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ot 423 > quiz 3 > Flashcards

quiz 3 Flashcards

1
Q

explain the difference between extra and intra-articular fracture?

A

Extra-articular: occurs outside joint (bone shaft) and not too big of a deal unless it is a complete fracture
intra-articular: occurs within the joint space and can affect ROM

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2
Q

Explain a boxer fracture

A

Cause: hitting something very hard with closed fist
Involves proximal end of the 5th metacarpal into the palm
Results from a blow on the distal - dorsal aspect of the closed fist
After a splint comes off, there is a loss in ROM in the MCP jt.
Type of fracture? → impacted, comminuted, simple fracture line

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3
Q

Explain a scaphoid fracture

A

If it is tender it may = a fracture
Palpation in the snuff box area to the wrist distal to the radial styloid.
MOST COMMON carpal fracture
Damage is usually due to hyperextension of the thumb.
Common cause is falling on outstretched hand. (FOOSH)
Requires open reduction. A hereberts screw is commonly used.
If left untreated, patient may develop avascular necrosis.

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4
Q

what is a colles fracture?

A

it is a fracture of the distal radius which results in a dinner fork deformity and can happen when falling on an outstretched hand (FOOSH)

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5
Q

what is a torn ulnar collateral ligament of the MCP joint of the thumb?

A

There can be a grade 1, 2, or 3 sprain
Happens when extreme radial deviation/adduction of the thumb occurs.
Lateral stress it applied to stress patency.

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6
Q

what is a mallet finger?

A

Avulsion injury
Flexion posture or “droop” of finger at the DIP joint
Complete passive but incomplete active extension of the DIP joint
Cause by a blow to the tip of an extended finger
To repair- splinting in DIP hyperextension for 6 weeks.

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7
Q

what is the boutonniere deformity?

A

Flexion of PIP jt. & hyperextension of the DIP jt.
Openly reduced→ dorsal hood will be changed forever.

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8
Q

what is a swan neck deformity?

A

Hyperextension of PIP joint & flexion of DIP joint
Volar and the dorsal hood will be changed forever

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9
Q

what is a closed reduction?

A

it is less invasive and does not require opening of soft tissues, splits and casts are forms of this

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10
Q

what is an open reduction?

A

it is more invasive and requires the opening of soft tissues and is usually used in cases where there are more severe fractures that need wires, pins, screws and/or plates

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11
Q

what is a complete fracture?

A

bone breaks cleanly and does not break the skin

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12
Q

what is a compound/open fracture?

A

bone ends penetrate through soft tissues and the skin

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13
Q

what is a greenstick fracture

A

a fracture where the bone breaks incompletely, and occurs more frequently in the younger population because their bones are not ossified yet so it doesn’t break it bends

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14
Q

what is a transverse fracture?

A

when the bone breaks in a straight line across the bone

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15
Q

what is an oblique fracture?

A

when a break occurs diagonally when torsion occurs on one end when is being fixed

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16
Q

what is a spiral fracture?

A

jagged bone end are S-shaped because excessive torsion is applied to a fixed bone, commonly caused by twisting of the bone and heals incorrectly if not fixed (will have to be rebroken if this happens) more common in the finger

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17
Q

what is an avulsion?

A

Bone fragment is pulled off by an attached tendon or ligament (tendon tears but takes the bone with it)
Caused by injury/fall
Example of avulsion→ mallet finger, dorsal hood tears off distal pharynx.

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18
Q

what is a comminuted fracture?

A

Bone fragments into several pieces
example → distal radial fractures
Open reduction needed to fix

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19
Q

what is an epiphyseal fracture?

A

“Growth plate” break
Separation involves the epiphysis of the bone
Identified by X-Ray and need a specialized surgeon to perform surgery.
This type of break prohibits and stunts growth

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20
Q

what is an impacted fracture?

A

another bone is driven into another piece of bone

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21
Q

what is a depressed fracture?

A

Occurs on flat bones when the broken bone portion is driven inward
Diffuse axonal and focal axonal
Causes→ blunt trauma
Baseball bat
Hard fall

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22
Q

what is a synonym for healing?

A

union

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23
Q

what are influences of healing?

A

age and presence of disease

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24
Q

what nerve wraps around the humerus?

A

radial nerve

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25
Q

what are 3 phases approach to therapy program based on healing?

A

stabilize

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26
Q

what is an adhesion?

A

when two tissues stick together that are not usually stuck together

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27
Q

what is the etiology of thoracic outlet syndrome (TOS)?

A

A. Tight pectoralis minor. Collar bone and deeper first rib (shoulder girdle) movement can affect the amount of space.
B. Congenital first rib anomaly (not normal from birth) can cause this problem. It takes away the space from the brachial plexus, subclavian vein, and subclavian artery. This is the only one that can be taken care of through surgery.
2B. Dynamic posture related, depending on posture depends how much space those structures have. Narrowing and opening of the space.
C. Tight scalene muscle or overdeveloped scalene muscle.

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28
Q

what is the pathology of thoracic outlet syndrome (TOS)?

