical)

* Casting, external fixation, splint, braces to immobilize for healing

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17
Q

Fracture reduction: Open reduction-

A
  • May use plates, screws, pins

* ORIF- Open reduction with internal fixation for joints

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18
Q

Fracture reduction can be a combination of:

A

Closed and open reduction

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19
Q

Objectives for treatment:

A
  • reduce the fracture by realigning the fracture fragments
  • Maintain the fragments in correct alignment by immobilization
  • Restore function and prevent excessive loss of joint mobility
20
Q

Traction:

A

Temporary immobilization to reduce bone fracture. -prevent/reduce muscle spasm-immobilize a joint or part of the body-reduce a fracture or dislocation-treat a joint pathologic condition.(Hip, femur, knee, back), correct alignment and prevent further soft tissue damage. Can provide some relief from pain and muscle spasms.

21
Q

Complications of traction: Skin

A
  • Pressure over bony sites cause breakdown.

* Persistent skin pressure can cause peripheral neuro vascular injury

22
Q

Buck’s tx:

A

Simple form provides pull on the affected limb

23
Q

Russell traction:

A

Allows some movement. Permits flexion of the knee joint. Used for fx of the femur when surgery is contraindicated

24
Q

Skin traction is _____ pounds

A 
7-10
Buck's
Russell's
Bryant's (children)
Pelvic belt
Head halter
25
Q

Skeletal Tractions:

A
  • Overhead arm (90-90)
  • Lateral arm
  • balanced suspension
26
Q

The purpose of trochanter rolls:

A

is to maintain alignment while in bed

27
Q

Reduction

A

realignment of bone fractures

28
Q

Fixation-

A

immobilization of fragment sites

29
Q

Casts are:

A

fiberglass or plaster

30
Q

Types of casts:

A
  • sugar-tong splint
  • posterior splint
  • short arm cast
  • long arm cast
  • body jacket cast(cast syndrome-abd pain, pressure, n/v)
  • hip spica
  • long leg cast
  • short leg cast
  • cylinder cast
31
Q

Jones dressing:

A

bulky padding material, splint, ace wrap or bia cut stockinette

32
Q

Internal Fixation: ORIF

A
  • preferred method to manage a femoral fracture
  • pins, plates and screws
  • surgically inserted at the time of realignment
  • stainless steel, titanium
33
Q

External fixation:

A
  • metallic device composed of metal pins that are inserted into the bone and attached to external rods to stabilize fracture.
  • Can be used alone or in conjunction with plaster
  • Provides extremely rigid fixation.
  • Alignment evaluated by x-ray
34
Q

Common Drug Therapy: Tetanus

A

*If fracture is open

35
Q

Drug therapy: Antibiotics

A
  • Bone penetrating
  • cefazolin (Ancef, Kefzol)
  • Preventive measure
36
Q

Drug therapy: Analgesics

A

Treatment for pain

37
Q

Drug therapy: Skeletal Muscle Relaxant

A
  • Soma (Carisoprodol)
  • Flexeril (cyclobenzaprine)
  • Robaxin (methocarbamol)
38
Q

Drug Therapy:

A
  • Antibiotics
  • Analgesics
  • Skeletal muscle relaxant
39
Q

Hip Fracture d/t advanced age:

A
  • Elderly prone to falls
  • d/t neuromuscular instability
  • Inability to correct postural imbalance
  • Inadequacy of local tissue shock absorbers
  • Underlying skeletal strength
  • Bone remodeling is altered
  • Muscle mass and strength decrease
  • Loss of motors neurons
  • Tendons and ligaments less flexible
40
Q

Hip Fracture misc risk factors:

A
  • osteoporosis
  • female
  • caucasian
  • decreased estrogen
  • prior hip fractions
  • alzheimer disease
  • residing in institution
  • sedentary lifestyle
  • inadequate calcium and vit D
  • excessive intake of protein
  • caffeine intake
  • smoking
  • use of ETOH
  • psychotropic drugs
41
Q

Classification of hip fractures:

A
  • Intracapsular (femoral neck)
  • Extracapsular fracture (intertrochanteric)
  • Subtronchanteric fracture
42
Q

Intracapsular (femoral neck) hip fracture:

A
  • Occurs within the hip joint and capsule
  • Can disrupt blood supply
  • R/F nonunion and avascular necrosis
43
Q

Extracapsular hip fracture (intertochanteric):

A
  • Occurs outside the hip joint below to an area (2 inches) of the lesser trochanter
  • Complications: malunion and shortening of the affected extremity.
44
Q

Subtronchanteric hip fracture:

A

*below the lesser trochanter

45
Q

S/S of a hip fracture:

A
  • Severe pain at the fracture sight
  • Inability to move leg voluntarily
  • Shortening and external rotation of leg
  • Other s/s consistent with those of any fracture
46
Q

Hip Fracture surgical management:

A
  • Reduction and stabilization of fracture
  • Insertion of an internal fixation device (ORIF)
  • pin, screw, nail, plates
  • Occasionally may replace hip joint (hip arthroplasty)

NSG 2202 (22 decks)

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