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Clinical Medicine 1 > Traumatic Disorders of the MS System > Flashcards

Traumatic Disorders of the MS System Flashcards

1
Q

Reactions of Musculoskeletal Tissues to Disorders and Injuries: bone

A

local death
alteration of bone deposition
alteration of bone resorption
mechanical failure

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2
Q

osteonecrosis

A

local death of bone (avascular necrosis)

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3
Q

Alteration of bone deposition

A

acromegaly, OA
-too much bone, too much bone at point of contact
Increased deposition: increased matrix, normal calcification
OR
decreased deposition, decreased formation of matrix and hypocalcification

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4
Q

hypocalcification

A

not enough bone layed down

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5
Q

alteration of bone resorption

A

increased (osteoporosis)
decreased
-could be combination of both

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6
Q

mechanical failure

A

fracture

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7
Q

Reaction of MS Tissues to D and I: Articular Cartilage

A 
Destruction: trauma, intervertebral disk degeneration, stenosis (narrowing of joints b/c cartilage destruction)
Degeneration
Peripheral proliferation (degeneration and ossification of peripheral cartilage)
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8
Q

Reaction of MS Tissues to D and I: Synnocial Membrane

A

effusion
hypertrophy
adhesions

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9
Q

effusion

A

excessive fluid production inside joint space

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10
Q

hypertrophy

A

thickening

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11
Q

adhesions

A

between synovial lining and articular cartilage

  • immobilization
  • can be neural adhesion
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12
Q

edema

A

fluid outside joint space

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13
Q

Reactions of MS TIssues to D and I: joint capsule and Ligaments

A

joint laxity

joint contracture

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14
Q

joint laxity

A

excessively stretched and elongated (hypermobile)

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15
Q

joint contracture

A

tight and shortened (hypomobile)

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16
Q

Inflammation (def)

A

tissue response to irritation, damage, injury
-heat, redness, pain, swelling
local reaction of living tissues to an irritant

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17
Q

4 clinical signs of inflammation

A
  1. rubor (redness)
  2. tumor (swelling-effusion/edema)
  3. Calor (heat)
  4. Dolor (pain)
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18
Q

Soft Tissue injuries: contusion

A

ecchymosis

  • bleeding within a muscle or joint due to a direct blow. Creates increased fluid in the area, pain, limited function
  • within mm belly, chance of developing myositis ossificans
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19
Q

myocitis officans

A

ossification of muscle tissue, creating a calus

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20
Q

soft tissue injuries: ligamentous sprain

A

due to a tension overload of a ligament
-sprain: partial or complete tear
-avulsion: break off a fragment of bony attachment
local swelling (effusion), tenderness pain, when ligament on stretch
-protect ligament from stress during healing process (no strengthening exercises)

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21
Q

soft tissue injuries (muscle): muscle strain

A

chronic overstretching of muscle or tendon

-most common location is musculotendinous junction

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22
Q

charley horse

A

muscle damage due to increased tension applied to an already contracted muscle
-may lead to more severe problem (rupture, myocitis ossificans

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23
Q

soft tissue injuries: sprain degrees

A

1st degree- loss of a few fibers without loss of ligamentous integrity
2nd degree- greater disruption of fibers with some loss of joint stability (hypermobility)
3rd degree- complete loss of structural or biomechanical integrity (leads to instability)
stabalization can not be used with movement
-closed chain exercises
-if unstable-no strengthening

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24
Q

subluxation

A
  • disruption of a joint with partial loss of continuity between the articular surfaces
  • diastasis: separation of bones conencted by fibrous tissue (ankle, symphysis pubis)
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25
Q

dislocation

A

disruption of a joint with complete loss of continuity between the articular surfaces

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26
Q

subluxation/dislocation

A

either may have occurred momentarily and reduced spontaneously

  • if not reduced spontaneously, reduction to restore normal congruency of joint surfaces
  • -closed manipulation (reduced by orthapaedist/specialist)
  • -opedn reduction (surgery to restore joint)
27
Q

fractures: definition

A

any defect in the continuity of a bone
damage to surrounding tissues
-trauma not located to one tissue

28
Q

fractures: general classification

A
  • fracture by sudden impact
  • stress or fatigue fracture (over time, runners)
  • pathological fracture
  • fractures may also be classified as open (also called compound) or closed depending upon whether the skin is breached or not
29
Q

fractures: clinical manifestations

A
  • pain and tenderness
  • increased pain on weight bearing
  • edema
  • ecchymosis (discoloration)
  • loss of general function
  • loss of mobility
  • resulted in instability
30
Q

diagnosis

A

visual inspection-swelling, possible nerve and circulatory compromise, burning, permanent damage and loss of function may result

