Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MSK > MSK Injuries - Exam 1 > Flashcards

MSK Injuries - Exam 1 Flashcards

(94 cards)

Start Studying
1
Q

What are the major differences between a strain and a sprain?

A

muscle sTrain is an injury to a muscle or muscle tendon unit

ligament sPrain is trauma to the ligaments that connect bones of a joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where the MC muscle strain sites? What is the MOA?

A

more common in muscles that attach 2 joints

aka think bigger muscles hamstrings, gastrocnemius, biceps and quads

forceful eccentric loading of a muscle

aka forced muscle-tendon unit lengthening during active contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where are the MC ligament sprain injury sites? What is the MOA?

A

ankle, knee and wrist during sports activity

joint in overextended and the ligament is overstretched

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Where are ligament sprain LESS common in children and older adults?

A

because these populations have weaker bones so they are more likely to avulse it or growth plate fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are 9 risk factors for strain and sprains?

A

poor ergonomics

environment

increased age with reduced physical activity

deconditioned/unstretched muscles

specific activities

overuse

body habitus

fatigue

previous injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When does bruising/discoloration usually appear in a strain/sprain?

A

usually takes around 24-48 hours to appear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What will the PE of a muscle strain look like?

A

+/- visible or palpable defect

pain with ACTIVE and PASSIVE FLEXION of the muscle

asymmetric swelling, tenderness and ecchymosis of injured area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What will the PE look like for a ligament sprain?

A

pain with active and passive ROM

joint instability/laxity: more common for higher grade sprains

+ special tests to determine which specific ligament is injuried

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the muscle strain grading scale? What is it based on?

A

Grade 1-4 with 1 being the most normal and grade 4 being the worst

grade scale is based on the number of fibers affected by the injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What does grade 1-4 muscle strain mean in detail?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the scale for ligament sprain grading?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do you dx a strain/sprain? ______ is utilized if high concern for fracture

A

clinical suspicion: labs/imaging are NOT necessary

xray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the indications to get an xray for a strain/sprain?

A

positive “Ottawa Ankle Rule”

worsening pain/swelling with approperiate management

persistent pain/swelling after 7-10 days of appropriate management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the Ottawa ankle rule for ankle sprains?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the ottawa ankle rule for foot sprains?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

_____ is utilized to confirm or grade strain/sprains. When it is indicated?

A

MRI

Suspected rupture or severe sprain
or
Surgical intervention is likely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the broad overview of strains and sprains pathophys?

A

phase 1: hemostasis

phase 2: inflammatory phase

phase 3: proliferative phase

phase 4: maturation phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is happening in phase 1 of strain/sprains pathophys? When does it occur?

A

occurs immediately after the injury!

platelets aggregate and release cytokines, chemokines and hormones

vasoconstriction to limited bleeding to the area

clot formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Why does the skin temporarily blanch in phase 1?

A

Vasoconstriction occurs to limit bleeding into affected area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the associated timing for phase 2 of s/s pathophys? Describe what is happening.

A

immediately after the injury to 72 hours

Bleeding and necrosis of the soft tissue induces an inflammatory cascade

Homeostasis of fluid balance is disrupted resulting in swelling

Capillaries dilate and become more permeable → increase in blood transmission into the extravascular space (bruising) & increase in the concentration of local inflammatory mediators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the associated timing for phase 3? Describe what is happening

A

72 hours to 3 weeks

Granulation tissue is formed

Neovascularization occurs at the injury, supporting tissue healing

Inflammatory mediators are reduced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the associated timing for phase 4 of s/s pathophys? Describe what is happening

A

3 weeks to 2 years

Collagen and myofibers increase in number, strength, and organization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the different phases of s/s management goals? What is the associated timing?

A

hemostasis/inflammatory phase (day 0-3)

reparative phase (day 3- week 3)

maturation phase (week 3- 2 years)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the management goals for s/s depending on the day?

A

hemostasis/inflammatory phase (day 0-3): rest, control pain and ICE*

reparative phase (day 3- week 3): protection, pain control, full AROM, progressive muscular strength, endurance and power

