Unit VII part 2 Flashcards
Neurovascular checks
Pain Pallor Pulse Parastasis Paralysis
Kyphosis
Round back, forward bending of spine
Hunchback
Scoliosis
Lateral curvature of the spine
Genu valgum (valgus)
Outward turning of foot
Knock knee
Genu varum (varus)
Outward turning of foot
Knock knee
Effusion
Escape of fluid into a body part
Atrophy
Muscle wasting
Ankylosis
Scarring of joint
Contracture
Resistance to movement of a muscle or joint
Measurement of the degree of heat radiating from the skin surface
Thermography
What’s the #1 priority post procedure
Check neurovascular status on that extremity
What is the most common dx to assess muscular skeletal system
X ray
Views of specific planes & tissue depth
Tomogram
CT
Used to visualize spinal column & subarachnoid space
Myelography
Joint aspiration
Arthrocentesis
X ray of cervical or lumbar discs
Discography
IV injection of radioisotope that is taken up by the bones
Bone scan
Measures the electrical activity of muscles via needle electrodes
Electromyography
Measures the time it takes for a muscle to respond after the nerve to that muscle has been electrically stimulated
Nerve conduction velocity
Recipe
Rest Elevate Compression Ice Proper exercise NSAIDS
Displacement of part , usually above, from it’s normal anatomical position within a joint
Dislocation
Partial or incomplete displacement of the joint surface
Subluxation
Most frequent dislocation joints
Fingers Elbow Shoulder Hip Knee
Signs and symptoms of joint and soft tissue injuries
Pain Decrease ROM Tender Edema Ecchymosis
Transitory muscle contractions by spontaneous stimulation of a single muscle fiber
Fibrillations
Severe burning pain from PN injuries
Causalgia
What nerve is damaged by incorrect usage of crutches
Brachial plexus
Muscle excitation
Muscle spasm
Bruise without break in skin
Contusion
Collection of blood
Hematoma
Inflammation of a tendon sheath & synovial sac
Tendosynovitis
Pain over lateral epicondal of humerous radiating to outer side of arm & forearm
Tennis elbow
Entrapment syndrome
Carpal tunnel syndrome
Occurs when s/s reappear by tapping the median nerve at the wrist
+ tinels sign
Flex the wrist for one minute
+ phalens sign
Cystic structure adjacent to a joint or tendon
Ganglion
Contracture of Palmer fascia causing ring finger and pinky to bend into the palm
Dupuytrens contracture
Injury to the intra articular cartilage padding that attaches on sides & top of tibia
Meniscus injury
Injury to ligament between tibia & femur
Anterior cruciate ligament
Cyst containing synovial fluid communicating with synovial fluid of a joint
Popliteal cyst
Sudden knife like pain, bulge in calf
Achilles tendon rupture
Deformity of the 2nd toe
Hammer toe
Deformity of great toe
Bunion
Hallucinating valgus
Bunion
Localized thickening of skin
Corn
Same as corn but larger
Callus
Function of skeletal system
Support Protection Movement Mineral storage Hematopoiesis
Mature cells
Maintain structure
Osteocytes
Bone forming cells
Osteoblasts
Cells that reabsorb bone
Osteoclasts
The process by which intra cellular material is formed & hardening minerals are deposited into the bone
Ossification
Space in diaphysis
Medullary or marrow cavity
Where diaphysis joins epiphysis
Metaphysis
Dense white fibrous covering around bone
Except at joint surfaces
Periosteum
Thin layer of hotline cartilage covering the epiphysis where bone forms a joint with another bone
Articular cartilage
Junction between two or more bones
Joints
Synarthroses
No movement
Amphiarthroses
Slightly movable joint
Freely moveable joint
Diarthroses
Concave surface fits into a convex surface
Hinge
One surface rotates around a peg or pivot
Pivot joint
Joint that permits full freedom of movement
Ball & socket
Hip/shoulder
Joint where both articular surfaces are flat
Gliding
Ex. Between carpal/tarsal bones
An oval condyle fits into an elliptical cavity
Condyloid/ellipsoidal
Concave end fits onto a convex surface of another bone
Saddle joint
Ex. Metacarpal joint in thumb
Moving a part forward
Protraction
Moving a part backward
Retraction
Toes toward head
Dorsiflexion
Point toes say from body
Plantarflexion
What is the function of cartilage
Support soft tissue
Provide articulating surfaces for joint movement
Nourished by diffusion from capillaries
Avascular
Types of cartilage
Hyaline
Elastic
Fibrocartilage
Most common type of cartilage
Hyaline
Made of moderate amt of collagen fibers
Ex. Bhronchi, nose
Hyaline
Contains collagen & elastic fibers
Ex. Larynx
Elastic
Contains collagen & elastic fibers
Ex. Larynx
Elastic
Mostly collagen
Tough tissue
Functions as shock absorber
Fibrocartilage
Type of muscle found in heart
Involuntary
Cardiac
Muscle found in the walls of hollow structures (bladder, blood vessels) involuntary
Smooth
Muscle that is voluntary attached to bones
Skeletal muscles
Contractile unit of the myofibril
Sacromere
Arrangement of thick & thin filaments in the sarcomere
Banding
Cell membrane
Sarcolemma
Cytoplasm with in these cells
Sarcoplasm
Junction between the nerve cell & muscle cell it supplies
Neuromuscular junction
Point of attachment on the bone closest to trunk
Origin
Point of attachment farthest from trunk
Insertion
Contract to produce movement
Prime movers
What relaxes the muscle
Antagonist
Contract to stabilize the area involved
Synergist
What is needed for muscle contractions
ATP
