Soft Tissue Injuries and Fractures

Question 1

CTM assessment?

Answer 1

circulation temperature movement sensation

Question 2

7 p’s?

Answer 2

pallor pulse puffiness paralysis parasthesia pain

Question 3

Sprain?

Answer 3

stretch/tear ligament tissue surrounding a joint S&S: pain, edema, bruising, reduce function Treatment: Rest Ice Compression Elevation-above heart level

Question 4

strain?

Answer 4

muscle/tendon over-stretching or tearing S&S: pain, edema, bruising, reduce function Treatment: Rest Ice- 20 on 20 off, after first 48 hrs, apple heat Compression Elevation-above heart level

Question 5

dislocation?

Answer 5

complete displacement/separation of joint S&S: deformity, local pain, edema, loss of function Treatment: reduction of immobilization

Question 6

subluxation?

Answer 6

partial separation of a joint surface

Question 7

Fracture?

Answer 7

Disruption/break in the continuity of the structure of the bone. Classified according to: Open or closed (communication with the external environment, condition of the skin & tissue) Complete or incomplete Based on direction of fracture Displaced or not displaced Can be caused by trauma or disease process

Question 8

Clinical Signs: Fractures?

Answer 8

Question 9

Stages of Bone Healing

Answer 9

Hematoma formation Production of granulation tissue Callus formation Ossification Consolidation Remodeling

Question 10

OPEN REDUCTION care?

Answer 10

Correction of bone alignment through surgical incision Includes internal fixation with use of wires, screws, pins, plates, intramedullary rods, or nails

Question 11

TRACTION: SKIN or SKELETAL care?

Answer 11

Application of a pulling force to an injured or diseased part of body or extremity, while counter-traction pulls in opposite direction Purpose of any traction Prevent or ↓ muscle spasm Immobilize joint or part of body ↓ a fracture or dislocation Treat a pathological joint condition Used for short-term treatment until skeletal traction or surgery is possible Tape, boots, or splints applied directly to skin to maintain alignment, assist in reduction, and help diminish muscle spasms in injured extremity Traction weights 2.3 to 4.5 kg assess for skin breakdown + traction remains in place

Question 12

SKELETAL TRACTION

Answer 12

In place for longer periods Used to align injured bones and joints Pin or wire inserted into a bone Weight ranges 2 to 20 kg

Question 13

IMMOBILIZATION?

Answer 13

Goal: maintain anatomical re-alignment Can be accomplished by: External devices Internal devices Casts

Question 14

IMMOBILZATION: EXTERNAL FIXATION?

Answer 14

Attached directly to bone by percutaneous transfixing pins or wires

Question 15

IMMOBILZATION: cast

Answer 15

Arm (short, long) Leg (short, long) Body (trunk) Spica (trunk and one or two extremities: single or double spica)

Question 16

TRACTION care?

Answer 16

Inspect exposed skin regularly when slings are used with traction. Assess over bony prominences C (Continuous) Skeletal traction never interrupted A (Alignment) Pt must be in the center of bed R (Resistance) Not present, weights must hang freely O (Opposing traction) Body weight, patient high in bed L (Line of pull) Unobstructed pull, ropes do not touch pulleys

Question 17

COMPLICATIONS OF FRACTURES?

Answer 17

Blood vessels and nerve damage Compartment syndrome Deep vein thrombosis Fat embolism Bone infection Bone malunion and nonunion pulse difficult to find

Question 18

COMPARTMENT SYNDROME:?

Answer 18

Develops when swelling and pressure occur within a confined space or compartment. The pressure causes perfusion to the muscle to be compromised. Ischemia of the muscle and nerve damage result if enough pressure builds. Early recognition is essential to avoid permanent damage to muscles and nerves.

Question 19

COMPARTMENT SYNDROME S&S?

Answer 19

Pain that increases in severity, especially with passive stretching of the muscle and that is unrelieved with narcotic analgesics. Paresthesia Decreased or absent pulses, cynosis, cold, slow cap refill Tense skin over the limb Paralysis

Question 20

COMPARTMENT SYNDROME therapeutic measures?

Answer 20

Early detection is single most important measure (Why?). Elevation of the extremity to heart level (NOT ABOVE). Release of restrictive devices (casts/bandages) Fasciotomy (release pressure)

Question 21

DEEP VEIN THROMBOSIS:?

Answer 21

Veins of lower extremities and pelvis are highly susceptible to thrombosis. Precipitating factors Incorrectly applied cast or traction Local pressure on a vein Immobility darn turn into emboli if left untreated S&S: warm to touch, edema

Question 22

FAT EMBOLISM SYNDROME:?

Answer 22

Presence of systemic fat globules from fracture that are distributed into tissues and organs after a traumatic skeletal injury Contributory factor in many deaths associated with fracture S&S: respiratory distress

Question 23

BONE INFECTION:?

Answer 23

Open fractures Soft tissue injuries Osteomyelitis: severe infection of bone & surrounding tissues S&S: pain, blood test for infection, CT/MRI scan

Question 24

MALUNION AND NONUNION?

Answer 24

never healing