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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
dislocation
disruption of a joint with complete loss of continuity between the articular surfaces
26
subluxation/dislocation
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
fractures: definition
any defect in the continuity of a bone damage to surrounding tissues -trauma not located to one tissue
28
fractures: general classification
- 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
fractures: clinical manifestations
- pain and tenderness - increased pain on weight bearing - edema - ecchymosis (discoloration) - loss of general function - loss of mobility - resulted in instability
30
diagnosis
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
clinical signs of embolism
dyspnea (shortness of breath), chest pain, pallor, cyanosis (effected blood flow)
32
phases of fracture healing
1. hematoma formation 2. cellular proliferation 3. callus formation 4. ossification 5. consolidation and remodeling callus internal and external callus formation
33
wolfes law
bone (or any tissue) will remodel according to stresses placed on it
34
callus
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
fracture healing
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
factors affecting fracture healing
- age - site and configuration of fx - initial displacement (reduced) - blood supply to fracture (avascular necrosis?)
37
fracture healing age
children: 4-6 weeks adolescents: 6-8 weeks adults: 8-10 weeks
38
medical conditions/medications affecting healing of fx
diabetes mellitus | prednisone
39
signs of failure of fixation of fx
presence of callus, loss of motion, pain
40
management of fractures
1. traction (cast around neck, elevates joint) 2. external fixation (cast) 3. electrical stimulation of fx healing
41
management of fractures depends upon..
- location of fracture - assessment of fracture type - need for reduction - presence of instability after reduction - functional requirements for individual
42
fracture location
- diaphysis (shaft) - metaphysis (portion of developing long bone between the diaphysis or shaft and the epiphysis) - epiphysis (end of long bone)
43
types of fractures
- open fracture (compound) - closed fracture - simple fracture - comminuted fracture (pieces of bone)
44
comminuted fractures
- 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
extra-articular fracture
-outside the joint
46
intra-articular fracture
- inside joint | - effects joint play
47
joint play
passive involuntary movement of synovial joint
48
types of fracture lines
- transverse - oblique - spiral (s-shaped) - longitudinal (long axis)
49
compression (impacted fracture)
muscle forces draw the distal fragment into the proximal fragment
50
butterfly
loose fragment that does not involve the complete cortex
51
avulsion
separation of a bone fragment from its cortex at an attachment of a ligament or tendon
52
stellate fx
a fracture with numerous fissures radiating from the actual point of injury
53
stress fx
- 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
greenstick
bone ends are in continuity, not totally through bone
55
management of fractures: closed treatment
casting splinting or fracture bracing -greater the instability, the greater the immobilization
56
management of fractures: open treatment
- plates, pins rods | - open reduction, internal fixation
57
disadvantages of open treatment
-infection, invasive, deconditioning, rejection of hardware
58
odontoid fracture (type of xray)
- open mouth xray - shows c1-c2 attachment - helps detect cervical fracture
59
plate fixation
- adds fusion and stability - may be a result of osteoarthritis - lessen risk of spinal movement - stabilization exercises
60
bony complications
malunion delayed union nounion
61
malunion
- poor healing | - failure of bone to unite
62
delayed union
takes longer than it should
63
nonunion
no healing

Clinical Medicine 1 (7 decks)

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