A

compression of the brachial plexus (subclavian vein/artery)

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29
Q

what is RSD or reflex sympathetic dystrophy aka complex regional pain syndrome

A

it is a secondary complication due to trauma with a skeletal fracture and the sympathetic nervous system is inactive, worsening symptoms

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30
Q

what is phase one of RSD?

A

phase one is early: hot or cold skin, skin is blotchy, edema (ballooning/soft and pitted edema), aching/burning pain, hypersensitivity, skin is shiny

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31
Q

what is phase 2 of RSD?

A

phase two is late: Excessive hair growth, venous congestion (blue hue to the skin), atrophy, sweaty skin, edema is spreading beyond initial site (now hard/brawny/chronic edema), hypersensitivity

32
Q

phase three is very late:

A

osteoporosis (loss of bone density), pain is less, decrease blood flow, increased or decreased sweating, loss of connective tissue, contractures are present (meaning there are hard end feels which result in loss of passive and active ROM).

33
Q

what is septicemia

A

blood that is poisoned by bacteria, which affects all parts of the body

34
Q

what are the skin layers

A

epidermis, dermis which has an upper layer dermis and lower layer dermis which is called the basal layer, and the subcutaneous layer

35
Q

what layer of skin has two layers

A

the dermis

36
Q

what is the basal layer responsible for?

A

the healing process and angiogenesis
heals deep to superficial and margins out to in

37
Q

what are the wound classifications?

A

tidy: is a clean laceration
wound healing: primary intention(sutures, glue, or staples are used to close up)
untidy: a significant amount of damage which has destroyed three layers of skin (blood vessels, nerves, tendon, muscle and or bone
wound healing: Delayed primary intention (waits until the wound is clear of infection and is clean then uses primary intentions like sutures to close up)
a wound with tissue loss: this uses secondary intention which lets the wound heal on its own

38
Q

what are the four signs of inflammation?

A

redness, swelling, pain and warmth

39
Q

what is a form of tenosynovitis?

A

trigger finger

40
Q

what is the red, yellow, black classification system?

A

it is used for wound color because it is a reflection of a balance between new tissue and necrotic tissue
red: this is a good color for a wound because it means it is healing
yellow: should be closely monitored because it is a red flag for possible infection, odor in this stage is a big sign of infection
black: means there is black necrotic tissue, ischemia (depletion of blood, o2 and nutrients) can be a common cause and poor health is also a contributor.

41
Q

what is selective debridement?

A

it is the removal of necrotic tissue to get rid of the scar

42
Q

what is non-selective debridement?

A

this type removes healthy and unhealthy tissue alike, dry gauze can remove this fairly easy

43
Q

ganglion cysts

A

mucin-filled soft tissue cyst formed in the synovial lining of a joint or tendon sheath. these cysts usually arise from the scapholunate joint and ligament of the wrist, and they are the most common tumors accounting for 15-60% of all cases in the hand and wrist. there are various theories on formation (includes mucoid degeneration, synovial herniation, and trauma to the joint capsule or ligaments)

44
Q

dorsal wrist ganglions

A

these are usually seen over the dorsum of the wrist and usually is between the extensor pollicis longus and the extensor digitorum communis at the level of the scapholunate ligament. these are the most common type of ganglion cyst accounting for 60-70% of ganglion cysts in the hands and wrist cases

45
Q

volar wrist ganglions

A

commonly associated with underlying scapholunate ligament, commonly seen on the radial aspect of the wrist (over the flexor carpi radialis tendon). this is the second most common type composed of 15-20% of cases and an allen’s vascular test may be performed to palpate the cyst.

46
Q

Lipomas

A

common soft tissue tumor comprised of mature fat cells and characterized by their soft consistency. pain is unusual unless the tumor is pressing on a nerve. most common location is in the deep palmar space

47
Q

enchondroma

A

most common primary bone tumor in the hand, and accounts for 90% of cases. there are benign cartilaginous tumors most commonly found in the proximal phalanx followed by the metacarpal and middle phalanx.

48
Q

melanoma

A

it is one type of malignant epithelia tumor (skin cancer) and is one of the most serious types. it develops in the melanocyte cells and is potentially life threatening due to the tendency to rapidly spread to the lymph nodes

49
Q

assess for a wound clinical infection

A

check for edema, erythema, exudate, tenderness, increase in temperature, pain and odor

50
Q

decubitus ucler stages (bed sores)

A

Stage 1- skin is red, when pushed on it becomes blanched (whiter color), then red again
Stage 2- stays red, does not blanch anymore with pressure.
Stage 3- tissue breakdown of the epidermis or dermis
Stage 4- breakdown goes thru bone tendon and muscle

51
Q

who gets bed sores

A

Elderly and someone who is bedridden (cannot move themselves)

52
Q

why do bed sores happen?

A

blood pools in one place for too long

53
Q

where are common sites for bed sores?

A

Shoulder blades, elbows, hips, heels, back of head as well as any bony prominence

54
Q

what is the first stage of wound and tissue healing

A

Stage 1, Acute inflammatory stage (2 parts)
The body shuts down blood supply immediately to contain anything no long viable (vasoconstriction)
Mast cells made of heparin and histamine are released to create vasodilation.
Once this occurs phagocytosis begins and then that triggers the release of macrophages to dispose of the garage (AKA the clean up phase)

55
Q

what is the second stage of wound and tissue healing?

