Trauma and Trauma Systems > extremity trauma > Flashcards

extremity trauma Flashcards

(51 cards)

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1
Q

introduction to musculoskeletal injuries

A

-Millions of Americans experience annually
-Multiple MOI:
– Falls, crashes, violence, etc.
– Multi-system trauma

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2
Q

skeletal tissue and structure

A
  • give the body its structural form
  • protect vital organs
  • promote efficient movement despite the forces of gravity
  • store salts and other materials needed for metabolism
  • produce RBCs
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3
Q

bone structures

A
  • diaphysis
  • epiphysis- end of a long bone
  • metaphysis
  • medullary canal
  • periosteum
  • cartilage
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4
Q

epiphysis

A

-end of long bone

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5
Q

metaphysis

A
  • between epiphysis and diaphysis

- growth plate

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6
Q

medullary canal

A

-contains bone marrow

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7
Q

periosteum

A

-fibrous covering of diaphysis

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8
Q

cartilage

A

-connective tissue that provides a smooth articulation surface for other bones

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9
Q

joint types

A
  • ball and socket joint
  • condyloid joint
  • gliding joint
  • hinge joint
  • pivot joint
  • saddle joint
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10
Q

joint structure

A
  • tendon
  • bone
  • bursa
  • synovial membrane
  • articular cartilage
  • joint cavity
  • joint capsule
  • bone
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11
Q

skeletal organization

A
  • 206 bones
  • axial skeleton- head, thorax, and spine
  • appendicula skeleton- upper and lower extremities
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12
Q

bone aging

A
  • birth to adult (18-20)- transition from flexible to firm bone
  • adult to elderly (40+):
  • reduction in collagen matrix and calcium salts diminution of bone strength
  • spinal curvature
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13
Q

types of muscle

A
  • smooth
  • striated
  • cardiac
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14
Q

muscular tissue and structure

A

-600 muscle groups

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15
Q

pathophysiology of the musculoskeletal system

A
  • muscular injury
  • contusion
  • compartment syndrome
  • penetrating injury
  • fatigue
  • muscle cramp muscle spasm
  • strain
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16
Q

joint injury

A
  • sprain
  • subluxation
  • dislocation
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17
Q

bone injury

A
  • open fracture
  • closed fracture
  • hairline fracture
  • impacted fracture
  • transverse
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18
Q

pediatric considerations

A

-flexible nature

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19
Q

geriatric considerations

A

-osteoporosis

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20
Q

pathological fractures

A

-pathological diseases

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21
Q

general considerations with musculoskeletal injuries

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A
  • neurological compromise
  • decrease stability
  • muscle spams
22
Q

bone repair cycle

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A
  • osteocytes produce osteoblasts
  • deposition of salts
  • increasing strength of matrix
23
Q

inflammatory and degenerative conditions

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A
  • bursitis
  • tendonitis
  • arthritis:
  • osteoarthritis- degenerative
  • rheumatoid arthritis- chronic, systemic, progressive, debilitating
  • gout- inflammation of joints produced by accumulation of uric acid crystals
24
Q

arthritis

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A
  • osteoarthritis- degenerative
  • rheumatoid arthritis- chronic, systemic, progressive, debilitating
  • gout- inflammation of joints produced by accumulation of uric acid crystals
25
scene size up
- clues to specific injuries - pelvic fractures or bilateral femur fractures are "load and go" - control major bleeding - history may suggest other injuries
26
initial assessment
- categories of urgency: - life and limb threatening injury - life threatening injury and minor musculoskeletal injury - non life threatening injuries but serious musculoskeletal injuries - non life threatening injuries and only isolated minor musculoskeletal injuries
27
musculoskeletal injury assessment
- rapid trauma assessment -only press on pelvis if no clinical signs of injury are present such as pain - focused H&P- 6 Ps: pain, pallor, paralysis, paresthesia, pressure, pulses - detailed physical exam - ongoing assessment - sports injury considerations
28
detailed exam of extremities
- deformity - contusions - abrasions - penetrations - burns - tenderness - lacerations - swelling - also check PMS*
29
general principles of musculoskeletal injury management
- protecting open wounds - positioning the limb - immobilizing the injury - checking neurovascular function - pulse- palpate and utilize pulse oximetry - motor - sensation
30
splinting devices
- rigid splints - formable splints- vacuum splints, air splints - soft splints - traction splints - other splinting aids- cravats or velcro splints
31
musculoskeletal injury management
- splinting devices - fracture care - joint care - muscular and connective tissue care
32
fracture management: pelvis
- scoop stretcher - pelvic sling device - fluid resuscitation
33
femur fracture management
- traction splints- contraindicated in hip/knee injuries - high force injury - high potential for shock
34
tibia fibula fracture management
- frequently open fractures - cove bone ends with moist dressing - depending on level of fracture, use: - rigid splint - air splint - pillow
35
clavicle fracture management
- most frequently fractured bone in the body - transmitted to 1st and 2nd rib - alert lung injury
36
care for specific joint injuries
- hip - knee - ankle - foot - shoulder - elbow - wrist/hand - finger - be alert for neurological compromise
37
hip fractures
- common in the elderly - may be able to support weight- ability to walk does not rule out fracture - leg often externally rotated - may refer pain to the knee - use other leg for splint - use vacuum mattress if available
38
hip dislocation
- orthopedic emergency - posterior dislocation most common - hip flexed and leg rotated internally - severe pain on attempts to straighten
39
hip dislocation management
- splint in most comfortable position - document sensation and pulse - prompt transport - be alert for associated knee injuries or fractures
40
knee fracture or dislocation
- orthopedic emergency - frequently causes vascular injury - dislocation associated with 50% rate of amputation of leg
41
knee fracture or dislocation management
- obvious dislocation without distal pulse -> apply gentle traction along the long axis of the joint - if gentle traction does not restore the pulse -> splint in place - prompt transport
42
foot or hand injury
- common industrial injury - often disabling - rarely life threatening - splint foot with pillow - splint hand in position of function
43
shoulder injury
- AC separation- sling and swathe - shoulder dislocation- use pillow with sling and swathe - fracture- use sling and swathe
44
elbow injury
- fracture or dislocation may because neurovascular injury - splint in position found - transport promptly
45
rigid splint
-keep hand in position of function
46
air splint
-may be hard to reassess circulation
47
forearm/wrist injury
use a pillow
48
soft and connective tissue injuries
- tendon - ligament - muscle
49
other injury considerations: musculoskeletal injury management
- pediatric musculoskeletal injury - athletic musculoskeletal injury - patient refusals and referral - psychological support
50
tendon
-muscle to bone
51
ligament
-bone to bone
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