GPT 2.09 Notes Flashcards
(26 cards)
What pathways are involved in pain perception in the peripheral nervous system?
Nociceptive pathways via Aδ and C fibers to the dorsal horn and spinothalamic tract
What pathways carry proprioception signals?
Dorsal columns (gracile and cuneate fasciculi) to the brain
What is the lumbo-sacral plexus?
Network of nerves from L1-S4 supplying lower limb muscles and skin
Which major nerves arise from the lumbo-sacral plexus?
Femoral, sciatic, obturator, tibial, common peroneal nerves
How does the sciatic nerve relate to pain and function?
Supplies most lower limb muscles; sciatic pain causes radiating leg pain
What is the basic structure of bone?
Cortical (compact) bone and trabecular (spongy) bone
What is the role of cartilage in joints?
Smooth surface for articulation and shock absorption
What are tendons and ligaments?
Tendons connect muscle to bone; ligaments connect bone to bone
How is the musculoskeletal system adapted to absorb physical stress?
Collagen fibers, bone remodeling, cartilage cushioning, joint synovium
What cells are involved in bone growth and remodeling?
Osteoblasts (build bone), osteoclasts (resorb bone), osteocytes (maintenance)
How do calcium and phosphate homeostasis regulate bone?
Parathyroid hormone, vitamin D, and calcitonin regulate absorption and resorption
How does bone repair differ from soft tissue repair?
Bone heals by direct callus formation and remodeling; soft tissue heals by scar formation
What are types of hip fractures?
Intracapsular (femoral neck), intertrochanteric, subtrochanteric
What is basic surgical management of hip fractures?
Fixation (pins, screws) or arthroplasty depending on fracture type and patient
What are key perioperative considerations for fractured neck of femur?
Assess fitness, early surgery (<48h), spinal or general anesthesia, pain control, DVT prophylaxis
What types of anesthesia are commonly used in hip fracture surgery?
Spinal anesthesia preferred; general anesthesia if contraindicated
What are common methods of postoperative pain relief after hip surgery?
Opioids, NSAIDs, nerve blocks, PCA (patient-controlled analgesia)
What are risk factors for postoperative pneumonia?
Immobility, advanced age, smoking, poor cough, aspiration risk
Which drugs affect the coagulation cascade for DVT prophylaxis?
Low molecular weight heparin, unfractionated heparin, direct oral anticoagulants
What are risk factors for fractures in elderly patients?
Osteoporosis, falls, frailty, previous fracture
How do patient factors influence fracture prophylaxis?
Bone density, fall risk, comorbidities guide calcium/vitamin D, bisphosphonates
What is the NICE pathway for venous thromboembolism (VTE) prophylaxis?
Assess risk; use mechanical (compression stockings) and pharmacological (LMWH) measures
What physiological changes occur with ageing relevant to mobility?
Muscle mass loss (sarcopenia), decreased bone density, joint stiffness
What physical changes increase fall risk in elderly?
Poor balance, slower reflexes, vision impairment, neuropathy