Muscle cells require what to generate power
Oxygen
Glucose
Does not produce movements, holds muscle in position
Tonic
What produces movement, muscle shortens
Isotonic
Increase tension in muscle but doesn’t produce movement
Isometric
A quick jerky reaction to a single stimulus
Twitch
Sustained twitch, series of stimuli in rapid succession
Tetany
Asynchronous contraction of individual fibers
Fibrillation
Abnormal uncoordinated tetnic contractions in varying muscle groups
Convulsions
Attach muscle to bone
Tendon
Connect bone to bone
Ligaments
Layers of connective tissue, separates one muscle from another
Fascia
Small sacs of connective tissue located wherever pressure is exerted over moving parts
Bursae
Disruption or break in the continuity or structure of the nine
Fracture
Complete separation of the bone into 2 fragments
Closed fracture
Break in the skin
Bone may or may not stick out
Open
Compound
Line of fx extends across the bone
Complete Transverse fx
Line of fx extends in a spiral direction
Twisting of bone
Spiral
Fx in 3 or more fragments
Comminuted
A bone fragment is forced into another fragment
Impacted
Spontaneous fx usually caused by a disease process or neoplasm
Pathologic fx
Fx seen in children in which only partial thickness of bone is broken
Incomplete or greenstick
Hairline fx
Difficult to dx in x ray
Stress fx
Fx of bone resulting from a strong pulling effect of tendons or ligaments at the bone attachment
Avulsion fx
s/s fx
Pain Edema Muscle spasm Deformity Crepitus Loss of sensation Excessive motion
Bone healing stages
Hematoma formation Cellular proliferation Callus formation Ossification Consolidation Remodeling
Excess cells reabsorbed & union complete
Remodeling
Decrease distance between bone fragments until closed
Consolidation
Formation of new bone 3-10 weeks
Ossification
Osteoclasts destroy old bones and new bone formed by osteoblasts
Occurs 6-10 days after injury
Callus formation
Fibrin mesh work formation phagocytosis of necrotic tissue
Cellular proliferation
Hematoma surrounds ends of fragments
Hematoma formation
Factors that enhance bone healing
Immobilization of fx Maximum bone fragment contact Sufficient blood supply Proper nutrition Exercise Electric potential across fx
Factors that inhibit bone healing
Edema
Bone loss
Inadequate immobilizer
Space between bone fragments
Overall goals of fx treatment
Anatomical realignment of bone fragments (reduction)
Non surgical
Manual realignment
Closed reduction
Correction of bone alignment through a surgical incision
Open reduction
Short term traction
Skin traction
Long term traction
Skeletal traction
What fractures heal quickly
Flat bone fractures
Pelvis, scapula
Immobilization & support of spinal injuries of thoracic or lumbar spine or after spinal surgery
Body jacket casts
Weights used to suspend the part correctly & continuously
Balanced suspension
Planning overall goals
Physiological healing with no associated complications
Pain relief
Achieve maximal rehabilitation potential
Stiff claw-like deformity of the arm & hand
Caused by super condylar fx of humerous
Volkmann contracture
what is essential to prevent permanent deficits
early detection
lactic acid released by necrotic tissue
metablic acidosis
damaged muscles cells release K+, possible heart damage
hyperkalemia
excessive myoglobin in circulation, clogs the renal tubules
renal failure
ruslut of prolonged continuous pressure on large muscles
crush syndrome
myoglobin released from skeletal muscle into blood stream
rhabdomylosis
characterized by the presence of fat globules in tissue & organs after a traumatic skeletal injury
fat embolism syndrome
what are some predisposing factors for fat embolism syndrome
fractures, burns, DI, alcoholism, shock, sepsis
what tissues are most often effected from fat embolism syndrome
lungs
what is the first sign of fat embolism syndrome
mental status change
12-72 hours after injury
tiny, flat red spots located on neck, chest, axillia
petechia
late sign of Fat embolism syndrome
most common complication following trauma of the lower extremity in adults
venous thrombosis
what is the most common fatal complication of orthopedic surgery
venous thrombosis
when does venous thrombosis occur
24-48 hours after the injury, but not apparent for 7-10 days
what is the average adult blood volume
4-5 liters
what is the 1st sign of shock
mental status change
open fractures & soft tissue injuries have an increase incidence of ?
infection
if there is an open wound what shot needs to be given
tetnus
bone loses its blood supplu and dies
avascular necrosis
what are pts high risk for due to bone destruction
kidney stones
fracture healing progressing more slowly than expected, haling eventually occurs
delayed union
what helps with production/stimulation of osteoblasts
electrical bone stimulation
complete failure of healing to take place
nonunion
transplanting pieces of bone to new location
bone grafting
what is the most important thing in mursing manangement of facial fractures
maintain a patent airway
what is the most common fx seen in the hospital
hip
occurs with in the hip joint and capsule
intracapsular fracture
inter trochnteric fx
extracapsular fracture
fracture to the distal radius
colles fracture
what is the minimum urine output after surgery
30 ml/hr
how is a fracture usually caused by
trauma
Measure joint motion
Goniometer
