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Orthopedic and Wound Emergencies > Orthopedic Injury > Flashcards

Orthopedic Injury Flashcards

1
Q

Ligaments..

A

Hold the bone together at the joint (sprain)

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2
Q

Tendon…

A

Holds a muscle to a bone (strain)

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3
Q

Complications of scapula/clavicle fractures

A

Large vessel injury
Pulmonary Issues
Rib fractures
Cervical spine fractures

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4
Q

Tx of scapula/clavicle

A

Sling and Rest

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5
Q

Also look for what complications of scapula/clavicle fractures..

A

Brachial plexus
Splenic injuries
Humerus fractures

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6
Q

Shoulder injuries

A

FOOSH
(falling on outstretched hand)
Older - break
Younger - dislocate

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7
Q

Shoulder injuries tx

A

Shoulder immobilizer

Sling with swathe to body

20% Require surgical interventions

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8
Q

Signs of anterior shoulder disloc.

A

Cannot touch ear of opposite site of disloc.

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9
Q

Thing to keep in consideration w/ midshaft humerus fracture

A

let elbow hang so the weight of the welbo helps reduce the fracture

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10
Q

Common complications of midshaft humerus fracture

A

Brachial artery injury (may lose up to 750 ml of blood)

Radial nerve damage

Fat emboli (24-48 hrs after the injury)

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11
Q

What is it called when you dislocate the radial head?

A

Nurse Maid elbow

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12
Q

What is nurse’s maid elbow

A

Can’t supinate or pronate

Can still flex or extend but won’t due to pain

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13
Q

How to pop nurse’s maid elbow back in?

A

supinate it

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14
Q

What is nurse maid elbow most common

A

Children whose arms are pulled or jerked

Until age 5

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15
Q

Where do those with both complete elbow dislocations go?

A

OR

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16
Q

What is considered a complete elbow dislocation

A

ulna and radius dislocated

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17
Q

Ways to have a complete elbow dislocation

A

FOOSH

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18
Q

Complications of a complete elbow dislocation

A

Neruovascular involvement

Brachial artery lac

Median nerve impingement or damage (hand contracture)

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19
Q

Non-displaced elbow fracture

A

sling and encouragement of early use

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20
Q

Displaced elbow fracture

A

surgical intervention

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21
Q

What to asses for w/ elbow fracture

A

Median Nerve

Brachial Artery

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22
Q

What is Monteggia’s fracture

A

Fracture of the proximal 1/3 of the ulna

w/ radial head dislocation

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23
Q

What is Nightstick fracture

A

Fracture of the midshaft of the ulna - direct blow to forearm

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24
Q

Tx for forearm fx

A

Closed reduction

Cast applied to keep elbow 90 degrees

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25
Q

What to teach pt’s with forearm fx

A

Prevent dependency of arm

Prevent drooping of wrist inside sling after cast application - prevent compartment syndrome / edema

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26
Q

What is it called when your wrist fracture fall is like a fork

A

Colle’s fracture

Downward displacement of the distal radius

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27
Q

What is it called when your wrist fracture fall is like a hoe

A

Smith’s fracture
“Farmer smith had a hoe down”

Upward displacement of the distal radius

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28
Q

Scaphoid fracture is where?

A

Base of the thumb bone

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29
Q

If a scaphoid fracture doesn’t heal well what can you loose use of?

A

Thumb

30
Q

What is coopernail sign

A

Bruising and swelling in the scrotum or labial folds from pelvic bleeding

31
Q

Kidney trauma classic signs

A

Hematuria

Eccymosis over the flank

32
Q

Bladder trauma classic sign

A

Pt has to void but when the push nothing comes out yet it hurts to push

Abd distention

Lack of urine flowing from indwelling catheter

33
Q

Pelvic fracture tx supplies

A

Pelvic binder

Venous bleed - pelvic binder will pull the space smaller and tamponade the bleeding

Call tight enough where toes point in like a pigeon

34
Q

Pelvic fracture tx fluid

A

Aggressive fluid resuscitation

35
Q

Pelvic fracture be careful w/???

