Musculoskeletal Pathophysiology

Question 1

What is a wound?

Answer 1

An injury to living tissue caused by a cut, blow, or other impact, typically one in which the skin is cut or broken

Question 2

What is a fracture?

Answer 2

The cracking or breaking in the continuity of the bone

Question 3

What is a sprain?

Answer 3

A wrench or twist of the ligaments of the ankle, wrist or other joint, violently so as to cause pain and swelling but not dislocation

Question 4

What is a strain?

Answer 4

A strain is a force tending to pull or stretch something to an extreme or damaging degree

Question 5

What is trauma?

Answer 5

It is a deeply distressing or disturbing experience.

Question 6

What are some examples of trauma?

Answer 6

Road Traffic Collision (RTC)
Factory accidents
Building site accidents
Animal related accidents

Question 7

How are injuries caused?

Answer 7

Transfer of energy

Question 8

What percentage of people are likely to later display severe injuries after a trauma incident?

Answer 8

5-15%

Question 9

What is key with energy?

Answer 9

Energy is neither created nor destroyed, it only changes in form

Question 10

What determines the amount of energy exchange that takes place during trauma incident?

Answer 10

The number of body tissue particles that are impacted by the solid object

Question 11

How is the number of tissues particles affected determined by?

Answer 11

The density of the tissue

Air (lung)
Water (muscle and organs)
Solid (bones)

Question 12

What are the five types of fractures?

Answer 12

Greenstick
Spiral
Comminuted
Transverse
Compound

Question 13

What is a greenstick fracture?

Answer 13

Not completely broken bone

Question 14

What is a spiral fracture?

Answer 14

A break that is twisted

Question 15

What is a comminuted fracture?

Answer 15

Crushed bone

Question 16

What is a transverse fracture?

Answer 16

A straight break in the bone

Question 17

What is a compound fracture?

Answer 17

A protruding break in the bone piercing through the skin

Question 18

What is a dislocation?

Answer 18

An abnormal separation of the joint surfaces

Question 19

What is a partial dislocation also known as?

Answer 19

Subluxation

Question 20

What can a dislocation also be accompanied by?

Answer 20

Fracture

Question 21

What is soft tissue injuries?

Answer 21

Damage to muscle, ligament and tendons as a result of an injury that does not result in either a fracture or dislocation

Question 22

What does DCAP-BTLS-IC stand for?

Answer 22

Deformity
Contusions (bruising)
Abrasions (graze)
Penetrations

Burns
Tenderness
Lacerations (deep tear or cut in skin or flesh)
Swelling

Instability
Crepitus (grating sound caused by friction between bone and cartilage or fractured part of bone)

Question 23

What are the eight types of femur fractures?

Answer 23

Closed

Open

Transverse (still intact but broken laterally)

Spiral

Comminuted (crushed)

Impacted (bone break due to upward force)

Greenstick (slight break)

Oblique (break apart but not piercing - still in line)

Question 24

Neck of femur fractures are common in…

Answer 24

Elderly

Question 25

What does an unstable fracture of the pelvis increase the risk of?

Answer 25

High risk of blood loss

Question 26

What is the main cause of spinal cord injuries?

Answer 26

Falls

Question 27

What is the most common mechanisms of spinal injuries?

Answer 27

Axial stress Axial loading Compression between T12 and L2 Distraction Combination of distraction/rotation or compression/flexion

Question 28

What is a hyperflexion injury?

Answer 28

Movement of the flexor muscle beyond its normal limit

Question 29

What is a compression injury?

Answer 29

It is a type of crushing injury

Question 30

What is a hyperextension injury?

Answer 30

The movement or extension of joints, tendons or muscles beyond the normal limit or range of motion

Question 31

What may cause a spinal column injury? (4)

Answer 31

Movement of vertebrae from normal position Subluxation or dislocation Fractures Ruptured intervertebral discs

Question 32

What are the three main fractures that can occur in the spinal column? And what are the different properties?

Answer 32

Spinous process and transverse process (where back muscles and ligaments attach) Pedicle and laminae (pedicle is a stub of bone that connects the lamina to the vertebral body to form the vertebral arch) Vertebral body (thick oval segment of bone forming front of vertebra aka centrum)

Question 33

What are two main causes of lacerations in the spinal cord?

Answer 33

Bony fragments driven into the vertebral foramen (centre whole of spine) Cord may be stretched to point of tearing

Question 34

What indicates a haemorrhage in the spinal cord?

Answer 34

Swelling and disruption of impulses

Question 35

When would a haemorrhage be suspected? (3)

Answer 35

Associated with contusion, laceration or stretching

Question 36

What is considered primary cord injury?

Answer 36

Cord is cut, torn, crushed, or loses blood supply Damage is immediate and irreversible

Question 37

What is considered secondary cord injury?

Answer 37

Hypoxia, swelling, hypotension, compression from bleeding or swelling around the cord Develops after primary cord injury Good patient care will limit secondary injury

Question 38

What are the general signs and symptoms of spinal cord injuries?

Answer 38

Paralysis Pain with and without movement Tenderness along spine Impaired breathing Spinal deformity Priapism (condition where penis remains erect for hours in absence of stimulation or after stimulation has ended) Posturing Loss of bowel or bladder control Nerve impairment to extremities

Question 39

What are the two types of haemorrhage?

Answer 39

Internal and external

Question 40

What are some symptoms of internal bleeding?

Answer 40

Dizziness Severe weakness Passing out Low BP Acute visual problems Numbness Weakness on one side of the body Severe headache Severe abdo pain Shortness of breath Chest pain Nausea Vomiting Diarrhoea

Question 41

What are some symptoms of shock?

Answer 41

Rapid heart rate Low BP Sweaty skin Changes in overall alertness, including increase in sleepiness Overall weakness

Question 42

What can be some general causes of internal bleeding?

Answer 42

Damage to blood vessels (minor tears with an injury) Lack of clotting factors Certain medications (e.g. blood thinners) Chronic high BP Inherited bleeding disorder (e.g.haemophilia) Gastrointestinal causes Lifestyle factors Trauma Aneurysms Broken bones Ectopic pregnancy Surgery

Question 43

What are the three types of external bleeding?

Answer 43

Capillary bleeding Venous bleeding Arterial bleeding