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Human Conditions I OTD7160 > Week 9 Terms: UE Orthopedics, Burns, and Wound Healing > Flashcards

Week 9 Terms: UE Orthopedics, Burns, and Wound Healing Flashcards

1
Q

Codman’s Pendulum Exercises

A

Therapeutic exercise for the shoulder joint in which the client bends forward at the waist with the arm perpendicular to the floor, then rocks the body side-to-side allowing the relaxed arm to freely move in a clockwise and counterclockwise direction

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2
Q

Controlled Range of Motion

A

active or passive movement within a predetermined safe arc. (middle of range gradually upgraded toward the full arc as healing occurs)

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3
Q

Scapular Plane

A

Midpoint between shoulder flexion and abduction; majority of functional activities occur in this plane

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4
Q

Shoulder Immobilizer

A

An orthopedic appliance that maintains the arm against the body in a slightly abducted and internally rotated position

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5
Q

Trendeleburg Gait

A

ambulation pattern that results from weakened gluteus medius; client lurches toward the injured side to place center of gravity over the hip; characterized by dropping of the pelvis on the unaffected side at heel strike of the affected foot.

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6
Q

Volkmann’s Ischemia

A

deformity of the hand, fingers, and wrist caused by injury to the muscles of the forearm

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7
Q

ORIF

A

Open Reduction Internal Fixation

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8
Q

Colle’s Fracture

A

complete fracture of the distal radius at the wrist with dorsal displacement

Cole waves at you

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9
Q

Smith’s Fracture

A

complete fracture of the distal radius with palmar displacement

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10
Q

Barton’s Fracture

A

Fracture of the lip of the distal radius

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11
Q

Impingement

A

compression of soft tissue between the ends of two or more bones

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12
Q

Subluxation

A

the partial displacement of a bone from its joint

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13
Q

Finkelstein’s Test

A

If positive, Indicates de Quervain’s tenosynovitis. Grasp the thumb against the palm and then move the wrist toward the midline in the ulnar deviation

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14
Q

Brachial Plexus

A

network of interlacing nerves found in the upper arm area

Originating from C5-T1
Forearm & Hand Nerves; Median, Ulnar, Radial

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15
Q

Shoulder Distocia

A

delayed or difficult birth of the fetal shoulders after the head is born

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16
Q

Waiter’s Tip

A
  • lateral rotators of the shoulder, arm flexors & hand extensor muscles
  • arm hanging by the side, rotated medially
  • forearm extended and pronated
  • wrist flexed

Erb’s Palsy

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17
Q

Claw Deformity

A

Position of MP hyperextension and PIP flexion associated with muscle imbalance in ulnar-innervated structures.

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18
Q

Wartenberg’s Sign

A

fifth finger held abducted from the fourth finger

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19
Q

Froment’s Sign

A

flexion of the IP of the thumb when a lateral pinch is attempted

Think Ok sign with fingers

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20
Q

Crutch Palsy

A

weakening of forearm, wrist, and hand muscles because of nerve impairment in the axilla caused by incorrectly fitted crutches or poor posture

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21
Q

Swan Neck Deformity

A

hyperextension of PIP joint and flexion of DIP joint

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22
Q

Boutonniere Deformity

A

flexion of PIP joint and hyperextension of DIP joint

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23
Q

Dupytren’s Contracture

A

A gradual thickening and tightening of the fibrous tissue layer (palmar fascia) under the skin in the hand
Restricts tendons from gliding through the sheath

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24
Q

Thermal Burns

A

caused by contact with open flames, hot liquids or surfaces, or other sources of high heat

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25
Q

Chemical Burns

A

Damage caused to the skin by chemicals

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26
Q

Radiation Burns

A

redness and blistering on the surface of the skin or other organs caused by intense exposure to ionizing radiation

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27
Q

Electricity Burns

A

Burns caused by alternating

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28
Q

Light Burns

A

burns caused by infrared rays, eclipse light, and laser burns

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29
Q

Frictrion Burn

A

resulting from harsh rubbing of the skin

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30
Q

Superficial Burn

A

a burn that involves only the epidermis, the outer layer of the skin; also called a first-degree burn.

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31
Q

Superficial Partial Thickness Burn

A

Involves the epidermis and the upper portion of the dermis

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32
Q

Deep Partial Thickness Burn

A

extends into the skin dermis; 2nd degree

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33
Q

Full Thickness Burn

A

a burn in which all the layers of the skin are damaged; also called a third (or fourth) degree burn.

