Ortho Overview Part 1 (Steiner) Flashcards Preview

Clin Med II MHM - FINAL > Ortho Overview Part 1 (Steiner) > Flashcards

Flashcards in Ortho Overview Part 1 (Steiner) Deck (53):
1

What does orthopaedics literally mean?

Straight child

2

Orthopedics is the medical discipline devoted to which system?

Musculoskeletal

3

Functions of MSK system

Support, protection, movement

4

Function of bone

Provides support

5

Function of cartilage

Provides smooth surface for articulating bones

6

Function of intervertebral disks

Sustains and distributes load

7

Function of muscles

Contract to create movement

8

What do tendons connect?

Muscle to bone

9

What do ligaments connect?

2 bones
*Defines the motion of the joint

10

Is bone tissue dynamic or static?

Dynamic - osteoblasts make new bone and osteoclasts remove necrotic bone

11

2 types of bone

-Cortical (less porous, denser outer portion)
-Cancellous (more porous, trabecular, surrounded by cortical bone)

12

Strength and stiffness of bone is generally in which direction?

In the direction of load application

13

Which bones deal with longitudinal stresses best?

Long bones

14

Long bones deal with which stresses best?

Longitudinal stresses

15

How do fractures generally occur?

1. Single momentary load exceeds the tolerance of that bone (usually from trauma)
2. Repeated loading (stress)

16

When do stress fractures occur?

Repeated loading where rate of damage exceeds rate of repair

17

5 stages of fracture healing

1. Impact
2. Inflammation (hematoma formation)
3. Soft callus formation
4. Hard callus formation
5. Remodeling

18

How does a hematoma progress at fracture site?

-Granulation tissue replaces hematoma
-Fibroblasts make collagen
-Osteoclasts remove necrotic bone

19

When does a fracture appear clinically healed?

When soft callus becomes hard callus

20

What procedure is performed when a fracture requires surgical intervention?

ORIF (open reduction and internal fixation)

21

ORIF vs. conservative tx of fractures

ORIF heal more quickly but are more at risk for infection, complications of anesthesia or surgery

22

Which type of hardware placed for fractures is better tolerated?

Deeper hardware

23

Are plates or rods better tolerated by pts?

Rods

24

What happens when a fracture fails to heal properly?

Non-union or malunion

25

Describe non-union of fracture

-When fragments fail to unite and heal
-If healing has not occurred w/in 6 months, it is called a "delayed union"
-Beyond 6 months it is considered a non-union

26

When can non-unions occur?

-Poor blood supply (elderly)
-Poor nutritional status
-Inadequate immobilization
-Soft tissue interposed b/w fragments
-Presence of infection or dead bone (sequestrum)

27

What is a sequestrum?

Piece of dead bone

28

Treatment of non-union

-Initially, stimulate normal osteogenic mechanisms
-Functional bracing combined w/wt bearing
-Use of implantable rods or compression plates
-Electrically w/bone stimulators
-Chemically w/autogenous bone transplants

29

How does bone respond to stress?

Becomes more dense

30

What is the most technologically advanced means of treating a non-union fracture?

Ilizarov method
-Application of an external fixator

31

Bony regeneration with the Ilizarov method occurs at what rate?

1 mm per day

32

Describe malunion of fracture

Healing has occurred but with an unacceptable degree of angulation, rotation, or shortening

33

Which type of fractures are more likely to be a/w nerve transections?

Open fractures

34

Which types of fractures are MC at risk of infection?

-Open
-Those treated surgically

35

What predisposes female athletes to osteopenia?

Amenorrhea

36

What may x-rays show with stress fractures?

Subtle cortical disruption or evidence of prior bone healing

37

What imaging is usually more helpful for stress fractures?

Bone scan

38

Treatment of stress fractures

-Rest
-Splints
-In some cases, casting
*Best thing is prevention

39

What can help amenorrheic women reduce the risk of osteopenia?

OCPs

40

Untreated stress fractures may evolve into:

Complete fracture

41

Definition and function of joints

-Articulation where 2 bones meet
-Allow movement of 1 bone on another

42

Types of joints

1. Cartilaginous (minimal movement)
2. Fibrous (immovable)
3. Synovial (freely moveable)

43

Examples of cartilaginous joints

-Symphysis pubis
-Vertebral bodies
-AC joint
-Sternoclavicular joint

44

Examples of fibrous joints

Skull sutures

45

Examples of synovial joint

-Hip, shoulder (ball & socket)
-Fingers, elbow (hinge)
-Knee, TMJ (condylar)

46

Examples of ball & socket synovial joints

Hip, shoulder

47

Examples of hinge synovial joints

Fingers, elbow

48

Examples of condylar synovial joints

Knee, TMJ

49

Describe articular cartilage

-Avascular tissue composed of chondrocytes and an organic matrix
-Found at ends of bones (joint)
-One dimensional

50

Osteoarthritis occurs from:

Wearing down of articular cartilage and subsequent exposure of underlying bone

51

Why does articular cartilage have little capacity to repair itself?

Chondrocytes have a low rate of metabolism

52

How does the body attempt to repair articular cartilage?

-With new hyaline cartilage
-This results in fibrocartilage (not ideal for joint surfaces)

53

When is there NO capacity for repair to cartilage defects?

If they extend through entire thickness to the calcified plate at the bony junction