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Clin Med II MHM - FINAL > Ortho Overview Part 1 (Steiner) > Flashcards

Ortho Overview Part 1 (Steiner) Flashcards

1
Q

What does orthopaedics literally mean?

A

Straight child

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2
Q

Orthopedics is the medical discipline devoted to which system?

A

Musculoskeletal

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3
Q

Functions of MSK system

A

Support, protection, movement

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4
Q

Function of bone

A

Provides support

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5
Q

Function of cartilage

A

Provides smooth surface for articulating bones

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6
Q

Function of intervertebral disks

A

Sustains and distributes load

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7
Q

Function of muscles

A

Contract to create movement

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8
Q

What do tendons connect?

A

Muscle to bone

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9
Q

What do ligaments connect?

A

2 bones

*Defines the motion of the joint

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10
Q

Is bone tissue dynamic or static?

A

Dynamic - osteoblasts make new bone and osteoclasts remove necrotic bone

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11
Q

2 types of bone

A
  • Cortical (less porous, denser outer portion)

- Cancellous (more porous, trabecular, surrounded by cortical bone)

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12
Q

Strength and stiffness of bone is generally in which direction?

A

In the direction of load application

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13
Q

Which bones deal with longitudinal stresses best?

A

Long bones

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14
Q

Long bones deal with which stresses best?

A

Longitudinal stresses

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15
Q

How do fractures generally occur?

A
  1. Single momentary load exceeds the tolerance of that bone (usually from trauma)
  2. Repeated loading (stress)
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16
Q

When do stress fractures occur?

A

Repeated loading where rate of damage exceeds rate of repair

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17
Q

5 stages of fracture healing

A
  1. Impact
  2. Inflammation (hematoma formation)
  3. Soft callus formation
  4. Hard callus formation
  5. Remodeling
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18
Q

How does a hematoma progress at fracture site?

A
  • Granulation tissue replaces hematoma
  • Fibroblasts make collagen
  • Osteoclasts remove necrotic bone
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19
Q

When does a fracture appear clinically healed?

A

When soft callus becomes hard callus

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20
Q

What procedure is performed when a fracture requires surgical intervention?

A

ORIF (open reduction and internal fixation)

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21
Q

ORIF vs. conservative tx of fractures

A

ORIF heal more quickly but are more at risk for infection, complications of anesthesia or surgery

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22
Q

Which type of hardware placed for fractures is better tolerated?

A

Deeper hardware

23
Q

Are plates or rods better tolerated by pts?

A

Rods

24
Q

What happens when a fracture fails to heal properly?

A

Non-union or malunion

25
Q

Describe non-union of fracture

A
  • When fragments fail to unite and heal
  • If healing has not occurred w/in 6 months, it is called a “delayed union”
  • Beyond 6 months it is considered a non-union
26
Q

When can non-unions occur?

A
  • Poor blood supply (elderly)
  • Poor nutritional status
  • Inadequate immobilization
  • Soft tissue interposed b/w fragments
  • Presence of infection or dead bone (sequestrum)
27
Q

What is a sequestrum?

A

Piece of dead bone

28
Q

Treatment of non-union

A
  • Initially, stimulate normal osteogenic mechanisms
  • Functional bracing combined w/wt bearing
  • Use of implantable rods or compression plates
  • Electrically w/bone stimulators
  • Chemically w/autogenous bone transplants
29
Q

How does bone respond to stress?

A

Becomes more dense

30
Q

What is the most technologically advanced means of treating a non-union fracture?

A

Ilizarov method

-Application of an external fixator

31
Q

Bony regeneration with the Ilizarov method occurs at what rate?

A

1 mm per day

32
Q

Describe malunion of fracture

A

Healing has occurred but with an unacceptable degree of angulation, rotation, or shortening

33
Q

Which type of fractures are more likely to be a/w nerve transections?

A

Open fractures

34
Q

Which types of fractures are MC at risk of infection?

A
  • Open

- Those treated surgically

35
Q

What predisposes female athletes to osteopenia?

A

Amenorrhea

36
Q

What may x-rays show with stress fractures?

A

Subtle cortical disruption or evidence of prior bone healing

37
Q

What imaging is usually more helpful for stress fractures?

A

Bone scan

38
Q

Treatment of stress fractures

A
  • Rest
  • Splints
  • In some cases, casting
  • Best thing is prevention
39
Q

What can help amenorrheic women reduce the risk of osteopenia?

A

OCPs

40
Q

Untreated stress fractures may evolve into:

A

Complete fracture

41
Q

Definition and function of joints

A
  • Articulation where 2 bones meet

- Allow movement of 1 bone on another

42
Q

Types of joints

A
  1. Cartilaginous (minimal movement)
  2. Fibrous (immovable)
  3. Synovial (freely moveable)
43
Q

Examples of cartilaginous joints

A
  • Symphysis pubis
  • Vertebral bodies
  • AC joint
  • Sternoclavicular joint
44
Q

Examples of fibrous joints

A

Skull sutures

45
Q

Examples of synovial joint

A
  • Hip, shoulder (ball & socket)
  • Fingers, elbow (hinge)
  • Knee, TMJ (condylar)
46
Q

Examples of ball & socket synovial joints

A

Hip, shoulder

47
Q

Examples of hinge synovial joints

A

Fingers, elbow

48
Q

Examples of condylar synovial joints

A

Knee, TMJ

49
Q

Describe articular cartilage

A
  • Avascular tissue composed of chondrocytes and an organic matrix
  • Found at ends of bones (joint)
  • One dimensional
50
Q

Osteoarthritis occurs from:

A

Wearing down of articular cartilage and subsequent exposure of underlying bone

51
Q

Why does articular cartilage have little capacity to repair itself?

A

Chondrocytes have a low rate of metabolism

52
Q

How does the body attempt to repair articular cartilage?

A
  • With new hyaline cartilage

- This results in fibrocartilage (not ideal for joint surfaces)

53
Q

When is there NO capacity for repair to cartilage defects?

A

If they extend through entire thickness to the calcified plate at the bony junction

Clin Med II MHM - FINAL (16 decks)

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