A

Cath

1st check site with retrograde urethrogram

You can completely tear it - don’t put anything in if there is blood

36
Q

IF pt doesn’t improve after application of pelvic binder?

A

Possibly arterial bleed

37
Q

What is the only way to stop a pelvic arterial bleed?

A

Radiology for embolization
or
OR

38
Q

Where do you put the pelvic binder?

A

Level of greater trochanter and sympysis pubis

39
Q

Things to consider w/ hip dislocations

A

Reduce in six hours yo prevent femoral head nerosis

40
Q

Posterior hip dislocation

A

Leg rotated inward toward other leg

41
Q

Femur bone normally…

A

takes those big thigh muscles and stretches them out to make your leg longer

So when you break it.. MUSCLES CONTRACT
sharp ends = lac

42
Q

On average what is the blood loss after a femur bone fracture..

A

1 L but can exceed 3L

43
Q

What happens to the leg during a femur fracture?

A

Leg becomes short and fat = can hold more blood

44
Q

What do you want on a femur fracture quickly?

A

Traction splint to stretch it out to tamponade bleeding

45
Q

Do not apply traction splint on femur if..

A

there is a tibia or fibula fracture

Or

serious injuries to the foot

46
Q

Can a traction splint be applied to a pelvic fracture?

A

Yes as long has it does not cause severe pain

47
Q

What nerves to assess w/ a knee fracture/dislocation

A

Peroneal

Tibial

48
Q

Tx for knee fracture / dislocation

A

surgery - dislocation

long leg splint

49
Q

What artery must you watch w/ knee fracture/dislocation

A

Popliteal artery

50
Q

What holds the patella in place?

A

A ligament that goes down in front of the leg

51
Q

Way to relocate a dislocated patella?

A

Straighten the leg… pulls ligament down and pops it into place

52
Q

Fracture the patella tx?

A

Surgery - poor healing process due to lack of blood supply

53
Q

Fracture tib/fib are usually open due to?

A

Closeness to skin

54
Q

Open fractures have highest risk of…

A

blood loss and infection

Less to tamponade bleeding

55
Q

Tibia is …

A

non weight bearing

Cannot walk into ER

56
Q

Fibula is …

A

weight bearing

Can walk into ER still pain

57
Q

Tib/Fib fracture tx

A

Cast

58
Q

What medication can increase risk of achilles tendon rupture

A

Fluoroquinolone
Levaquin
Cipro
Avelox

Or direct steroid injection into the tendon

59
Q

Achilles tendon rupture pt’s cannot what with he foot?

A

Stand on ball of foot

Plantar flex the foot

60
Q

3 things you do for achilles tendon rupture?

A

Splint the foot
Crutches
OR referal

61
Q

Calcaneus rupture usually happens from

A

falling from a great height

62
Q

Calcaneus classic triad?

A

Lover’s fracture - jump off balcony

COMPRESSION fracture L spine and tibial plateau

63
Q

3 things for Calcaneus fracture tx

A
  1. Compression dressing
  2. Crutches
  3. Surgery
64
Q

General ice and heat rule for tx of orthopedic injuries

A

Apply ice 20 minutes once an hour

Change to heat 48 hrs after injury

Compartment syndrome? no ice

65
Q

Where do you elevate an extremity?

A

Above the heart

66
Q

How do you elevate the extremity if their is compartment syndrome

A

TO the level of the heart

If you do it above the heart it dec oxygen delivery

67
Q

Apply a splint …

A

how the injury was found

UNLESS

there is poor circ and you need to readjust it

68
Q

Immobilize what part of the fracture?

A

above and below

If there is movement it can increase risk of injury and fat emboli

69
Q

Cover open fractures w/

A

Saline soaked dressings

70
Q

When you take a solid or a liquid and turn it into a gas. it takes up how much room??

A

WAY more than a solid or liquid

GAS WAVE

Hurricanes are like 200-300mph, Gas wave can be thousands

Orthopedic and Wound Emergencies (11 decks)

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