maturation phase (week 3- 2 years): maintenance of ROM and flexibility, strength, endurance, power, speed and agility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the acrononm to help you remember what the tx is for the inflammatory phase of healing?
PRICE Protection, Rest, ICE, Compression, Elevation
26
What is the ice recommendation pt education?** When is it contraindicated?
Apply for 15-20 minutes every 2-3 hours for the first 48 hours Contraindications: Raynaud's, PVD, impaired sensation, cold allergy/hypersensitivity, severe cold induced urticaria
27
______ needs to be avoided in s/s during the first phase
heat
28
When is surgical repair indicated for s/s? When do you need to refer?
Indicated with COMPLETE tear of muscle, tendon or ligament Refer if joint instability, failure of conservative therapy, neurovascular compromise
29
_____ are first line pain management therapy in s/s
NSAIDs
30
What is the MOA behind overuse syndrome?
Repetitive motions, stresses, or sustained exertion of that body part Repetitive microtrauma to the muscle or tendon leading to an acute or chronic degenerative state
31
What are extrinsic factors that cause overuse syndrome?
repetitive mechanical load and equipment problems
32
What are intrinsic factors that cause overuse syndrome?
anatomic factors: Malalignment, inflexibility, muscle weakness, muscle imbalance, decreased vascularity age related factors: Tendon degeneration, decreased healing response, increased tendon stiffness systemic factors: Inflammatory disorders, quinolone-induced tendinopathy
33
How will overuse syndrome present?
Pain, muscle fatigue, numbness, swelling that SLOWLY progressed over time
34
What is the tx for overuse syndrome?
avoid the activity that caused the problem pain management: ice/heat, NSAIDs, injections
35
What are the 2 different layers of the bone anatomy?
periosteum and endosteum Periosteum: thick outer layer that contains vessels, nerve endings and cells that repair fractures endosteum: Inner lining of the marrow cavity
36
What are the 3 sections of bone in kids? Which section contains the growth plate? Which section is most susceptible to compression fracture? provides the most structural support?
diaphysis: provides the most structural support metaphysis: most susceptible to compression fractures epiphysis: contains growth plates
37
What are the 2 sections of bone in an adult?
diaphysis and metaphysis
38
If there is an obvious fracture, what do you need to make sure you do during PE?
ALWAYS inspect bones/joints above and below the injury!
39
What are the different fracture descriptions according to the Gustillo and Anderson classification?
40
Describe the fracture
mid- shaft diaphyseal fracture of the right tibia
41
distal diaphysis of the left radius and distal metaphysis of the left ulna
42
medial aspect of the distal tibial metaphysis and distal 1/3 of the fibular diaphysis
43
define the following fracture directions? transverse oblique spiral
Transverse (Simple) - fx perpendicular to the shaft of the bone Oblique - angulated fracture line Spiral - multiplanar and complex fracture line
44
define the following fracture directions? Comminuted Segmental Avulsed
Comminuted - fx in which there are more than two fracture fragments Segmental - type of comminuted fx in which there are 2 fracture lines isolating a segment of bone Avulsed - a detached bone fragment that results from the excessive pulling of a ligament, tendon, or joint capsule from its point of attachment on a bone
45
What is an intra-articular fracture?
crosses the articular cartilage and enters the joint
46
transverse fracture, mid-shaft diaphysis of the humerus with 100% displacement
47
spiral fracture of the mid-shaft diaphysis of the femur
48
oblique fracture of the diaphysis of the proximal phalanx of the 2nd digit
49
segmental fracture of the tibial diaphysis
50
What is the difference between a nondisplaced and displaced fracture?
Nondisplaced → fragments are in anatomic alignment Displaced → fracture is no longer in anatomic alignment
51
**How do you describe the degree of displacement?
Note severity in mm or % with regard to the direction the DISTAL fragment is offset in relation to the proximal fragment
52
**How do you describe angulation in a fracture?
Described as degree and direction of deviation of the distal fragment
53
What is the difference between bayoneted and distracted?
Bayoneted (Shortened): Distal fragment longitudinally overlaps the proximal fragment in mm/cm distracted: Distal fragment is separated from the proximal fragment by a gap in mm/cm
54
What is rotational deformity? How is it detected?
Degree the distal fragment is twisted on axis of normal bone Usually detected by physical exam
55
100% displaced transverse diaphysis humeral with 30% medial angulation`
56
25% ventral displacement without angulation with shortening
57
femur transverse 100% displacement diaphysis transverse fracture of the mid-shaft diaphysis femur. 100% medial displacement with shortening. No angulation
58
diaphysis radial 100% displacement with 35 medial angulation oblique fracture of the distal 1/3 diaphysis of the radius. 100% lateral displacement with shortening and 30 degree ventral angulation
59
comminuted tibial fracture at the mid-diaphysis. 100% medial displacement and without angulation. Oblique fibular fracture at mid-diaphysis. 100% medial displacement with approx 10 degree medial angulation
60
What is a torus fracture? What is another name for it?
An **incomplete fracture** along the **distal metaphysis** where the bone is most spongy buckle fracture
