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Trauma and Trauma Systems > extremity trauma > Flashcards

extremity trauma Flashcards

1
Q

introduction to musculoskeletal injuries

A

-Millions of Americans experience annually
-Multiple MOI:
– Falls, crashes, violence, etc.
– Multi-system trauma

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2
Q

skeletal tissue and structure

A
  • give the body its structural form
  • protect vital organs
  • promote efficient movement despite the forces of gravity
  • store salts and other materials needed for metabolism
  • produce RBCs
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3
Q

bone structures

A
  • diaphysis
  • epiphysis- end of a long bone
  • metaphysis
  • medullary canal
  • periosteum
  • cartilage
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4
Q

epiphysis

A

-end of long bone

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5
Q

metaphysis

A
  • between epiphysis and diaphysis

- growth plate

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6
Q

medullary canal

A

-contains bone marrow

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7
Q

periosteum

A

-fibrous covering of diaphysis

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8
Q

cartilage

A

-connective tissue that provides a smooth articulation surface for other bones

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9
Q

joint types

A
  • ball and socket joint
  • condyloid joint
  • gliding joint
  • hinge joint
  • pivot joint
  • saddle joint
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10
Q

joint structure

A
  • tendon
  • bone
  • bursa
  • synovial membrane
  • articular cartilage
  • joint cavity
  • joint capsule
  • bone
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11
Q

skeletal organization

A
  • 206 bones
  • axial skeleton- head, thorax, and spine
  • appendicula skeleton- upper and lower extremities
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12
Q

bone aging

A
  • birth to adult (18-20)- transition from flexible to firm bone
  • adult to elderly (40+):
  • reduction in collagen matrix and calcium salts diminution of bone strength
  • spinal curvature
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13
Q

types of muscle

A
  • smooth
  • striated
  • cardiac
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14
Q

muscular tissue and structure

A

-600 muscle groups

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15
Q

pathophysiology of the musculoskeletal system

A
  • muscular injury
  • contusion
  • compartment syndrome
  • penetrating injury
  • fatigue
  • muscle cramp muscle spasm
  • strain
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16
Q

joint injury

A
  • sprain
  • subluxation
  • dislocation
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17
Q

bone injury

A
  • open fracture
  • closed fracture
  • hairline fracture
  • impacted fracture
  • transverse
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18
Q

pediatric considerations

A

-flexible nature

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19
Q

geriatric considerations

A

-osteoporosis

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20
Q

pathological fractures

A

-pathological diseases

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21
Q

general considerations with musculoskeletal injuries

A
  • neurological compromise
  • decrease stability
  • muscle spams
22
Q

bone repair cycle

A
  • osteocytes produce osteoblasts
  • deposition of salts
  • increasing strength of matrix
23
Q

inflammatory and degenerative conditions

A
  • bursitis
  • tendonitis
  • arthritis:
  • osteoarthritis- degenerative
  • rheumatoid arthritis- chronic, systemic, progressive, debilitating
  • gout- inflammation of joints produced by accumulation of uric acid crystals
24
Q

arthritis

A
  • osteoarthritis- degenerative
  • rheumatoid arthritis- chronic, systemic, progressive, debilitating
  • gout- inflammation of joints produced by accumulation of uric acid crystals
25
Q

scene size up

A
  • clues to specific injuries
  • pelvic fractures or bilateral femur fractures are “load and go”
  • control major bleeding
  • history may suggest other injuries
26
Q

initial assessment

A
  • categories of urgency:
  • life and limb threatening injury
  • life threatening injury and minor musculoskeletal injury
  • non life threatening injuries but serious musculoskeletal injuries
  • non life threatening injuries and only isolated minor musculoskeletal injuries
27
Q

musculoskeletal injury assessment

A
  • rapid trauma assessment -only press on pelvis if no clinical signs of injury are present such as pain
  • focused H&P- 6 Ps: pain, pallor, paralysis, paresthesia, pressure, pulses
  • detailed physical exam
  • ongoing assessment
  • sports injury considerations
28
Q

detailed exam of extremities

A
  • deformity
  • contusions
  • abrasions
  • penetrations
  • burns
  • tenderness
  • lacerations
  • swelling
  • also check PMS*
29
Q

general principles of musculoskeletal injury management

A
  • protecting open wounds
  • positioning the limb
  • immobilizing the injury
  • checking neurovascular function
  • pulse- palpate and utilize pulse oximetry
  • motor
  • sensation
30
Q

splinting devices

A
  • rigid splints
  • formable splints- vacuum splints, air splints
  • soft splints
  • traction splints
  • other splinting aids- cravats or velcro splints
31
Q

musculoskeletal injury management

A
  • splinting devices
  • fracture care
  • joint care
  • muscular and connective tissue care
32
Q

fracture management: pelvis

A
  • scoop stretcher
  • pelvic sling device
  • fluid resuscitation
33
Q

femur fracture management

A
  • traction splints- contraindicated in hip/knee injuries
  • high force injury
  • high potential for shock
34
Q

tibia fibula fracture management

A
  • frequently open fractures
  • cove bone ends with moist dressing
  • depending on level of fracture, use:
  • rigid splint
  • air splint
  • pillow
35
Q

clavicle fracture management

A
  • most frequently fractured bone in the body
  • transmitted to 1st and 2nd rib
  • alert lung injury
36
Q

care for specific joint injuries

A
  • hip
  • knee
  • ankle
  • foot
  • shoulder
  • elbow
  • wrist/hand
  • finger
  • be alert for neurological compromise
37
Q

hip fractures

A
  • common in the elderly
  • may be able to support weight- ability to walk does not rule out fracture
  • leg often externally rotated
  • may refer pain to the knee
  • use other leg for splint
  • use vacuum mattress if available
38
Q

hip dislocation

A
  • orthopedic emergency
  • posterior dislocation most common
  • hip flexed and leg rotated internally
  • severe pain on attempts to straighten
39
Q

hip dislocation management

A
  • splint in most comfortable position
  • document sensation and pulse
  • prompt transport
  • be alert for associated knee injuries or fractures
40
Q

knee fracture or dislocation

A
  • orthopedic emergency
  • frequently causes vascular injury
  • dislocation associated with 50% rate of amputation of leg
41
Q

knee fracture or dislocation management

A
  • obvious dislocation without distal pulse -> apply gentle traction along the long axis of the joint
  • if gentle traction does not restore the pulse -> splint in place
  • prompt transport
42
Q

foot or hand injury

A
  • common industrial injury
  • often disabling
  • rarely life threatening
  • splint foot with pillow
  • splint hand in position of function
43
Q

shoulder injury

A
  • AC separation- sling and swathe
  • shoulder dislocation- use pillow with sling and swathe
  • fracture- use sling and swathe
44
Q

elbow injury

A
  • fracture or dislocation may because neurovascular injury
  • splint in position found
  • transport promptly
45
Q

rigid splint

A

-keep hand in position of function

46
Q

air splint

A

-may be hard to reassess circulation

47
Q

forearm/wrist injury

A

use a pillow

48
Q

soft and connective tissue injuries

A
  • tendon
  • ligament
  • muscle
49
Q

other injury considerations: musculoskeletal injury management

A
  • pediatric musculoskeletal injury
  • athletic musculoskeletal injury
  • patient refusals and referral
  • psychological support
50
Q

tendon

A

-muscle to bone

51
Q

ligament

A

-bone to bone

Trauma and Trauma Systems (18 decks)

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