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34
Q

Hypermetabolism

A

A higher-than-normal metabolic rate

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35
Q

Escharotomy

A

Escar is removed and skin grafts or artificial skins are placed

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36
Q

Fasciotomy

A

A surgical incision through the fascia to relieve tension or pressure

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37
Q

Pruitus

A

Severe itching

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38
Q

Microstomia

A

Abnormally small mouth

39
Q

Tendinopathy

A

Tendons are not well vascularized = easily damaged

40
Q

Biomechanical Deficits of Tendinopathy

Symptoms

A

Muscle Weakness
Decreased ROM
Scar Tissue
Pain w/ AROM, Resistance, Passive Stretch

41
Q

Tendonitis

A

Inflammation
Microtears in tendon
Sudden or Heavy Force

Less common than tendinosis; Often wrongly identified

42
Q

About how long does it take to heal tendonitis?
A. 4 weeks
B. 5 weeks
C. 6 weeks
D. 7 weeks

A

C. 6 weeks

43
Q

Tendinosis

A

NO inflammatory response
Degenerative Changes
Overuse
Collagen needs nourished
Pain can be severe
Significant impact on function

44
Q

About how long does it take to heal tendinosis?
A. 10 weeks to 10 months
B. 8 weeks to 8 months
C. 6 weeks to 6 months
D. 4 weeks to 4 months?

A

C. 6 weeks to 6 months

45
Q

Lateral Epicondylitis

Tennis Elbow

A

involves the extrinsic extensors of the hand at their origin

Extensor Carp Radialis Brevis is most commonly involved

46
Q

There is pain in wrist BLANK with lateral epicondylitis (tennis elbow).

A

There is pain in wrist extension with
lateral epicondylitis (tennis elbow).

47
Q

Medial Epicondylitis

Golfer’s Elbow

A

involves the extrinsic flexors at their orgin on the volaar aspect of the medial elbow

Flexor Carpi Radialis most commonly involved

48
Q

There is pain in wrist BLANK & BLANK with medial epicondylitis (golfer’s elbow).

A

There is pain in wrist Flexion & Supination with medial epicondylitis (golfer’s elbow).

49
Q

Treatment for Lateral and Medial Epicondylitis

A

Rest
Ice
Therapy
NSAIDs
Ergonomics
Cortisone Injection
Occasionally Surgery

50
Q

Symptoms of DeQuervain’s Tenosynovitis

A

Pain and swelling along radial side of wrist with gross grasping

51
Q

Causes of Erb’s Palsy

Common Brachial Plexus Injury

A

Excessive stretching/tear upper trunk of BP
Shoulder dystocia during childbirth
Waiter’s Tip deformity
* lateral rotators of the shoulder, arm flexors & hand extensor muscles
* arm hanging by the side, rotated medially
* forearm extended and pronated
* wrist flexed
Loss of sensation in the lateral aspect of the forearm

52
Q

Symptoms of Thoracic Outlet Syndrome

A

Shoulder & neck pain
Neck muscle spasms
Numbness in fingers
Weak grip

53
Q

Causes of Thoracic Outlet Syndrome

A

Trauma
Poor posture
Repetitive injuries esp. above shoulder activity
Anatomical defects (extra rib)

54
Q

Cubital Tunnel Syndrome

A

Second most common UE nerve entrapment
Ulnar Nerve Compression

55
Q

Symptoms of Cubital Tunnel Syndrome

A

Forearm pain
Tingling/pins and needles
Decreased sensation small & ring fingers
Grip & pinch strength decreased

56
Q

Common Presentations of Cubital Tunnel Syndrome

A

Claw Hand
Wartenberg Sign
Froment’s Sign

57
Q

Radial Nerve Palsy can be caused by…

A

Compression
Ischemia (loss of blood flow)
Fractures
Wounds

58
Q

Lesion above the elbow results in…
A. Complete Wrist Drop
B. Sensory Loss
C. Infraspinatus Impingement
D. Both A and B
E. Both B and C

A

D. Both A and B
Lesion above the elbow results in complete wrist drop & sensory loss

59
Q

Posterior Interosseous Nerve Syndrome (PINS)

A

Entrapment at supinator muscle
Below Elbow

Purely Motor

60
Q

Posterior Interosseous Nerve Syndrome (PINS) is caused by…

A

Tumors
RA
Fractures
Dislocations

61
Q

Treatment of PINS

A

Maintaining PROM
Splinting to prevent deformity & promote function
Surgical decompression, if necessary

62
Q

True/False
The median nerve provides sensation to radial palm.

A

True

63
Q

True/False
The carpal tunnel does not protect the median nerve.

A

False
The carpal tunnel does protect the median nerve.

64
Q

Carpal Tunnel Syndrome

A

Compression of the median nerve under the flexor retinaculum

Caused by swollen or thickened tendons

65
Q

Symptoms of Carpal Tunnel Syndrome

A

Pain
Numbness
Tingling in median nerve distribution
Weak thumb flexion and abduction

66
Q

Treatments for Carpal Tunnel Syndrome

A

Night Splinting
Steroid Injection
Therapy
Surgery if needed

67
Q

Risk factors for Carpal Tunnel Syndrome

Not Necessarily Causes

A

Genetics
more common in people with small wrists
Females > males
Diabetes, rheumatoid arthritis, thyroid disorders
Obesity
Fluid retention as in pregnancy
(usually goes away after baby born)
Working with tools that vibrate
Frequent or prolonged wrist flexion