61
Where is the MC place to have a buckle fracture? What is important to note?
distal radius need to look at multiple views!!
62
What is a greenstick fracture? what is it usually due to?
A fracture that doesn’t extend through the entire periosteum Occurs in the pediatric population due to soft bone
63
When is the salter-harris classification system used?
Used to describe fractures involving the growth plate
64
When does the average females pt's growth plates close? male?
female 12-14 years old male 14-16 years old
65
If you are concerned about a Salter-Harris fracture, what should you do?
need to order xray of the UNAFFECTED side because it can be helpful to detect fractures in skeletally immature children
66
What are the 5 different types of salter- harris classifications? Which one is the MC?
type 2 S: slipped (type I) - some people say “straight across” A: above (type II) - does not affect the joint L: lower (type III) - affects the joint TE: through everything (type IV) R: rammed (type V)
67
What SH classification?
type 1
68
What SH classification?
type 4
69
What SH classification?
type 3
70
What SH classification?
type 2
71
What are the 3 phases of fracture healing?
stage 1: inflammatory phase stage 2: reparative phase stage 3: remodeling phase
72
What is happening in stage 1 of fracture healing?
bleeding from the fx site and surrounding tissue peaks after several days and bioactive cells migrate to fx site hematoma and leads to formation of granulation tissue
73
What is happening in stage 2 of fx healing?
neovascularization promotes healing Necrotic debris is removed by phagocytes and fibroblasts begin to produce **collagen** **Soft callus** is produced first and then *mineralization* begins to occur slowly *converting to woven/immature bone*
74
What is stage 3 of fracture healing? When does it typically occur?
Overlaps with repair phase and can continue for several months Woven (immature) bone is replaced with more mature lamellar bone around 6-10 weeks
75
What are indications for an IMMEDIATE orthopedic consultation?
Open, displaced, unstable or irreducible fractures Fractures complicated by compartment syndrome, nerve, or vascular injury
76
closed fracture management is regulated by what 4 factors?
bone involved type of fracture degree of displacement open vs closed fx
77
what 3 bones are considered more emergent automatically? What is the initial tx?
hip, pelvis and spine bed rest and NON-weight bearing
78
______ if done if the fx is displaced or angulated. What is severe?
reduction will require sx. Open reduction and internal fixation (ORIF) with plates, screws, pins or intramedullary devices
79
What is the tx for an open fx?
EMERGENCY!!! Require irrigation/debridement followed by application of sterile dressing NPO Pain medication IV abx
80
Why is an open fx considered an ortho emergency?
High risk of osteomyelitis, compartment syndrome and neurovascular injury
81
open type I and II fx, what abx?
Type I and II Fracture - 1st gen ceph: Cefazolin (Ancef) 1 g every 6-12h
82
open type III fx, what abx? What do you give if concern for anaerobic infection?
1st gen ceph + Aminoglycoside (gentamicin) add metronidazole
83
what 6 factors make the fx prognosis worse?
Skeletal maturity Fractures of multiple bones in the extremity Intra-articular fractures Marked displacement of fractures Unstable vertebral fractures Comminuted, oblique and segmental fractures
84
What is malunion? What are the typical underlying causes? What is the tx?
Inadequate alignment of a fracture Results from inappropriate reduction, immobilization or surgical error in alignment Osteotomy or bone cuts to restore anatomical alignment
85
What is considered a nonunion? What is the tx?
Lack of healing within 6 months of an injury or No healing progress in 3 consecutive months Surgical fixation, bone graft, electrical/US stimulation
86
What are 6 factors that affect healing?
Smoking indolent infection inadequate immobilization malnutrition NSAID use significant soft tissue injury
87
What are stress fx risk factors?
Prior stress fracture Low level of fitness Increasing volume and intensity of physical activity Female gender, especially when combined with menstrual irregularity Eating disorders (female athlete triad) Diets poor in calcium and vitamin D Poor bone health Poor biomechanics
88
T/F: Stress fractures are easily seen on xray
FALSE!! stress fractures may not appear on xray for several weeks If suspicion is high and diagnosis needs confirmed, proceed with MRI, CT or bone scan
89
What bones involves would be considered a low-risk stress fracture?
Fx of the 2nd-4th metatarsal shafts Posteromedial tibial shaft Fibula Proximal humerus or humeral shaft Ribs, sacrum and pubic rami
90
What bones involved are considered high-risk stress fractures?
Pars interarticularis of lumbar spine Femoral head and neck Patella Anterior cortex of tibia Medial malleolus Talus, tarsal navicular Prox 5th metatarsal shaft, great toes sesamoids, base of second metatarsal bone
91
What are the 4 goals of splinting?
reduce pain, bleeding and swelling around the injury immobilize the injury prevent further damage of muscles, nerves and blood supply prevent further laceration of skin and contamination of an open wound
92
_____ and _____ splints are the preferred splint of choice when a splint is expected to remain in place for more than a few hours
plaster fiberglass
93
When is the optimal timing post injury for cast placement?
once the swelling has resolved, usually 5-7 days
94

MSK (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions