Musculoskeletal Trauma Flashcards
(115 cards)
1
Q
What patients are at highest risk for DVT?
A
Patients with hip fracture or post-hip surgery
2
Q
Three stages of fractures
A
Inflammation, hematoma, growth of granulation tissues around site
3
Q
A break or disruption in the continuity of the bone that affects comfort and mobility
A
Fractures
4
Q
Diagnostic procedure needed to identify soft tissue damage
A
MRI
5
Q
Fracture causes
A
Fragility (osteoporosis, bone cancer), stress (athletes), compression (older adults)
6
Q
Fracture in which bone is broken perpendicular to its length
A
Transverse
7
Q
Fracture that follows a spiral or “corkscrew” pattern
A
Spiral
8
Q
Fracture occurring along the length of the bone
A
Longitudinal
9
Q
Fracture in which the bone shatters into three or more pieces
A
Comminuted
10
Q
Fracture that cuts diagonally across the width of the bone
A
Oblique
11
Q
Fracture in which the ends of the broken bone are impacted together
A
Impacted or Buckle fracture
12
Q
Impacted/Buckle fractures are common in
A
Children’s arm
13
Q
Fracture often seen in children in which the bone is broken, but not all the way through
A
Green stick
14
Q
Fracture characterized by tiny cracks in a bone, caused by repetitive use
A
Stress
15
Q
What kind of bones are commonly affected by stress fractures?
A
Weight-bearing bones such as the legs/feet
16
Q
Fracture caused by blow to the flexed knee and simultaneous forceful pull of the quadriceps muscle
A
Avulsion
17
Q
T or F: Avulsion fractures are common in pediatric athletes and often heal without surgical intervention
A
True
18
Q
Complete fractures occur commonly in
A
Long bones of arms/legs
19
Q
Causes of complete fractures
A
Severe trauma such as MVAs or falls from tall heights
20
Q
S/S of complete fractures
A
Pain, limited movement of fractured bone, surrounding tissue/organ damage, internal bleeding
21
Q
Pulmonary complication of complete fractures
A
Pneumothorax
22
Q
Surgical treatment for complete fractures
A
Open Reduction Internal Fixation (ORIF)
23
Q
Treatment of intracapsular and extracapsular hip fractures
A
ORIF
24
Q
Primary risk factor for hip fracture
A
Osteoporosis
25
Locations of intracapsular hip fractures
Femoral neck and intertrochanteric
26
Intracapsular hip fracture located at the junction of femoral neck and femoral head
Femoral neck
27
Intracapsular hip fracture located between greater and lesser trochanters
Intertrochanteric
28
Locations of extracapsular hip fractures
Subtrochanteric and Trochanteric
29
Extracapsular hip fracture located just below the lesser trochanter, extending down the femur
Subtrochanteric
30
Extracapsular hip fracture involving greater or lesser trochanter
Trochanteric
31
Fracture that occurs in children
Salter-Harris
32
Complications of untreated Salter-Harris fractures
Growth restriction, pain, immobility
33
Salter-Harris fracture through the growth plate without involving the bone
Type I
34
Characteristics of Salter-Harris type I
Least effect on bone growth, good prognosis for healing
35
Salter-Harris fracture through the growth plate and into a portion of the bone
Type II
36
Characteristics of Salter-Harris type II
Most common, good prognosis with careful monitoring
37
Salter-Harris fracture through the growth plate and into portion of the joint surface
Type III
38
Characteristics of Salter-Harris type III
Requires careful evaluation due to risk of joint surface involvement
39
Salter-Harris fracture through the growth plate, the bone, and a portion of the joint surface
Type IV
40
Characteristics of Salter-Harris type IV
Common in children with post-traumatic arthritis, complex, extensive treatment
41
Salter-Harris fracture involving compression injury to the growth plate without a clear fracture line
Type V
42
Characteristics of Salter-Harris type V
Rare, hard to diagnose, most effect on bone growth
43
Three phases of bone healing
Inflammatory, reparative, remodeling
44
Duration of inflammatory phase of bone healing
1-5 days post injury
45
Duration of reparative phase of bone healing
Several weeks
46
Duration of remodeling phase of bone healing
Months to years
47
Bone healing phase that involves blood clot formation, inflammation, and immune cell activity
Inflammatory phase
48
Phase of bone healing characterized by soft and hard callus formation
Reparative phase
49
Soft callus is made of __________
Collagen
50
What structures are responsible for the formation of soft callus in the reparative phase of bone healing?
