trauma/tissue integrity Flashcards
VO2 max
how much oxygenation someone is capable of
- exercise capability also depends on this
neuro involvement in activity and fatigue
- CNS and hypothalamus
- brainstem adjusts vital signs
- adrenal gland hormone secretion of fight or flight hormones to increase oxygen delivery
- vasodilatory factors stimulated
- increase in cardiac output
low O2 will cause
bronchodilation
cardiac output for skeletal muscles at rest
20% of cardiac output
cardiac output for skeletal muscles during activity
95% of cardiac output
anaerobic metabolism
when demand exceeds supply and there is no more ATP production
fatigue
activity intolerance due to exhausted reserves
physiologic cause of fatigue
inadequate ATP to generate muscle activity
psychologic
inadequate CNS ability to generate activity
chronic fatigue
unclear onset and cause, rest does not lead to recovery, ADL’s are interfered with
chronic fatigue syndrome (myalgic encephalomyelitis, systemic exertion intolerance disease)
unclear onset with long duration and a non specific symptomatology
S&S of chronic fatigue syndrome
- chronic fatigue> 6 months with effect on ADL
- post exercise malaise
- unrefreshing sleep
- cognitive or orthostatic effects
acute injury
sudden force
- fractures
- contusions
- articulation injuries
chronic injury
overuse
-stress fractures
- strains and sprains with no time to heal
musculoskeletal system
70% of body mass
- bones, cartilage, joints, ligaments, tendons, muscle
ligaments
connect bone to bone; attach ends together
tendons
connect muscle to bone; attach muscle to bone periosteum
sprain
ligament injury; mechanical overload of a joint
- pain, inflammation, decreased function, contusion
- inversion of ankle, knee, elbow, wrist
meniscus
C-shaped fibre cartilage between tibia and femur
strain
tendon/muscle injury; excessive stretch or contraction
- pain, inflammation, increased pain with aggravating activity
- lower back muscles, C spine, elbow and shoulder
common pediatric fractures
clavicle and femur
common adult fractures
clavicle, femur, radius, head
common elderly fractures
hip, spinal disk
fracture S&S
pain, possible shock, inflammation, hematoma, deformity, loss of function, injury to surrounding area
unstable fractures
oblique, spiral, comminuted
type 1 epiphyseal fracture
through growth plate
type 2 epiphyseal fracture
most commonly seen in the ER; through growth plate and metaphysis
type 3 epiphyseal fracture
affects growth; through growth plate and epiphysis
type 4 epiphyseal fracture
affects growth; through all 3 segments (growth plate, metaphysis, epiphysis)
type 5 epiphyseal fracture
affects growth; crush injury of growth plate
- the worst of all of them
epiphysis
where ossification and calcification take place
- weakest part of bone
- 15% of fractures in children
external traction
method of pulling closed fracture into place
- manual = pulling
- skeletal= pins and wires
external fixation
stabilization long term
surgical reduction and internal fixation
used in open fractures
haematoma stage of healing (stage 1)
immediate stage;
coagulation cascade activated, inflammatory cells and mediators released
inflammation stage of healing (stage 2)
recruitment and activation of osteoprogenitor cells and clearance of necrotic tissue
callus formation (stage 3)
differentiation of MSC’s, 4 week stage, initial stabilization replaced by calcified tissue
granulation tissue (stage 4)
active proliferation of osteoprogenitor cells
- angiogenesis
- 6 week stage
quick healing
bones, synovial joints
- due to good blood and nerve supply
slow healing
meniscus, tendons, ligaments
stress fracture healing time
4 weeks
long bone healing time
up to 6 months