A

Stage 2, Repair and regenerate
Soft tissue- fibroblast produce a scar over the damaged tissue
Bony tissue- osteoblasts produce callus across the bone fracture

56
Q

what is the third stage of wound and tissue healing?

A

Stage 3, Remodeling/maturation
Soft tissue- becomes stronger and reorientation itself
Movement and compression is needed to strengthen it
Movement adds to cosmesis (looks like normal)
Compression helps realign the lines of stress
Bony tissue- osteoclast take care of the callus after the bone is healed.

57
Q

what helps determine infection?

A

IF THE FOLLOWING THINGS HAPPEN, THEN COME BACK
Color, odor, drainage, temperature (warmth), edema, erythema

58
Q

True of false, ice slows down the healing process in stage 2

A

true

59
Q

what are the grades of muscle/tenon strains and ligament sprains?

A

Grade 1
Pain, microtearing of collagen fibers
Usually fixed by a splint
Grade 2
More pain, more tearing of tissues, instability of joints and muscle weakness
What is the test used to detect this? → lateral slide test
Usually fixed by a splint
Grade 3
Severe pain, loss of tissue, loss of ROM, complete joint instability.
AKA dislocation, the tissue is torn
Will need surgery most likely

60
Q

surgical dressings include what layers

A

Contact layer: the first layer of dressing on the wound
Must be non-adherent dressing to decrease the chances of it sticking to the wound.
Intermediate layer: second layer of dressing consist of usually gauze (placed on top of contact layer).
THESE 2 LAYERS ARE KNOWN AS PRIMARY DRESSING
Outer Layer: third layer is absorbent cotton pads placed over the primary dressing.
***Wrapping of the primary layer
Example, cling wrap

61
Q

What are the functions of bulky dressing and what % of dressings are bulky?

A

99%
Functions-
Provides protection from outside trauma
Absorb blood and fluid from exiting relative to a strike through
Prevent infection
Stabilize the body part

62
Q

what is a strike-through?

A

When drainage seeps through dressing immediately

63
Q

what is the first stage of peripheral nerve compression?

A

Blood nerve barrier breakdown
Nerve has ischemia, getting compressed and not getting the blood and nutrients it needs
S&S: nocturnal parathesis (numbness and tingling) and parathesis associated with activity pressing on the medial nerve.
KEY HERE- no muscle weakness.

64
Q

what is the second stage of peripheral nerve compression

A

Demyelination
Nerve is choked off now for too long and hard, so now the myelin is affected and signals are slowed. Nerve conduction velocity is no longer as efficient
S&S: persistent parathesis, now there is muscle weakness

65
Q

what is the third stage of peripheral nerve compression

A

Axonal loss
Axons are contained within the nerves and they are now damaged
S&S: asensate (no feeling or sensations) NO paresthesia
Muscle weakness and muscle atrophy (able to be seen)
Example- Thenar eminence will be sunken right in
Outcome and course is determined on what stage the surgery was done in.

66
Q

what is the etiology of fibromyalgia?

A

hormones, genetics, immunological

67
Q

what is the pathology of fibromyalgia?

A

abnormalities in the neuroendocrine and autonomic nervous systems, genetic factors, psychosocial variables, and environmental stressors

68
Q

what are the signs and symptoms of fibromyalgia?

A

pain and stiffness, fatigue and tiredness, depression and anxiety, sleep problems, headaches and migraines, problems with thinking, memory, and concentration.

69
Q

what is the course of fibromyalgia?

A

no cure, but medication can be used to control symptoms, exercise, relaxation, and stress-reduced measures.

70
Q

what is the prognosis of fibromyalgia?

A

medication and lifestyle changes needed to control symptoms. NOT progressive (manageable)

71
Q

what is the etiology of Dupuytren’s contracture?

A

no exact cause of Dupuytren’s contracture but it is a possibility that it is hereditary

72
Q

what is the pathology of Dupuytren’s contracture

A

fibrosing disorder that results in slowly progressive thickening and shorting of the palmar fascia and leads to debilitating digital contractures, particularly of the metacarpophalangeal (MCP) joints or the proximal interphalangeal (PIP) joints. Overtime pulls the MCP and PIP into flexion.

73
Q

what are the signs and symptoms of Dupuytren’s contracture?

A

Dupuytren’s contracture can cause one or more fingers to stay bent toward the palm. This can complicate everyday activities

74
Q

what is the course of Dupuytren’s contracture?

A

typically progresses slowly, over years. The condition usually begins as a thickening of the skin on the palm of your hand. As it progresses, the skin on your palm might appear puckered or dimpled

75
Q

what is the prognosis of Dupuytren’s contracture?

A

progresses very slowly, over a period of years, and may remain mild enough such that no treatment is needed. In moderate or severe cases, however, the condition makes it difficult to straighten the involved digits.

ot 423 (1 decks)

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