Musculo II Flashcards
Joint injuries: strains
Stretching injury to the muscle or musculotendinous unit due to mechanical overloading
-atypical muscle contraction or excessive stretch causes stiffness, pain, and swelling
Tx: RICE, elestic wraps, NSAIDS
Joint injuries: sprains
causes by abnormal or excessive movement of a jt and involves ligaments surrounding the jt
common sites: ankle, knee, and elbow
tx: cryotherapy, compression, elevate limb, NSAIDs, cast for severe sprain
Joint injuries: dislocation
separation of two bones where they meet t a jt (congenital, taumatic, or pathologic)
subuxation- incom/partial dislocation of jt
loose bodies- small pieces of bone or cartilage in a jt space
shoulder dislocation
highly mobile and thus unstable
susceptible to sprains, dislocations, and degenerative processes
composed to scapula, clavicle, and humerus
anterior dislocation most common
reduction of anterior dislocation
upright technique:
from behind, the inf angle of the scapula is pushed medially and acromion inferiorly
an assistant exerts gentle downward traction on the arm by pushing on the elbow while holding the wrist
successful reduction is signaled by a “clunk” as the humeral head returns to the glenoid fossa and appears normal shape
Knee
ligaments and tendons help stabilize the jt
-tibial collateral (MCL) prevents hyperabduction of the leg at the knee
anterior cruciate ligament (ACL) prevents femur from moving too far posteriorly relative to the tibia
Knee: unhappy triad
in response to lateral stress
- MCL is strained or torn
- medial meniscus is injured because it is attached to MCL
- force transferred to ACL, which may also tear
Knee: meniscus tear
tears can result from a blow or rotation while the knee is flexed and the foot is planted
Tx- RICE and brace/crutches (initially), strengthening support muscles (quads), and surgery if motion is severly compromised and ACL torn
Hip fractures
major health problem
primarily femoral neck and intertrochanteric fratures
fall prevention and treatment of osteoporosis critical
Compartment syndrome
condition of increased pressure in a limited space
can occur im limbs, because muscles, nerves, and vessels are enclosed in inelastic fascia
decrease in compartment size- constrictive dressings and casts, closure of fascial defects, and burns
increase in compartment size- trauma, swelling, bleeding, and venous obstruction
manifestations- pain out of proportion to injury, persistent deep ache or burning pain, paresthesias
Tx: relieve external pressure. Fasciotomy (last resort)
Bone healing: (1) hematoma and inflammatory phase
blood clot forms immed and facilitates the influx of inflamm cleanup cells
cytokines stimulate cell recruitment/differentiation, producing cells that build bone and new cartilage
10%
Bone healing: (2) reparative phase
fibrocartilaginous callus and bony callus formation
40%
Bone healing: remodeling phase
formation of cortical bone and remodeling of bony callus by osteoblasts and osteoclasts
70%
Fracture repair: hematoma
1
ruptured vessels bleed into and around fracture producing a clot that faciitates influx of inflamm cells, fibroblasts and capillaries
Fracture repair: fibrocartilaginous (soft) callus
2
hematoma replaced by actively growing connective tissue (procallus)
chondroblasts form a dense reg connective tissue assoc with cartilage (fibrocartilge)
fibrocartilaginous callus conists of cartilage, fibrous tissue, woven bone, osteoid and vessels
