MSK: Trauma Flashcards by Bethany Au

Explain the difference between a sprain and a strain

Sprain: Ligaments: twisted/wrenched
Strain: Tendons stretched

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What are some manifestations of sprains/strains?

How are they diagnosed?

Pain, edema, decreased function, bruising

X-ray: exclusion diagnosis
MRI: best visual

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What is an avulsion fracture?

Ligament pulling loose a fragment of a bone

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Explain dislocation vs. subluxation

Dislocation: complete displacement/separation of joint surfaces

Subluxation: partial/incomplete displacement of joint surfaces

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What are some symptoms of dislocation/subluxations?

Deformity, pain, swelling, loss of function

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What are two possible complications of dislocations/subluxations?

How are dislocations/subluxations diagnosed?

Intraarticular fractures
Avascular necrosis

X-ray or aspiration

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Explain avascular necrosis

Decreased blood supply leads to bone cell death

Develops slowly

Pain= most common symptom

Bones lose structure and become weak

RISKS: trauma, steroids, alcohol, chemo, organ transplants

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Explain RSI and give an example

Repetitive Strain Injury

Carpal Tunnel Syndrome
-compression of median nerve
-Tinel/Phalen signs
-tingling, numb, pain, weak

LATE: atrophy, dysfunction

Prevention is key!

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Explain the two testing signs for carpal tunnel

Tinel: tap median nerve on wrist
-wait for tingling

Phalen: hold backs of hands together for 60 seconds
-wait for tingling/pain

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What kind of things lead to a rotator cuff injury?

Degenerative aging process
repetitive stress
traumatic injury

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How is a rotator cuff injury diagnosed? What are some manifestations?

Shoulder weakness, pain, decreased ROM, pain w/ abduction

Positive drop arm test:
-T-pose, slowly adduct arms
-injured cuff will drop arm

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How are rotator cuff injuries treated?

Rest, ice heat, NSAIDS, steroids, PT, surgery

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What are common causes of menisci injuries?

Sports injuries
-rotational stress, blow to knee, squatting/kneeling

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How do menisci injuries manifest? How are the diagnosed?

Tender, pain, effusion, clicking/popping, locking up/giving way

MRI

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What causes ACL injuries? What is a common manifestion?

Diagnosis?

Pivoting, landing from jump, stopping abruptly

hears a “pop” in knee w/ severe pain
-usually unable to walk: knee unstable!

MRI diagnosis

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Explain bursitis

Inflammed bursae from repeated/excessive trauma, friction, gout, RA, infection

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What is a pathologic fracture?

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Non-trauma related, or very little trauma

Weakened bones break spontaneously or easily

What is the #1 manifestation of a fracture?

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Acute pain

How is fracture pain different from sprain/strain pain?

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Fracture: point tenderness
-one specific spot hurts when touched

Sprain/Strain: general pain w/ a specific movement

Explain closed fracture reduction

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Nonsurgical, MANUAL realignment of bone fragments
-local or general anesthetics
-immobilize after

Explain open fracture reduction

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Surgical incision and fixation
-pins/rods
-Reduced immobility risks
-usually no cast after
-infection risk

What kind of fractures would indicate a tetanus shot?

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Open fractures

Explain:
Fracture Hematoma

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Fracture healing stage 1

-blood clot forms

Explain: Granulation Tissue

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Fracture healing stage 2

-phagocytosis of area
-hematoma converted into granulation tissue
-forms basis for new bone substance

Explain: Callus Formation

Fracture healing stage 3 -Minerals + matrix deposited -Callus formed around frature, visible on x-ray -osteoblasts, angiogenesis, fibroblasts

Explain: Ossification

Fracture healing stage 4 -callus ossifies -prevents movement at stress site -cast can be removed, implement weight/lifting restrictions

Explain: Consolidation

Fracture healing stage 5 -Distance between bone fragments decreases and eventually closes -may take up to 1 year

Explain: Remodeling

Fracture healing stage 6 Excess bone tissue is resorbed by osteoclasts Union is complete, accomplished by physical load/stress stimulating deposition in stressed areas

What 2 complications of fractures require immediate intervention?

Severe blood loss -pelvic/rib fractures Adjacent vital organ damage

What 3 fracture complications are direct?

Bone infection nonunion/malunion avascular necrosis

Explain compartment syndrome

high priority fracture complication Swelling/increased pressure inside non-stretching fascia OR decreased compartment size---compromises neurovascular function---ischemia

What is compartment syndrome associated with?

Fractures w/ extensive tissue damage and crush injury

What is the immediate NEED when treating compartment syndrome?

Relieve pressure! -fasciotomy

How does compartment syndrome pain manifest?

Pain out of proportion to injury -opioids don't help -passive stretch (nonpainful movements) cause pain

Other than pain, what are manifestations of compartment syndrome? (5 more P's)

Pressure Paresthesia: feels cool (poikilothermia) Pallor Paralysis Pulseless

Explain fat embolisms

Rare complication of fractures -10% mortality -Fat globules within bone travel to circulation -Delayed onset- 24-48 hrs post injury -impairs perfusion -Dyspnea, chest pain, confusion -petechial rash on chest, neck, axilla

Explain rhabdomyolysis

Damaged skel. muscle releases myoglobin- gets stuck in nephron, obstructs renal tubules -Acute Tubular Necrosis -dark to reddish brown urine

What can immobility from a fracture lead to?

VTE, PE, DVT

What is a colles' fracture?

Distal radius fracture

Explain pelvic fractures

High mortality rate- high bleed risk from lacerated/injured abdominal organs

Explain hip fractures -where? -mortality rate? -manifestations?

upper 1/3 of femure 37%- very high-within 1 year External rotation/shortening of leg, muscle spasms, severe pain

What complication is possible w hip fractures?

May disrupt blood supply to femoral head- avascular necrosis

MSK: Trauma Flashcards

(42 cards)