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3254/64 > Musculoskeletal Trauma > Flashcards

Musculoskeletal Trauma Flashcards

1
Q

What patients are at highest risk for DVT?

A

Patients with hip fracture or post-hip surgery

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2
Q

Three stages of fractures

A

Inflammation, hematoma, growth of granulation tissues around site

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3
Q

A break or disruption in the continuity of the bone that affects comfort and mobility

A

Fractures

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4
Q

Diagnostic procedure needed to identify soft tissue damage

A

MRI

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5
Q

Fracture causes

A

Fragility (osteoporosis, bone cancer), stress (athletes), compression (older adults)

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6
Q

Fracture in which bone is broken perpendicular to its length

A

Transverse

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7
Q

Fracture that follows a spiral or “corkscrew” pattern

A

Spiral

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8
Q

Fracture occurring along the length of the bone

A

Longitudinal

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9
Q

Fracture in which the bone shatters into three or more pieces

A

Comminuted

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10
Q

Fracture that cuts diagonally across the width of the bone

A

Oblique

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11
Q

Fracture in which the ends of the broken bone are impacted together

A

Impacted or Buckle fracture

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12
Q

Impacted/Buckle fractures are common in

A

Children’s arm

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13
Q

Fracture often seen in children in which the bone is broken, but not all the way through

A

Green stick

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14
Q

Fracture characterized by tiny cracks in a bone, caused by repetitive use

A

Stress

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15
Q

What kind of bones are commonly affected by stress fractures?

A

Weight-bearing bones such as the legs/feet

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16
Q

Fracture caused by blow to the flexed knee and simultaneous forceful pull of the quadriceps muscle

A

Avulsion

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17
Q

T or F: Avulsion fractures are common in pediatric athletes and often heal without surgical intervention

A

True

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18
Q

Complete fractures occur commonly in

A

Long bones of arms/legs

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19
Q

Causes of complete fractures

A

Severe trauma such as MVAs or falls from tall heights

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20
Q

S/S of complete fractures

A

Pain, limited movement of fractured bone, surrounding tissue/organ damage, internal bleeding

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21
Q

Pulmonary complication of complete fractures

A

Pneumothorax

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22
Q

Surgical treatment for complete fractures

A

Open Reduction Internal Fixation (ORIF)

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23
Q

Treatment of intracapsular and extracapsular hip fractures

A

ORIF

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24
Q

Primary risk factor for hip fracture

A

Osteoporosis

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25
Q

Locations of intracapsular hip fractures

A

Femoral neck and intertrochanteric

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26
Q

Intracapsular hip fracture located at the junction of femoral neck and femoral head

A

Femoral neck

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27
Q

Intracapsular hip fracture located between greater and lesser trochanters

A

Intertrochanteric

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28
Q

Locations of extracapsular hip fractures

A

Subtrochanteric and Trochanteric

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29
Q

Extracapsular hip fracture located just below the lesser trochanter, extending down the femur

A

Subtrochanteric

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30
Q

Extracapsular hip fracture involving greater or lesser trochanter

A

Trochanteric

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31
Q

Fracture that occurs in children

A

Salter-Harris

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32
Q

Complications of untreated Salter-Harris fractures

A

Growth restriction, pain, immobility

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33
Q

Salter-Harris fracture through the growth plate without involving the bone

A

Type I

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34
Q

Characteristics of Salter-Harris type I

A

Least effect on bone growth, good prognosis for healing

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35
Q

Salter-Harris fracture through the growth plate and into a portion of the bone

A

Type II

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36
Q

Characteristics of Salter-Harris type II

A

Most common, good prognosis with careful monitoring

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37
Q

Salter-Harris fracture through the growth plate and into portion of the joint surface

A

Type III

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38
Q

Characteristics of Salter-Harris type III

A

Requires careful evaluation due to risk of joint surface involvement

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39
Q

Salter-Harris fracture through the growth plate, the bone, and a portion of the joint surface

A

Type IV

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40
Q

Characteristics of Salter-Harris type IV

A

Common in children with post-traumatic arthritis, complex, extensive treatment

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41
Q

Salter-Harris fracture involving compression injury to the growth plate without a clear fracture line

A

Type V

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42
Q

Characteristics of Salter-Harris type V

A

Rare, hard to diagnose, most effect on bone growth

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43
Q

Three phases of bone healing

A

Inflammatory, reparative, remodeling

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44
Q

Duration of inflammatory phase of bone healing

A

1-5 days post injury

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45
Q

Duration of reparative phase of bone healing

A

Several weeks

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46
Q

Duration of remodeling phase of bone healing

A

Months to years

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47
Q

Bone healing phase that involves blood clot formation, inflammation, and immune cell activity

A

Inflammatory phase

48
Q

Phase of bone healing characterized by soft and hard callus formation

A

Reparative phase

49
Q

Soft callus is made of __________

A

Collagen

50
Q

What structures are responsible for the formation of soft callus in the reparative phase of bone healing?

