Flashcards in 22- Soft Tissue Trauma Deck (54):
What are ligaments?
elastic structures that stabilize the joints
What is a sprain?
occurs when the a tensile (stretching) force elongates a ligament beyond its elastic limit, which will tear wither in its midsubstance or at the attachment of bone
What is an avusion Fx?
when a ligament pulls a sliver of bone off
What is a 1st degree sprain?
denotes only slight stretching of the ligament and microscopic damage limited to the collagen fibrils associated with no discernible instability to the joint
What is a 2nd degree sprain?
represents a partial tearing of the ligament gross continuity of the ligament is preserved there is abnormal laxity (looseness) of the joint is produced when joint is stressed
What is a 3rd degree sprain/?
represents a complete tear injury may paradoxically cause less discomfort than a second-degree sprain because there is no remaining intact ligament to be stretched and it is the stretch that produced pain leads to gross instability
Why might 3rd degree sprains initially appear stable?
because of muscle spasm temporally holding the joint in place
What is a dislocation?
when instability of the joint leads to the articular surfaces completely lose contact with each other (seen with complete tears)
What is a subluxation?
joint surfaces begin to dissociate but do not completely lose contact with each other
What are the 4 types of injuries sustrained for sprains?
injury to the ligament, residual instability of the joint, disruption of the articular surface, injury to surrounding arteries and nerves
What is a Hills-Sachs lesion?
when the humeral head is forced forward out of the glenoid socket, its posterior surface can collide with the front of the glenoid and cause an impaction injury
Why can osteonecrosis happen after hip dislocations?
by trauma to the vascular bundle that are bound to the femur
What does RICE stand for?
What are the 3 capsular ligaments that stabilize the shoulder?
superior, middle, inferior glenohumeral ligaments
What is the stabilizer of the anterior transduction for the shoulder?
inferior glenohumeral lig
What is the glenoid labrum?
a fibrous structure attached to the circumference of the glenoid socket deepens the saucer like glenoid socket to lend additional stability
Which muscles provide dynamic stability to shoulder?
Rotor cuff, biceps, and scapular rotator muscles
What happens in atraumatic dislocations?
characterized by subluxations and dislocations of the joint in the absence of specific trauma, specifically from joint laxity and have no identifiable cause
What happens in a traumatic dislocation?
usually from a fall, 98% are anterior
What are acquired dislocations?
shoulder dislocations from repeat minor injuries (chronic knuckle children syndrome)
What are the characteristics of Marfans?
characterized by excessive height, long fingers, and toes, laxity of connective tissue, including connective tissue in the heart valves, aorta, and eyes (they have atraumatic instability)
When do you see Bankart lesions?
seen in most cases of an anterior dislocation where the anterior labrum and capsule are torn away from the glenoid
What are more likely to happen if you dislocate your shoulder as a kid?
More dislocations (viscous cycle)
Which views do you need on a X-ray for shoulder dislocations?
AP, transcapular, and lateral (Y view)
What is the Tx for a first time shoulder dislocation?
Closed reduction followed by a period of immobilization and then a program of rehab
What is the fxn of the ACL?
stabilizes the knee against anterior subluxation of the tibia
Which muscles supplement the ACL's actions?
hamstrings and gastrocnemius
What is the mechanism of rupture for an ACL?
is when the tibia is forced forward which typically occurs when an individual is attempting to change directions at a high rate of speed
What are traumatic dislocations fo the hip?
are characterized by sudden and violent displacement of the femoral head from the acetabulum
What is the appearance of a posterior dislocated hip?
hip flexion, internal rotation and adduction
What is the difference in blood supply to a traumatically dislocated hip and a developmentally dislocated hip?
Traumatic dislocated hip-can damage the blood vessels that travel along the femoral neck to supply the head of the femur
Developmentally dislocated hip-gradual displacement occur over time so blood vessels can adapt and grow along with the deformity
What is the most common mechanism to cause posterior dislocations of the hip?
common mechanism of the knee striking the dashboard during a motor vehicle crash transmitting forces along the femur to the flexed hip joint
What fractures are associated with posterior hip dislocations?
Why are hip dislocations emergencies?
Hip dislocation is an emergency because the longer the hip is out of the place the greater the risk to the blood vessels and the greater the risk for osteonecrosis
How can tendons rupture?
eccentric contraction of the musculotendinous unit that is a contraction of the muscles as it is pulled in the opposite direction by an external force
What is needed to rupture a tendon?
What age group typically tend to rupture tendons?
Middle aged dudes in recreational sports
What causes lacerated tendons?
direct penetrating trauma from sharp objects
Where in the body do lacterated tendons typically occur?
Hands (tendons are close to the skin)
Where do ruptured tendons typically occur?
occur in tendons that move the large joints of the extremity’s (quad tendons, achilles tendon)
How do you treat a ruptured tendon?
Typically by surgery, but sometimes you can position it well enough to allow healing
Why is it hard to treat lacerated flexor tendons in the hand?
They pass through sheaths and pulleys to work efficiently, so it's hard to make it not sticky or bulky to fit in the sleeve.
How many pt's are hospitalized from severe burns every year in the US?
What are electrical burns?
essentially a thermal burn from the heat generated by current conducting through the body
Which tissue is at risk for electrical burn injuries?
Especially harmful to nerves because the higher electrical resistance in other soft tissues promotes travel of the current within the neural tissue
What are 1st degree burns?
superficial burns involve the epidermis only
• Present with pain, edema, and erythema of the skin
What are 2nd degree burns?
partial thickness burns extend down to the dermis
• Present with painful blistering of the skin
What are 3rd degree burns?
full thickness burns extends all the way through the skin can penetrate deep into muscle and bone
• Present with burns that appear waxy and dry skin is leathery and often white or charred
• Associated nerve death results in injuries that are not painful
What are the problems with burns to the hands?
You can't play video games (lol Grandma's Boy)
also it results in contractures of the skin --> claw --> hard to correct
What are the problems with circumfrential burns?
can create a constricting band of tissue (eschar) that impairs arterial blood flow and prevents the drainage of edema fluid
What is myositis ossification?
abnormal production of bone within muscle
What are the signs of myositis ossificiation?
patient reports pain with motion of the involved muscle tenderness to palpartion and swelling maybe palpable mass
What are the etiologies of myositis ossification?
result from trauma or as a secondary manifestation of a systemic disease or genetic disorder