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N1115 - Trans. to Associates > Exam 3 - Chpt 37 Musculo. Trauma > Flashcards

Exam 3 - Chpt 37 Musculo. Trauma Flashcards

(79 cards)

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1
Q

soft tissue injury produced by blunt force

A

contusion

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2
Q

contusion s/sx

A

pain
swelling
discoloration (ecchymosis)

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3
Q

pull muscle injury to the musculotendinous joint

A

strain

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4
Q

strain s/sx

A 
pain
edema
muscle spasm
ecchymosis
loss of function
--graded 1st, 2nd, 3rd degree
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5
Q

injury to ligaments and supporting muscle fiber around a joint

A

sprain

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6
Q

sprain s/sx

A

joint tenderness
painful movement
edema
disability, pain increases during the first 2-3 hours

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7
Q

articular surfaces of the joint are not in contact

A

dislocation

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8
Q

when is a dislocation an emergency

A

pain
changes in contour, axis, length of limb
loss of mobility

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9
Q

RICE

A

rest
ice
compression
elevation

  • immobilization
  • anti-inflammatory meds
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10
Q

2 types of factures

A

open, closed

-no break in the skin

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11
Q

open fractures are aka

A

compound/complex fractures

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12
Q

open/compound/complex fractures extend to the ___

A

bone

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13
Q

how many grades of open/compound/complex fractures are there?

A

3

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14
Q

grade 1 open/compound/complex fracture

A

1cm long, clean wound

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15
Q

grade 2 open/compound/complex fracture

A

large wound without extensive damage

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16
Q

grade 3 open/compound/complex fracture

A

high contaminated
extensive soft tissue injury

–may have amputation

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17
Q

intra-articular fracture extends into the ___ ___

A

joint surface

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18
Q

s/sx of fracture

A 
acute pain
loss of function
deformity
shortening of extremity
crepitus
local swelling, discoloration
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19
Q

Dx a fracture

A

symptoms
pt reports injury to the area
radiography

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20
Q

fracture emergency management

A

immobilize
splinting
assess neuro before, after splinting

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21
Q

emergency management for an open fracture

A

cover with a sterile dressing to prevent contamination

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22
Q

restoration of the fracture fragments to anatomic alignment and positioning

A

fracture reduction

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23
Q

medical management of fractures

A

fracture reduction
closed: manipulation, manual traction
open: internal fixation
immobilization

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24
Q

factors that affect fracture healing

A 
inadequate immobilization
inadequate blood supply
multiple trauma
extensive bone loss
infection
poor adherence to Rx restrictions
malignancy
older age
some disease process
-RA
certain meds
-corticosteroids
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25
early complications of fractures
shock (hypovolemic) fat embolism compartment syndrome VTE, PE
26
hypovolemic shock is common with which fracture
pelvis
27
fat embolism is common with which fracture
long bone
28
delayed fracture complications
delayed union, malunion, and nonunion avascular necrosis of bone complex regional pain syndrome (CRPS) heterotrophic ossification
29
prolongation of expected healing time for a fracture
delayed union
30
death of a tissue secondary to poor perfusion and hypoexmia
avascular necrosis
31
rehab r/t clavicle fracture
strap, sling | exercise elbow, wrist, fingers ASAP
32
how soon after a clavicle fracture can you elevate the arm above the shoulder
6 weeks
33
rehab r/t humeral neck, shaft fracture
slings, bracing | activity limitations until adequate period of immobilization
34
what to monitor for regularly with elbow fractures
neurovascular
35
how long to limit elbow movement after immobilization and healing for nondisplaced, casted
4-6 weeks
36
how long to limit elbow movement after internal fixation
about 1 weeks
37
rehab r/t radial, ular, wrist, and hand fractures
early rehab exercises | active ROM for fingers, shoulder
38
rehab r/t pelvic fracture
depends on fracture and associated injuries stable fractures are tx'd within a few days of bed rest, symptom management early immobilization reduces problems r/t mobility
39
rehab r/t hip fracture
sx is usually done to fixate | care is similar to THA
40
rehab r/t femoral shaft fractures
low leg, foot, hip exercises to preserve function, improve circulation early ambulation PT, weight bearing as Rx active, passive knee exercises ASAP to prevent restriction of knee movement
41
technique used with dressing changes
aseptic
42
rigid, external immobilizing device
cast
43
cast materials
nonplaster (fiber glass) | plaster of Paris
44
uses for cast
immobilize a reduced fracture correct a deformity apply uniform pressure to soft tissue support, stable weak joints
45
when are contoured splints of plaster or pliable thermoplastic materials used
rigid immobilization not required anticipated swelling special skin care required
46
braces (orthoses) are used for
support control movement prevent additional injury
47
6 P's of neurovascular changes
``` pain poikilothermia (cool to touch) pallor pulselessness paresthesia paralysis ```
48
occurs from increased pressure in a confined space; compromises blood flow
compartment syndrome
49
what is the early indicator of compartment syndrome
pain
50
compartment syndrome treatment
notify physician - cast may be removed - emergency fasciotomy may be necessary
51
pt will c/o this with a cast pressure ulcer
painful "hot spot" and tightness
52
muscle atrophy and loss of strength
disuse syndrome
53
disuse syndrome treatment
isometric exercises | muscle setting exercises
54
what is used to relieve cast itching
hair dryer on cool setting
55
application of pulling force to a part of the body
traction
56
purpose of traction
reduce muscle spasms reduce, align, immobilize reduce deformity increase space between opposing forces --used short term
57
all tractions are applied in how many directions?
2
58
the lines of pull are aka
vectors of force
59
types of skin traction
buck extension cervical head pelvic
60
musculoskeletal traction is
skeletal traction
61
how often to inspect the skin if pt is in traction
TID
62
how often to assess pressure points with traction
q8h
63
TKA and THA are commonly performed d/t
obesity
64
how to reposition a pt after a THA
log roll
65
methods to prevent dislocation of THA
correct positioning using splint, wedge, pillows | keep abduction with turning, adduction when transferring
66
limit flexing the hip less than __ degrees
90
67
should the legs cross midline of the body after a THA
No
68
how soon do pts ambulate after THA
POD1
69
THA are at risk for infection up to ___ months
24
70
neuro checks how often with TKA
q2-4h
71
acute rehab for TKA
1-2 weeks total: 6 weeks recovery
72
orthopedic preop assessment
``` routine preop assessment hydration status med hx knowledge support, coping possible infection --ask about colds, dental problems, UTI, infections within 1-2 weeks ```
73
what baseline needs to be obtained prior to sx
pain
74
when should a foley be removed
POD1
75
when should you assess for voiding
4 hours after foley has been removed
76
a fever within 24 hours post op is indicative of
PNA
77
a fever 48-72 hours post op is indicative of
UTI
78
a fever 72 hours post op is indicative of
wound infection
79
large amounts of ___ should not be given to orthopedic pts are on bedrest
milk d/t hypercalcemia

N1115 - Trans. to Associates (21 decks)

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