  • a fracture of long bones and pelvis may cause a fat embolism due to escape of marrow
  • confirmed by x-ray
  • stress fracture: conventional radiograph may not be adequate (radionucleotide bone scanning-scintigraphy)
31
Q

clinical signs of embolism

A

dyspnea (shortness of breath), chest pain, pallor, cyanosis (effected blood flow)

32
Q

phases of fracture healing

A
  1. hematoma formation
  2. cellular proliferation
  3. callus formation
  4. ossification
  5. consolidation and remodeling
    callus
    internal and external callus formation
33
Q

wolfes law

A

bone (or any tissue) will remodel according to stresses placed on it

34
Q

callus

A

fusiform mass around the fracture. ossification occurs initially at the periphery and gradually moves centrally. as the callus matures, it develops trabeculae and a cortex
-internal and external callus formation

35
Q

fracture healing

A

biomechanical healing: living tissue and forces placed on it

  • interdigitation of fracture fragments
  • soft callus
  • hard callus (ossification)
  • remodeling into compact and woven bone
36
Q

factors affecting fracture healing

A
  • age
  • site and configuration of fx
  • initial displacement (reduced)
  • blood supply to fracture (avascular necrosis?)
37
Q

fracture healing age

A

children: 4-6 weeks
adolescents: 6-8 weeks
adults: 8-10 weeks

38
Q

medical conditions/medications affecting healing of fx

A

diabetes mellitus

prednisone

39
Q

signs of failure of fixation of fx

A

presence of callus, loss of motion, pain

40
Q

management of fractures

A
  1. traction (cast around neck, elevates joint)
  2. external fixation (cast)
  3. electrical stimulation of fx healing
41
Q

management of fractures depends upon..

A
  • location of fracture
  • assessment of fracture type
  • need for reduction
  • presence of instability after reduction
  • functional requirements for individual
42
Q

fracture location

A
  • diaphysis (shaft)
  • metaphysis (portion of developing long bone between the diaphysis or shaft and the epiphysis)
  • epiphysis (end of long bone)
43
Q

types of fractures

A
  • open fracture (compound)
  • closed fracture
  • simple fracture
  • comminuted fracture (pieces of bone)
44
Q

comminuted fractures

A
  • 3 or more segments
  • butterfly or wedge shaped fracture
  • two or three segmented fracture
  • multiple segments (shattering)
  • mechanism of injury=generally compressive, butterfly is blunt trauma
45
Q

extra-articular fracture

A

-outside the joint

46
Q

intra-articular fracture

A
  • inside joint

- effects joint play

47
Q

joint play

A

passive involuntary movement of synovial joint

48
Q

types of fracture lines

A
  • transverse
  • oblique
  • spiral (s-shaped)
  • longitudinal (long axis)
49
Q

compression (impacted fracture)

A

muscle forces draw the distal fragment into the proximal fragment

50
Q

butterfly

A

loose fragment that does not involve the complete cortex

51
Q

avulsion

A

separation of a bone fragment from its cortex at an attachment of a ligament or tendon

52
Q

stellate fx

A

a fracture with numerous fissures radiating from the actual point of injury

53
Q

stress fx

A
  • also called march, fatigue, and spontaneous fractures
  • may be caused by overload by muscle contraction and/or altered stress distribution in bone accompanying muscle fatigue, and rhythmically repeated repetitive stress
  • bone scan show inflammned area, together with clinical eval will diagnose
54
Q

greenstick

A

bone ends are in continuity, not totally through bone

55
Q

management of fractures: closed treatment

A

casting
splinting or fracture bracing
-greater the instability, the greater the immobilization

56
Q

management of fractures: open treatment

A
  • plates, pins rods

- open reduction, internal fixation

57
Q

disadvantages of open treatment

A

-infection, invasive, deconditioning, rejection of hardware

58
Q

odontoid fracture (type of xray)

A
  • open mouth xray
  • shows c1-c2 attachment
  • helps detect cervical fracture
59
Q

plate fixation

A
  • adds fusion and stability
  • may be a result of osteoarthritis
  • lessen risk of spinal movement
  • stabilization exercises
60
Q

bony complications

A

malunion
delayed union
nounion

61
Q

malunion

A
  • poor healing

- failure of bone to unite

62
Q

delayed union

A

takes longer than it should

63
Q

nonunion

A

no healing

Clinical Medicine 1 (7 decks)

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