68
Q

Extensor Hood

A

Where finger extensors connect
(Extensor digitorum, lumbricals, interossei)
Extensor digitorum can only extend MP joint by itself
Intrinsics extend the PIPs and DIPs but cannot extend MP joint
Both are needed for full extension of the finger

69
Q

Symptoms of a Scaphoid Fracture

A

Tender on palpation at anatomical snuff box
Pain may increase with pinch/grip

FOOSH

70
Q

Symptoms of a Scaphoid Fracture

A

Tender on palpation at anatomical snuff box
Pain may increase with pinch/grip

Potential Radial Nerve Compression

71
Q

Treatment of Scaphoid Fracture

A

Extended immobilization
Surgery
Therapy to restone decreased ROM and oss of ADL function of the hand

72
Q

Complex Regional Pain Syndrom (CRPS)

Also known as Reflex Sympathetic Dystrophy

A

Pain is disproportionate to injury
There are three different types

Any upper extremity injury has the potential to result in CRPS

73
Q

Complex Regional Pain Syndrome (CRPS)
Symptoms

STAMP

A

Sensory; allodynia, hypo-/hyperalgesia, hypo-/hyperesthesia
Trophic; skin, hair, nail changes
Autonomic; swelling, edema, sweating
Motor; weakness, contractures, atrophy
Pain

74
Q

Causes of Compartment Syndrome

A

Bone fracture/crush injury
Serious bruising
Constricting bandages/cast
Return of blood flow following blockage

75
Q

Treatment of Compartment Syndrome

A

Anti-Inflammatory
Movement
Surgery

76
Q

What happens with compartment syndrome?

A

Swelling and bleeding can occur in a compartment and can cause increased pressure on nerves and blood vessels

77
Q

Types of Burns

Causes

A

Thermal
Chemical
Radiation
Electricity
Light
Friction

78
Q

Classification of Burns

Severity

A

Level of cellular injury:
Superficial
Superficial Partial-Thickness
Deep Partial-Thickness
Full-Thickness

79
Q

Superficial Burn

Burn Classification

A

Only the epidermis affected
Heal in 7 days
No scar

80
Q

Superficical Partial

Burn Classification

A

Epidermis and paprt of the dermis affected
Blister Formation
Heal in 7-12 days

81
Q

Deep Partial-Thickness

Burn Classification

A

Epidermis & into dermis affected
White blotches – damaged blood vessels
Often grafted to promote healing
Light touch impaired

82
Q

Full-Thickness

Burn Classification

A

Destruction of all skin layers
Waxy/white - adipose tissue visible
No sensation – nerve damage
Must be grafted

83
Q

Assessment of Burn Area

Rule of Nines

A

Major burn is defined as a burn covering 25% or more of total body surface area

84
Q

Why would it be important to know total body surface area that is burned?

A

Calculating nutritional & fluid requirements
Determining level of acuity
Establishing level of medical treatment needed
Classifying patients for use of standardized protocols

85
Q

What are the secondary effects of burn injury?

Local and Systemic

A

Dehydration and edema
Respiratory problems
Increased metabolic needs (while body is trying to heal)
Shock
Pain
Infection

86
Q

What is a major factor in recovery for burns?
A. Edema
B. Pain
C. Shock
D. Infection

A

B. Pain

87
Q

What are some some interventions that can exacerbate pain in someone with a burn injury?

A

Dressing changes
Debridement
ROM

88
Q

What does an infected burn look like?

A

Purulent Exudate (pus)
Blue-Green Color

It will be cultured to determine which microbe

89
Q

Emergent Phase

Burns

A
  • Immediate: Emergency treatment - 72 hours
    clean & cover to prevent infection
    inhalation injury
    edema develops inside airways
    may require intubation
  • Medically induced coma
    facilitate healing
    spare pain
  • Surgeries
90
Q

Escharotomy

A

scar is removed & skin grafts or artificial skins placed
graft site – now like a burn since skin has been removed
sometimes happens a couple times

Surgery for severe or extensive burns

91
Q

Fasciotomy

A

cutting facia to reduce constriction caused by edema

Surgery for severe or extensive burns

92
Q

Skin Grafts

Burns

A
  • Skin is taken from person’s own body
  • Cadaver or pig skin may be used temporarily
  • Person’s own skin cultured in lab for later use
  • Grafted skin may be meshed to stretched over larger area
  • Biosynthetic “skin” products developing
    faster healing, fewer surgeries, less scarring, less infection
93
Q

Rehabilitation Phase

Burns

A
  • Wound closure through scar maturation
  • May be 6 months to 2 years
  • Medical treatment
    pressure garments
    reconstructive surgeries
  • Therapy
    Scar management (measure & fit pressure garments)
    Contracture prevention
    Patient and family education
94
Q

Potential Complications

Burns

A
  • Pruritus (itching)
  • Microstomia (shrinkage of mouth opening)
  • Heterotopic ossification (bone formation where bone doesn’t belong)
  • Heat intolerance
    *Unable to sweat with split-thickness skin grafts
    May sweat a lot in unaffected areas
    Vulnerable to overheating. *

Human Conditions I OTD7160 (14 decks)

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