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Human Conditions I OTD7160 > Week 9 Terms: UE Orthopedics, Burns, and Wound Healing > Flashcards

Week 9 Terms: UE Orthopedics, Burns, and Wound Healing Flashcards

1
Q

Codman’s Pendulum Exercises

A

Therapeutic exercise for the shoulder joint in which the client bends forward at the waist with the arm perpendicular to the floor, then rocks the body side-to-side allowing the relaxed arm to freely move in a clockwise and counterclockwise direction

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2
Q

Controlled Range of Motion

A

active or passive movement within a predetermined safe arc. (middle of range gradually upgraded toward the full arc as healing occurs)

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3
Q

Scapular Plane

A

Midpoint between shoulder flexion and abduction; majority of functional activities occur in this plane

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4
Q

Shoulder Immobilizer

A

An orthopedic appliance that maintains the arm against the body in a slightly abducted and internally rotated position

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5
Q

Trendeleburg Gait

A

ambulation pattern that results from weakened gluteus medius; client lurches toward the injured side to place center of gravity over the hip; characterized by dropping of the pelvis on the unaffected side at heel strike of the affected foot.

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6
Q

Volkmann’s Ischemia

A

deformity of the hand, fingers, and wrist caused by injury to the muscles of the forearm

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7
Q

ORIF

A

Open Reduction Internal Fixation

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8
Q

Colle’s Fracture

A

complete fracture of the distal radius at the wrist with dorsal displacement

Cole waves at you

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9
Q

Smith’s Fracture

A

complete fracture of the distal radius with palmar displacement

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10
Q

Barton’s Fracture

A

Fracture of the lip of the distal radius

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11
Q

Impingement

A

compression of soft tissue between the ends of two or more bones

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12
Q

Subluxation

A

the partial displacement of a bone from its joint

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13
Q

Finkelstein’s Test

A

If positive, Indicates de Quervain’s tenosynovitis. Grasp the thumb against the palm and then move the wrist toward the midline in the ulnar deviation

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14
Q

Brachial Plexus

A

network of interlacing nerves found in the upper arm area

Originating from C5-T1
Forearm & Hand Nerves; Median, Ulnar, Radial

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15
Q

Shoulder Distocia

A

delayed or difficult birth of the fetal shoulders after the head is born

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16
Q

Waiter’s Tip

A
  • lateral rotators of the shoulder, arm flexors & hand extensor muscles
  • arm hanging by the side, rotated medially
  • forearm extended and pronated
  • wrist flexed

Erb’s Palsy

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17
Q

Claw Deformity

A

Position of MP hyperextension and PIP flexion associated with muscle imbalance in ulnar-innervated structures.

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18
Q

Wartenberg’s Sign

A

fifth finger held abducted from the fourth finger

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19
Q

Froment’s Sign

A

flexion of the IP of the thumb when a lateral pinch is attempted

Think Ok sign with fingers

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20
Q

Crutch Palsy

A

weakening of forearm, wrist, and hand muscles because of nerve impairment in the axilla caused by incorrectly fitted crutches or poor posture

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21
Q

Swan Neck Deformity

A

hyperextension of PIP joint and flexion of DIP joint

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22
Q

Boutonniere Deformity

A

flexion of PIP joint and hyperextension of DIP joint

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23
Q

Dupytren’s Contracture

A

A gradual thickening and tightening of the fibrous tissue layer (palmar fascia) under the skin in the hand
Restricts tendons from gliding through the sheath

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24
Q

Thermal Burns

A

caused by contact with open flames, hot liquids or surfaces, or other sources of high heat

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25
**Chemical Burns**
Damage caused to the skin by chemicals
26
**Radiation Burns**
redness and blistering on the surface of the skin or other organs caused by intense exposure to ionizing radiation
27
**Electricity Burns**
Burns caused by alternating
28
**Light Burns**
burns caused by infrared rays, eclipse light, and laser burns
29
**Frictrion Burn**
resulting from harsh rubbing of the skin
30
**Superficial Burn**
a burn that involves only the epidermis, the outer layer of the skin; also called a first-degree burn.
31
**Superficial Partial Thickness Burn**
Involves the epidermis and the upper portion of the dermis
32
**Deep Partial Thickness Burn**
extends into the skin dermis; 2nd degree
33
**Full Thickness Burn**
a burn in which all the layers of the skin are damaged; also called a third (or fourth) degree burn.
34
**Hypermetabolism**
A higher-than-normal metabolic rate
35
**Escharotomy**
Escar is removed and skin grafts or artificial skins are placed
36
**Fasciotomy**
A surgical incision through the fascia to relieve tension or pressure
37
**Pruitus**
Severe itching
38
**Microstomia**
Abnormally small mouth
39
**Tendinopathy**
Tendons are not well vascularized = easily damaged
40
**Biomechanical Deficits of Tendinopathy** | Symptoms
Muscle Weakness Decreased ROM Scar Tissue Pain w/ AROM, Resistance, Passive Stretch
41
**Tendonitis**
Inflammation Microtears in tendon Sudden or Heavy Force | Less common than tendinosis; Often wrongly identified
42
**About how long does it take to heal tendonitis?** A. 4 weeks B. 5 weeks C. 6 weeks D. 7 weeks
C. 6 weeks
43
**Tendinosis**
NO inflammatory response Degenerative Changes Overuse Collagen needs nourished Pain can be severe Significant impact on function
44
**About how long does it take to heal tendinosis?** A. 10 weeks to 10 months B. 8 weeks to 8 months C. 6 weeks to 6 months D. 4 weeks to 4 months?
C. 6 weeks to 6 months
45
**Lateral Epicondylitis** | Tennis Elbow
involves the extrinsic extensors of the hand at their origin | Extensor Carp Radialis Brevis is most commonly involved
46
**There is pain in wrist BLANK with lateral epicondylitis (tennis elbow).**
There is pain in wrist **extension** with lateral epicondylitis (tennis elbow).
47
**Medial Epicondylitis** | Golfer's Elbow
involves the extrinsic flexors at their orgin on the volaar aspect of the medial elbow | Flexor Carpi Radialis most commonly involved
48
**There is pain in wrist BLANK & BLANK with medial epicondylitis (golfer's elbow).**
There is pain in wrist **Flexion** & **Supination** with medial epicondylitis (golfer's elbow).
49
**Treatment for Lateral and Medial Epicondylitis**
Rest Ice Therapy NSAIDs Ergonomics Cortisone Injection Occasionally Surgery
50
**Symptoms of DeQuervain's Tenosynovitis**
Pain and swelling along radial side of wrist with gross grasping
51
**Causes of Erb's Palsy** | Common Brachial Plexus Injury
Excessive stretching/tear upper trunk of BP Shoulder dystocia during childbirth Waiter’s Tip deformity * lateral rotators of the shoulder, arm flexors & hand extensor muscles * arm hanging by the side, rotated medially * forearm extended and pronated * wrist flexed Loss of sensation in the lateral aspect of the forearm
52
**Symptoms of Thoracic Outlet Syndrome**
Shoulder & neck pain Neck muscle spasms Numbness in fingers Weak grip
53
**Causes of Thoracic Outlet Syndrome**
Trauma Poor posture Repetitive injuries esp. above shoulder activity Anatomical defects (extra rib)
54
**Cubital Tunnel Syndrome**
Second most common UE nerve entrapment Ulnar Nerve Compression
55
**Symptoms of Cubital Tunnel Syndrome**
Forearm pain Tingling/pins and needles Decreased sensation small & ring fingers Grip & pinch strength decreased
56
**Common Presentations of Cubital Tunnel Syndrome**
Claw Hand Wartenberg Sign Froment's Sign
57
**Radial Nerve Palsy can be caused by...**
Compression Ischemia (loss of blood flow) Fractures Wounds
58
**Lesion above the elbow results in...** A. Complete Wrist Drop B. Sensory Loss C. Infraspinatus Impingement D. Both A and B E. Both B and C
**D. Both A and B** Lesion above the elbow results in complete wrist drop & sensory loss
59
**Posterior Interosseous Nerve Syndrome (PINS)**
Entrapment at supinator muscle Below Elbow | Purely Motor
60
**Posterior Interosseous Nerve Syndrome (PINS) is caused by...**
Tumors RA Fractures Dislocations
61
**Treatment of PINS**
Maintaining PROM Splinting to prevent deformity & promote function Surgical decompression, if necessary
62
**True/False** The median nerve provides sensation to radial palm.
**True**
63
**True/False** The carpal tunnel does not protect the median nerve.
**False** The carpal tunnel *does* protect the median nerve.
64
**Carpal Tunnel Syndrome**
Compression of the median nerve under the flexor retinaculum | Caused by swollen or thickened tendons
65
**Symptoms of Carpal Tunnel Syndrome**
Pain Numbness Tingling in median nerve distribution Weak thumb flexion and abduction
66
**Treatments for Carpal Tunnel Syndrome**
Night Splinting Steroid Injection Therapy Surgery if needed
67
**Risk factors for Carpal Tunnel Syndrome** | Not Necessarily Causes
Genetics more common in people with small wrists Females > males Diabetes, rheumatoid arthritis, thyroid disorders Obesity Fluid retention as in pregnancy (usually goes away after baby born) Working with tools that vibrate Frequent or prolonged wrist flexion
68
**Extensor Hood**
Where finger extensors connect (Extensor digitorum, lumbricals, interossei) *Extensor digitorum can only extend MP joint by itself Intrinsics extend the PIPs and DIPs but cannot extend MP joint **Both** are needed for full extension of the finger*
69
**Symptoms of a Scaphoid Fracture**
Tender on palpation at anatomical snuff box Pain may increase with pinch/grip | FOOSH
70
**Symptoms of a Scaphoid Fracture**
Tender on palpation at anatomical snuff box Pain may increase with pinch/grip | Potential Radial Nerve Compression
71
**Treatment of Scaphoid Fracture**
Extended immobilization Surgery Therapy to restone decreased ROM and oss of ADL function of the hand
72
**Complex Regional Pain Syndrom (CRPS)** | Also known as Reflex Sympathetic Dystrophy
Pain is disproportionate to injury There are three different types | Any upper extremity injury has the potential to result in CRPS
73
**Complex Regional Pain Syndrome (CRPS) Symptoms** | STAMP
**S**ensory; allodynia, hypo-/hyperalgesia, hypo-/hyperesthesia **T**rophic; skin, hair, nail changes **A**utonomic; swelling, edema, sweating **M**otor; weakness, contractures, atrophy **P**ain
74
**Causes of Compartment Syndrome**
Bone fracture/crush injury Serious bruising Constricting bandages/cast Return of blood flow following blockage
75
**Treatment of Compartment Syndrome**
Anti-Inflammatory Movement Surgery
76
**What happens with compartment syndrome?**
Swelling and bleeding can occur in a compartment and can cause increased pressure on nerves and blood vessels
77
**Types of Burns** | Causes
Thermal Chemical Radiation Electricity Light Friction
78
**Classification of Burns** | Severity
Level of cellular injury: Superficial Superficial Partial-Thickness Deep Partial-Thickness Full-Thickness
79
**Superficial Burn** | Burn Classification
Only the epidermis affected Heal in 7 days No scar
80
**Superficical Partial** | Burn Classification
Epidermis and paprt of the dermis affected Blister Formation Heal in 7-12 days
81
**Deep Partial-Thickness** | Burn Classification
Epidermis & into dermis affected White blotches – damaged blood vessels Often grafted to promote healing Light touch impaired
82
**Full-Thickness** | Burn Classification
Destruction of all skin layers Waxy/white - adipose tissue visible No sensation – nerve damage Must be grafted
83
**Assessment of Burn Area** | Rule of Nines
## Footnote Major burn is defined as a burn covering 25% or more of total body surface area
84
**Why would it be important to know total body surface area that is burned?**
Calculating nutritional & fluid requirements Determining level of acuity Establishing level of medical treatment needed Classifying patients for use of standardized protocols
85
**What are the secondary effects of burn injury?** | Local and Systemic
Dehydration and edema Respiratory problems Increased metabolic needs *(while body is trying to heal)* Shock Pain Infection
86
**What is a major factor in recovery for burns?** A. Edema B. Pain C. Shock D. Infection
B. Pain
87
**What are some some interventions that can exacerbate pain in someone with a burn injury?**
Dressing changes Debridement ROM
88
**What does an infected burn look like?**
Purulent Exudate (pus) Blue-Green Color | *It will be cultured to determine which microbe*
89
**Emergent Phase** | Burns
* Immediate: Emergency treatment - 72 hours clean & cover to prevent infection inhalation injury edema develops inside airways may require intubation * Medically induced coma facilitate healing spare pain * Surgeries
90
**Escharotomy**
scar is removed & skin grafts or artificial skins placed graft site – now like a burn since skin has been removed *sometimes happens a couple times* | Surgery for severe or extensive burns
91
**Fasciotomy**
cutting facia to reduce constriction caused by edema | Surgery for severe or extensive burns
92
**Skin Grafts** | Burns
* Skin is taken from person’s own body * Cadaver or pig skin may be used temporarily * Person’s own skin cultured in lab for later use * Grafted skin may be meshed to stretched over larger area * Biosynthetic “skin” products developing faster healing, fewer surgeries, less scarring, less infection
93
**Rehabilitation Phase** | Burns
* Wound closure through scar maturation * May be 6 months to 2 years * Medical treatment *pressure garments reconstructive surgeries* * Therapy *Scar management (measure & fit pressure garments) Contracture prevention Patient and family education*
94
**Potential Complications** | Burns
* Pruritus (itching) * Microstomia *(shrinkage of mouth opening)* * Heterotopic ossification *(bone formation where bone doesn't belong)* * Heat intolerance *Unable to sweat with split-thickness skin grafts May sweat a lot in unaffected areas Vulnerable to overheating. *

Human Conditions I OTD7160 (14 decks)

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