Intro To Ortho Injury PPT Flashcards Preview

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Flashcards in Intro To Ortho Injury PPT Deck (52)
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1
Q

What is a primary injury?

A

Injury that results directly from the initial, immediate trauma associated w/ a particular mechanism of insult

2
Q

What are the 3 types of primary injury?

A

Direct/Extrinsic, Indirect/Intrinsic, Overuse

3
Q

What is a direct primary injury? Give example.

A

trauma occurs @ place of impact where force meets body

i.e. contusion from direct force

4
Q

What is an indirect primary injury? Give example.

A

Force meets the body in such a way that energy is transmitted to another part of the body where the trauma is concentrated & the injury occurs
(i.e. dislocated shoulder from falling on outstretched hand)

5
Q

What is an overuse injury?

A

Acute repetitive friction OR chronic repetitive microtrauma

6
Q

What is secondary injury and what are the 2 types?

A

Additional injury that occurs as a result of primary injury.

Secondary enzymatic & hypoxic/ischemic

7
Q

What is the difference between short & long term secondary injury?

A

Short: results from sequelae of injury, if not managed properly; affects uninjured cells on periphery of the primary lesion

Long: over time may lead to degenerative conditions; increases total quantity of tissue damage; potentially increases healing time

8
Q

What are characteristics of secondary enzymatic injury (4)?

A
  1. lysosomes release enzymes
  2. enzymes damage surrounding cells
  3. cell membrane loses integrity & polarity
  4. swelling -> cell death
9
Q

What are characteristics of secondary hypoxic/ischemic injury (6)?

A
  1. failure of vasculature to supply enough blood = ischemia
  2. vascular & inflammatory changes cause a period of hypoxia
  3. shift to anaerobic metabolism
  4. inability to produce adequate ATP
  5. failure of membrane ion pumps
  6. swelling -> cell death
10
Q

Where can ischemia come from (7)?

A
  1. damaged blood vessels
  2. hemostasis/clotting
  3. inflammation induced hemoconcentration
  4. thicker blood does not flow as well
  5. increased extravascular pressure from expanding hematoma
  6. pain induced muscle spasm
  7. swelling of injured cells
11
Q

What are the 3 physiological problems that ischemia causes?

A
  1. hypoxia
  2. inadequate supply of nutrients
  3. inadequate removal of waste
12
Q

What are 6 general mechanisms of injury?

A

Tension, compression, shearing, torsion, bending, stretching

13
Q

What is tension?

A

force that pulls tissues (i.e. muscle tendon injuries, sprain/cramp)

14
Q

What is compression?

A

forceful blow to tissues (i.e. contusion/fracture)

15
Q

What is shearing?

A

Force that moves parallel to the tissues (i.e. vertebral disc injuries)

16
Q

What is torsion?

A

twisting/turning force, 1 end of object is twisted in 1 direction & the other end is stabilized / twisted in the opposite direction

17
Q

What is bending?

A

horizontal force causing the tissue to bend/strain (i.e. spiral fracture/greenstick)

18
Q

What is stretching?

A

elongation of tissue (i.e. ligaments, strain/sprain)

19
Q

Tendons & ligaments resist _____ force.

A

tensile

20
Q

Bones resist _____ force.

A

compressive

21
Q

Discs resist ______

A

tension, compressive, shear, & torsion forces

22
Q

What is a bruise?

A

compression that causes bleeding under the skin

23
Q

What is a contusion?

A

acute compression causing hemorrhage of a muscle tissue

24
Q

What are muscle cramps?

A

acute painful involuntary muscle contraction caused by dehydration or an electrolyte imbalance

25
Q

What is a muscle spasm?

A

reflex muscle contraction caused by acute trauma (serves to protect an area)

26
Q

What is muscle hypertonicity?

A

Increased activity of an otherwise normal muscle (no nerve/muscle pathology present, resting tone of muscle = greater than normal)

27
Q

What could muscle hypertonicity cause?

A

muscle imbalance w/an inhibited/weak antagonistic muscle

28
Q

What is muscle spasticity?

A

increase in muscle tone @ rest, result of Upper Motor Neuron Lesion (UMNL) (increased resistance to passive stretch, exaggerated deep tendon reflexes, & clonus)

29
Q

What is a sprain?

A

stretching/tearing damage to a ligament (if ligament fibers torn, assume other fibers are likely to have been torn… muscle/joint capsule/disc annulus)

30
Q

What are the differences btwn grades 1-3 sprains?

A
  1. 0-20%: minimal pain & loss of function, mild point tenderness, little/no swelling, & no abnormal motion when tested (stability of join intact)
  2. 20-75%: moderate pain, loss of function & swelling, moderate joint instability present
  3. 75+%: extremely painful w/a major loss of function, tenderness, swelling, & sever instability (surgical repair is probably indicated)
31
Q

What are 4 causes of sprains w/examples?

