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Clin Med I > ortho and radiology basics > Flashcards

ortho and radiology basics Flashcards

1
Q

acute injuries

A
  • less than 6 weeks
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2
Q

chronic injuries

A
  • greater than 6 weeks
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3
Q

provocative tests

A
  • recreate mechanism of injury to reproduce pts pain
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4
Q

stress tests

A
  • apply load to test ligament stability
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5
Q

functional test

A
  • assess injury severity and ADLs
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6
Q

open fracture

A
  • break in skin and underling soft tissue

- surgical tx within six hours

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7
Q

why would you immobilize a joint after a fracture?

A
  • maintain anatomic position
  • prevent movement of fx and further injury
  • limits NV injury
  • pain control
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8
Q

methods of immobilization

A
  • splint
  • cast
  • closed reduction percutaneous pinning (CRPP)
  • open reduction internal fixation (ORIF)
  • external fixator
  • intramedullary rodding
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9
Q

how long does it take for fx to heal? phases of healing?

A
  • 6 weeks
  • inflammatory phase- hematoma
  • reparative phase- callus that lasts 3-4 months
  • bone remodeling
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10
Q

splinting a fracture

A
  • splint for 2-3 days to allow swelling to decrease
  • refer to ortho for possible cast
  • splints allow soft tissue swelling
  • minimize NV compromise
  • immobilize joint above and below injury
  • eval distal circulation, motor function and sensation before AND after splinting**
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11
Q

casting a fracture

A
  • usually on for 4-6 weeks
  • changed at about 3 week mark if no fx movement
  • treatment of choice for most non-operative fx
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12
Q

what do you use short arm casts for?

A
  • wrist fx
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13
Q

what do you use long arm casts for?

A
  • forearm fx

- unstable wrist fx to prevent pronation and supination

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14
Q

what do you use thumb spica casts for?

A
  • scaphoid or radial styloid fx
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15
Q

what is the best immobilization option for LE fxs?

A
  • splint/ walking boot
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16
Q

what do you use short leg casts for?

A
  • foot fx
  • ankle fx
  • achilles injury
  • server’s syndrome
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17
Q

what do you use long leg casts for?

A
  • tib/fib fx

- quad tendon repair

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18
Q

closed reduction

A
  • reduce bone to near anatomic position
  • “recreate the fx” to align
  • MUST be a stable fx
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19
Q

closed reduction percutaneous pinning

A
  • reduce/hold stable closed fx if cannot cast
  • decreases need for ORIF
  • risk if skin or nerve/vessel damage
20
Q

ORIF

A
  • holds unstable fx
  • “internal splint”
  • restores length
  • needs 6 cortices above and below
  • rod- prevents ant/post mvmt
  • locking screws- prevent bone from rotation around rod
21
Q

external fixator

A
  • used when major non-lifesaving procedures must be avoided

- “bridge” to ORIF

22
Q

sprain

A
  • stretching/ tearing of ligaments
  • inversion vs/ eversion injury
  • ankle most common d/t inversion and plantar flexion
23
Q

strain

A
  • injury to muscle or muscle and tendon
  • muscle fibers tear
  • usually caused by overextension or over stretching
  • pain worse with use
  • cramping, muscle spasm/ weakness, swelling
24
Q

treatment for sprains/strains

A
  • RICE
  • splinting
  • NSAIDs
  • early ROM
  • PT
25
Q

dislocations

A
  • displacement of bone from normal position
  • joint forced beyond normal ROM
  • damage NV structures by compression or tearing
  • must be treated soon
26
Q

PE findings for dislocations

A
  • pain and TTP
  • inability to move extremity
  • loss of distal pulse increases severity of injury
  • eval NV status before AND after reduction
27
Q

tendinitis

A
  • inflammation/ irritation of tendon
  • pain and tenderness
  • common in shoulders, elbows, wrists, knees
  • treat with rest, ice, brace, NSAIDs, PT, cortisone
28
Q

tendon rupture

A
  • force applied to tendon may be 5X body weight

- treat with splint, ice, NSAIDs, surgery, early ROM, pt

29
Q

most common tendon ruptures

A
  • achilles
  • biceps (proximal)
  • RTC
  • quad
30
Q

initial imaging study of choice for skeletal trauma

A
  • XRAY

- need at least 2 views and be sure to examine pt first

31
Q

basics for interpreting x-rays

A
  • open vs. closed
  • anatomic location
  • morphology of fx line
  • displacement
  • distraction
  • angulation
  • rotation
32
Q

CT scans

A
  • best for determining subtle fx
  • good for visualization of articular extension of fx
  • good for assessment of presence of articular step off/ gap
33
Q

MRI

A
  • mainly for soft tissue eval
  • dx of occult fx i.e. femoral neck fx
  • modality of choice for disc herniation and internal derangement of joints
34
Q

ultra sound

A
  • assess soft tissue injury

- achilles tendon and quad tendon ruptures

35
Q

bone scan

A
  • best for assessment of metastases
36
Q

how do most fracture lines appear on x-ray

A
  • radiolucent lines

- need 2 views to assess

37
Q

mach band

A
  • appears at site of cortex overlap or skin fold over cortex
  • may mimic lucent lines
  • most common site- ankle where tibia overlaps fibula
38
Q

sclerotic line

A
  • usually d/t compression fx

- common in vertebral bodies or distal radius

39
Q

impaction fx

A
  • wedged into each other

- generally stable

40
Q

avulsion fx

A
  • d/t abnormal tensile stress on ligaments or tendons

- common in hands, feet, pelvis

41
Q

transverse fx

A
  • perpendicular to long axis of bone
  • usually d/t direct force
  • most common in forearm and leg
  • generally stable
42
Q

oblique fx

A
  • compression and angulation forces cause shear force
  • usually d/t indirect force
  • unstable -> OR
43
Q

spiral fx

A
  • caused by twisting mvmt through long bone axis -> rotation/ shear forces
  • unstable -> OR
  • least common
44
Q

comminuted fx

A
  • more than 2 fx fragments

- unstable -> OR

45
Q

butterfly fx

A
  • fragment produced along concave compression side

- bending of bone -> tension vector on convex side and compression vector on concave side

46
Q

greenstick fx

A
  • incomplete fx of long bone on convex side
  • concave side is bent
  • usually in forearm of young kids
  • d/t bending force applied perpendicular to shaft of bone
47
Q

buckle fx

A
  • aka torus fx
  • incomplete fx
  • occurs at metaphyseal diaphyseal junction after FOOSH
  • stable
  • heal faster than greenstick

Clin Med I (16 decks)

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