WEEK 6 - Musculoskeletal Injury Flashcards
What are the functions of the musculoskeletal system?
Primary: support & movement. Secondary: Protection Storage (Ca2+) Formation of blood cells (hematopoiesis) Heat production Venous return
What is vargus vs valgus?
Vargus = r = round (bowleggednedd) Valgus = knock knees
What are the key elements of assessment?
Presenting problem (S&S, function & limitations) Past Hx (injuries, surgical procedures, illnesses, meds)
What are the key elements of examination?
Inspection Palpation Strength testing ROM Special tests
What is a closed fracture?
No communication between the external environment and the fracture site
What is an open fracture?
Communication between the fracture site and external environment
Considered a surgical emergency due to high risk of infection *breach in skin integrity
What is a pathologic fracture?
Occurs through an area of bone that has been weakened by disease
Can occur spontaneously with little or no stress with minor trauma.
Eg, bone cysts, cancerous lesions, osteoporosis, Paget’s disease
What is a stress fracture?
Results from repeated stress/forces
Common in unconditioned athletes
What is the pathophysiology behind bone healing?
- Disruption to periosteum & blood vessels in the cortex, marrow and surrounding soft tissues.
- Bleeding -> clot formation (haematoma) within medullary cavity. Blood loss can be significant.
- Disruption to BF - necrosis of the bone tissue surrounding fracture.
- Inflammatory response (vasodilation, extrusion, infiltration by leukocytes and mast cells. Blood flow to bone increases i.e. histamine release. Numerous cytokines released to promote healing. Within 48 hrs vascularisation of # areas - angiogenesis).
- Activation of fibroblasts and osteoblasts.
- Sub-periosteal procallus (fracture fragments reunited, gap bridged).
- Callus formation - collagen & matrix mineralised.
- Callus ossification within 2-3 weeks; remodelling
- Healing = 4-6 weeks in children, 6-8 weeks in adolescents, 10-18 weeks in adults. Function returns within 6mo.
- Bone is unique -> new bone without scar tissue.
What is a dislocation?
A complete separation or displacement of the surfaces of a joint.
Simple (no fracture) or complex (assoc fracture).
What is a sublaxation?
A partial shift of the surfaces of a joint and some contact remains.
How do dislocations and sublaxations present?
Pain & joint swelling due to accumulation of inflammatory exudate into joint/tendon/ligament.
Joint deformity (muscle contractions)
Limitation of movements (effusion, bone displacement)
Investigations & treatment.
Presentation & X-ray
How do you manage dislocations and sublaxations?
Immobilise (2-6 weeks) and exercise
Surgery for recurrent dislocations
What is a strain?
Tearing of tendon fibres
Occurs due to trauma or when the muscle is overstretched eg. lifting excessive weight (biceps)
Usually no external evidence; pain, stiffness, swelling
What is a sprain?
Tearing of ligament fibres.
Can occur at any joint.
Usually occurs when a joint is forced beyond its range of motion.