A
  1. sudden load (whiplash)
  2. direct blow (later force to knee causing MCL sprain)
  3. repetitive overload (keyboard/typing)
  4. Sustained postural overload (long hrs @ workstation/studying)
32
Q

What are 6 clinical impressions of sprains?

A
  1. decreased active/passive range of motion w/pain (esp. in direction that stretches the ligament/capsule)
  2. isometric muscle contraction causes NO pain
  3. local tenderness & occasionally edema/bruising
  4. may have pain on weight bearing (esp. grade 1/2)
  5. Palpatory defect may be present in more severe sprains
  6. may produce joint instability
33
Q

What are 5 residual/late effects of sprains?

A
  1. fibrosis
  2. subluxation
  3. instability
  4. proprioceptive & coordinating/control problems
  5. atrophy of related muscles
34
Q

What is a strain?

A

acute stretch, tear, or rip in the muscle/tendon

35
Q

What are grades 1-3 of strains?

A
  1. -10%: minimal tearing w/ tenderness & decreased strength (function of muscle is intact but painful)
  2. 10-50%: moderate tearing w/ pain & impaired muscle function (function of muscle is painful & limited)
  3. 50+%: severe tearing w/pain, loss of muscle function & a palpable deformity (surgical repair is probably indicated)
36
Q

What are 4 causes of strains?

A
  1. sudden contraction/stretch
  2. repetitive contraction
  3. sustained postural load
  4. blow to a muscle
37
Q

What are 5 clinical impressions of strains?

A
  1. Isometric muscle contraction = most provocative for pain & weakness
  2. decreased active RoM w/ pain (concentrically/eccentrically)
  3. norm. passive RoM w/o pain until end range in the direction that stretches the muscle/tendon
  4. Local tenderness & occasionally edema
  5. palpatory defect may be present in more severe tears
38
Q

What are 6 residual/late effects of strains?

A

fibrosis, subluxation, MFTPs, proprioceptive & coordination/control probs, atrophy, myositis ossificans

39
Q

What are 6 types of synovial joint injuries?

A

acute synovitis, dislocation, subluxation, separation, intra-articular injury, extra-articular injury

40
Q

What is acute synovitis?

A

inflammation of the synovial membrane

41
Q

What is a dislocation & subluxation?

A

complete & incomplete separation btwn 2 articulating bones

42
Q

What is separation synovial joint injury?

A

increase in joint space btwn articulating surfaces

43
Q

What is an example of 4 intra-articular injuries?

A
  1. osteochondrosis - degenerative changes of bone epiphysis/apophysis
  2. osteochondritis dissecans - avascular degeneration of articular cartilage
  3. apophysitis - inflammation of the tendon-bone junctions
  4. traumatic arthritis - inflammation causing thickness of the synovium of a joint & resulting in creptitis & grating
44
Q

What is an example of 4 extra-articular injuries?

A
  1. bursitis - inflammation of a bursa
  2. capsulitis - inflammation of a joint capsule
  3. paratenonitis - inflammation of the outside of a tendon/ its sheath
  4. tendinosis - degeneration of the collagen matrix of a tendon
45
Q

What are 5 examples of peripheral nerve injury?

A
  1. Burner - irritation & pain from nerve traction/stretching
  2. Neuritis - inflammation of nerve cells
  3. Sciatica - stretch of the sciatic nerve
  4. Carpal Tunnel Syndrome - compression primarily of median nerve
  5. mortons neuroma - tumor of a neuron in the foot
46
Q

What are the 3 stages of nerve injury?

A
  1. Neuropraxia
  2. Axontemesis
  3. Neurotmesis
47
Q

What is the definition of neuropraxia?

A

transient physiological block = caused by ischemia from pressure/stretch of nerve w/no wallerian degeneration

48
Q

What are symptoms of neuropraxia (6)?

A

Pain, none/minimal muscle wasting, muscle weakness, numbness, proprioception affected, recover: minutes-days

49
Q

What is the definition of axontemesis?

A

Internal architecture of the nerve = preserved, but axons are so badly damaged that wallerian degeneration occurs

50
Q

What are symptoms of axontemesis (5)?

A

pain, muscle wasting evident, complete motor/sensory/sympathetic functions lost, sensation = restored before motor function, recover: months

51
Q

What is the definition of neurotmesis?

A

structure of the nerve is destroyed by cutting, severe scarring, or prolonged severe compression

52
Q

What are symptoms of neurotmesis (4)?

A

No pain (anesthesia), muscle wasting, complete motor/sensory/sympathetic functions lost, recover: months & only w/surgery