A

Fibroblasts and chondroblasts

51
Q

Bone cells that replace soft callus with harder woven bone to strengthen the fracture site during the reparative phase of bone healing

A

Osteoblasts

52
Q

Phase of bone healing involving modification of newly formed bone, continuing until the bone regains strength

A

Remodeling phase

53
Q

Key players in remodeling phase of bone healing

A

Osteoblasts and osteoclasts

54
Q

Function of osteoblasts in the remodeling phase of bone healing

A

Deposit compact bone in an organized manner

55
Q

Function of osteoclasts in the remodeling phase of bone healing

A

Removal of excess bone

56
Q

Stage of bone healing in which hematoma forms at injury site

A

Stage 1

57
Q

Stage of bone healing involving granulation formation at the hematoma and formation of fibrocartilage

A

Stage 2

58
Q

Stage of bone healing involving callus formation

A

Stage 3

59
Q

Stage of bone healing where callus is resorbed and transformed into bone

A

Stage 4

60
Q

Stage of bone healing involving remodeling

A

Stage 5

61
Q

Nutrition for fractures

A

High protein (roast beef), vitamin C, vitamin B, high “good” calories (low-fat milk)

62
Q

Most common sites for compartment syndrome

A

Tibial and forearm fractures

63
Q

Compartment syndrome treatment

A

Fasciotomy

64
Q

Bleeding into the body cavities or spaces, compressing vital organs

A

Tamponade

65
Q

Compression of muscles and tissues, often leading to complications

A

Crush injury

66
Q

Breakdown of muscle tissue, releasing myoglobin into the bloodstream

A

Rhabdomyolysis

67
Q

Elevated labs in a patient with rhabdomyolysis

A

BUN and creatinine

68
Q

Fat embolism risk factors

A

Hip surgery, patients 20-40, elderly

69
Q

Fat embolism supportive therapy

A

IV fluids, O2, bed rest

70
Q

Increased pressure within a muscle compartment, leading to reduced blood flow and potential nerve damage

A

Compartment Syndrome

71
Q

Prolonged healing time where the fractured bone takes longer than usual to reunite

A

Delayed union

72
Q

Failure of the bone ends to grow together, resulting in a persistent gap between them

A

Non-union

73
Q

Healing of the bone in a misaligned position, leading to deformity or functional impairment

A

Malunion

74
Q

Blood clot formation in deep veins, often due to immobilization and reduced blood flow

A

DVT

75
Q

DVT prevention

A

Compression stocks (SCDs), early mobilization, anticoagulants

76
Q

Migration of a blood clot to the lungs, potentially causing a life-threatening condition

A

PE

77
Q

Treatment of DVT

A

Anticoagulants and bed rest

78
Q

Treatment of PE

A

Pain management (IV morphine), O2, bed rest

79
Q

Diagnostic exam that visualizes and assesses extent and location of fracture

A

X-Ray

80
Q

Diagnostic exam that provides detailed imaging of complex fractures

A

CT scans

81
Q

Diagnostic exam that provides detailed images of soft tissues, ligaments, ad blood vessels

A

MRI

82
Q

Diagnostic exam that identifies areas of increased bone activity

A

Bone scans

83
Q

CT scans are useful for complex structures such as the

A

Hip and pelvis

84
Q

Bone reduction involving manipulation of the bone to pop back into place

A

Closed bone reduction

85
Q

Bone reduction involving surgical opening to fix the bone

A

Open bone reduction

86
Q

Purpose of traction

A

Decrease muscle spasms

87
Q

Why is ORIF the preferred method for surgical management of fractures?

A

Allows for early mobility

88
Q

Preferred method of surgical management for extracapsular hip fractures

A

ORIF with plates and screws

89
Q

Removal of a part of the body

A

Amputation

90
Q

Primary cause of amputation of upper extremities

A

Trauma

91
Q

Complications of amputation

A

Hemorrhage, infection, phantom limb pain*, neuroma, flexion contracture

92
Q

Amputation nursing care

A

Place stump cap before prosthetic, elevate stump to relieve swelling, monitor for infection, assess site every shift, ROM to prevent contractures

93
Q

signs of internal organ hemorrhage

A

Rigid abdomen, tachycardia, hypotension

94
Q

Pelvic fracture assessment finding

A

Hematuria (urine will be pink)

95
Q

Position for physical exam for patients with fracture(s)

A

Supine; unless patient has shoulder or upper arm fracture, then seated is best

96
Q

Compartment syndrome risk factor

A

Patients wearing casts

97
Q

6 P’s of compartment syndrome

A

Pain, pressure, paralysis, paresthesia, pallor, pulselessness (too late!)

98
Q

Fracture interventions

A

Immobilization of injury, bandage, splint, orthotic boots

99
Q

Why are splints preferred over casts?

A

Splints are flexible and allow for swelling

100
Q

Most common type of cast that is lightweight and dries within minutes

A

Fiberglass

101
Q

Characteristics of plaster cast

A

24 hr to dry, leave uncovered to dry

102
Q

Characteristics of a wet plaster cast

A

Feels cold, smells musty, grayish in color

103
Q

Cast window is for patients that have

A

Wounds

104
Q

Ice packs may be prescribed for the first ___-___ hrs for cast care

A

24-48

105
Q

Cast care

A

Inspect every shift (drainage,alignment, fit, hot spots), inspect under skin for irritation, cover with plastic bag to shower if not waterproof

106
Q

Arm cast care

A

Above heart to decrease swelling

107
Q

Cast removal

A

Split with vibrating blade, underlying padding cut with bandage scissors

108
Q

Two types of traction

A

Skin (buck’s) and Skeletal

109
Q

Type of traction that uses Velcro boot or belt secured around affected leg, weighing 5-10 lbs

A

Skin (Buck’s)

110
Q

Type of traction where screws are inserted into bone involving heavier weights (15-30 lbs)

A

Skeletal

111
Q

Traction care

A

Inspect each shift, weights should hang freely (not resting on floor)

112
Q

Older adult risk post ORIF

A

Delirium, falls

113
Q

Post hip ORIF care

A

Consider pillows to prevent hip adduction

114
Q

Amputation care

A

ROM to prevent flexion contractures (hip/knee), prone position q4h if tolerated, trapeze over bed for mobility

115
Q

Complications of skin traction

A

Edema, vascular obstruction, nerve palsy, skin necrosis over prominences, DVT, PE

3254/64 (4 decks)

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