Fibroblasts and chondroblasts
51
Bone cells that replace soft callus with harder woven bone to strengthen the fracture site during the reparative phase of bone healing
Osteoblasts
52
Phase of bone healing involving modification of newly formed bone, continuing until the bone regains strength
Remodeling phase
53
Key players in remodeling phase of bone healing
Osteoblasts and osteoclasts
54
Function of osteoblasts in the remodeling phase of bone healing
Deposit compact bone in an organized manner
55
Function of osteoclasts in the remodeling phase of bone healing
Removal of excess bone
56
Stage of bone healing in which hematoma forms at injury site
Stage 1
57
Stage of bone healing involving granulation formation at the hematoma and formation of fibrocartilage
Stage 2
58
Stage of bone healing involving callus formation
Stage 3
59
Stage of bone healing where callus is resorbed and transformed into bone
Stage 4
60
Stage of bone healing involving remodeling
Stage 5
61
Nutrition for fractures
High protein (roast beef), vitamin C, vitamin B, high “good” calories (low-fat milk)
62
Most common sites for compartment syndrome
Tibial and forearm fractures
63
Compartment syndrome treatment
Fasciotomy
64
Bleeding into the body cavities or spaces, compressing vital organs
Tamponade
65
Compression of muscles and tissues, often leading to complications
Crush injury
66
Breakdown of muscle tissue, releasing myoglobin into the bloodstream
Rhabdomyolysis
67
Elevated labs in a patient with rhabdomyolysis
BUN and creatinine
68
Fat embolism risk factors
Hip surgery, patients 20-40, elderly
69
Fat embolism supportive therapy
IV fluids, O2, bed rest
70
Increased pressure within a muscle compartment, leading to reduced blood flow and potential nerve damage
Compartment Syndrome
71
Prolonged healing time where the fractured bone takes longer than usual to reunite
Delayed union
72
Failure of the bone ends to grow together, resulting in a persistent gap between them
Non-union
73
Healing of the bone in a misaligned position, leading to deformity or functional impairment
Malunion
74
Blood clot formation in deep veins, often due to immobilization and reduced blood flow
DVT
75
DVT prevention
Compression stocks (SCDs), early mobilization, anticoagulants
76
Migration of a blood clot to the lungs, potentially causing a life-threatening condition
PE
77
Treatment of DVT
Anticoagulants and bed rest
78
Treatment of PE
Pain management (IV morphine), O2, bed rest
79
Diagnostic exam that visualizes and assesses extent and location of fracture
X-Ray
80
Diagnostic exam that provides detailed imaging of complex fractures
CT scans
81
Diagnostic exam that provides detailed images of soft tissues, ligaments, ad blood vessels
MRI
82
Diagnostic exam that identifies areas of increased bone activity
Bone scans
83
CT scans are useful for complex structures such as the
Hip and pelvis
84
Bone reduction involving manipulation of the bone to pop back into place
Closed bone reduction
85
Bone reduction involving surgical opening to fix the bone
Open bone reduction
86
Purpose of traction
Decrease muscle spasms
87
Why is ORIF the preferred method for surgical management of fractures?
Allows for early mobility
88
Preferred method of surgical management for extracapsular hip fractures
ORIF with plates and screws
89
Removal of a part of the body
Amputation
90
Primary cause of amputation of upper extremities
Trauma
91
Complications of amputation
Hemorrhage, infection, phantom limb pain*, neuroma, flexion contracture
92
Amputation nursing care
Place stump cap before prosthetic, elevate stump to relieve swelling, monitor for infection, assess site every shift, ROM to prevent contractures
93
signs of internal organ hemorrhage
Rigid abdomen, tachycardia, hypotension
94
Pelvic fracture assessment finding
Hematuria (urine will be pink)
95
Position for physical exam for patients with fracture(s)
Supine; unless patient has shoulder or upper arm fracture, then seated is best
96
Compartment syndrome risk factor
Patients wearing casts
97
6 P’s of compartment syndrome
Pain, pressure, paralysis, paresthesia, pallor, pulselessness (too late!)
98
Fracture interventions
Immobilization of injury, bandage, splint, orthotic boots
99
Why are splints preferred over casts?
Splints are flexible and allow for swelling
100
Most common type of cast that is lightweight and dries within minutes
Fiberglass
101
Characteristics of plaster cast
24 hr to dry, leave uncovered to dry
102
Characteristics of a wet plaster cast
Feels cold, smells musty, grayish in color
103
Cast window is for patients that have
Wounds
104
Ice packs may be prescribed for the first ___-___ hrs for cast care
24-48
105
Cast care
Inspect every shift (drainage,alignment, fit, hot spots), inspect under skin for irritation, cover with plastic bag to shower if not waterproof
106
Arm cast care
Above heart to decrease swelling
107
Cast removal
Split with vibrating blade, underlying padding cut with bandage scissors
108
Two types of traction
Skin (buck’s) and Skeletal
109
Type of traction that uses Velcro boot or belt secured around affected leg, weighing 5-10 lbs
Skin (Buck’s)
110
Type of traction where screws are inserted into bone involving heavier weights (15-30 lbs)
Skeletal
111
Traction care
Inspect each shift, weights should hang freely (not resting on floor)
112
Older adult risk post ORIF
Delirium, falls
113
Post hip ORIF care
Consider pillows to prevent hip adduction
114
Amputation care
ROM to prevent flexion contractures (hip/knee), prone position q4h if tolerated, trapeze over bed for mobility
115
Complications of skin traction
Edema, vascular obstruction, nerve palsy, skin necrosis over prominences, DVT, PE
