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N126-U5-Soft Tissues
Dobrisky-U5-Trauma to Soft Tissue Structures
| Question | Answer |
|---|---|
| the most common causes of trauma to soft tissue structures are | sports-related injuries |
| sports-related injuries include | blows, twisting or severe stretching |
| the most common sites for soft tissue traumas are | achilles tendon, shoulders, knees, ankles |
| soft tissue injuries of the knee may include complete or partial tissues of | ligaments, tendons or cartilage |
| the meniscus is a | curved fibrous cartilage in the knee |
| the meniscus act as | shock absorbers |
| there are two meniscus in the knee joint; they are located | medial and lateral |
| what type of injury to the meniscus is usually the result of twisting the leg when the knee is flexed and the foot is firmly on the ground? | tear |
| what type of rotation causes an injury to the medial meniscus? | internal |
| what type of rotation causes a tear in the lateral meniscus? | external |
| the symptoms of meniscal knee injury are | pain, swelling, tenderness in the knee, locked knee, clicking or snapping sound when the knee is moved |
| if a clicking or snapping sound is heard when moving the knee what type of knee injury is suspected? | meniscal |
| a longitudinal tear in the medial meniscus that causes the knee to lock is also known as what injury | bucket handle injury |
| treatment for the locked knee can be | manipulation followed by splinting or casting for 3-6 weeks; partial or total meniscectomy or arthroscopy |
| removal of all or part of the meniscus via arthroscopy is called | meniscectomy |
| which treatment for the locked knee involves one or more small incisions and a cutting device to remove the torn cartilage? | arthroscopy |
| ACL stands for | anterior cruciate ligament |
| what is the most common ligament injury to the knee? | ACL |
| what age group is at higher risk for ACL injury? | 15-25 yo |
| this injury normally occurs when the knee is hyperextended and the femur is externally rotated on a fixed tibia | ACL |
| ACL injuries usually happen while playing what sports? | soccer, football, skiing and basketball |
| the patient that has experienced a torn ACL will typically report what? | hearing a pop as the injury occurred |
| a twisting knee injury associated with a "pop" is normally indicative of injury to the | ACL |
| the ACL provides | support to the knee joint |
| what ligament is the ACL paired with to help stabilize the knee joint? | posterior cruciate |
| effusion is the | escape of fluid from blood vessels |
| s/s of injury may include severe pain, severe swelling, effusion, joint deformity and instability and the patient report that | the knee is giving way |
| drawer test may be performed to determine the degree of | anterior displacement of the tibia and the amount of laxity of the knee |
| describe the drawer test | ............. |
| laxity of movement suggests instability of | anterior or posterior cruciate ligaments or medial or collateral ligaments of the knee |
| what is the most useful diagnostic tool for ACL injuries? | MRI scans |
| factors determining treatment methods are | age, activity level, type of job, leisure activites, general medical condition and co-existing orthopedic injuries |
| the goal of treatment for the ACL injury is | to prevent further damage to the knee |
| conservative treatment includes | NSAIDS, application of ice; rest; electrical stimulation; rest and immobilization |
| surgical intervention prevents anterior subluxation of the | tibia |
| anterior subluxation means | partial separation |
| which is more common, conservative treatment or surgical intervention? | surgical intervention |
| what is the goal of treatment? | to prevent further damage; traumatic arthritis |
| the surgical intervention for ACL repair is often performed with the aid of | arthroscopy |
| is the joint surgically opened during arthroscopy? | no |
| reconstruction of the knee may include the use of what to repair the tendons? | autograft and allograft |
| post op complications associated with knee repairs include failure of what? | graft |
| post-op complications may include n/v, infection, DVT, pulmonary embolism, graft failure and | recurrent laxity |
| the rotator cuff is a group of muscles and tendons that form | a cuff over the shoulder |
| the rotator cuff holds the arm in its | ball and socket joint |
| the rotator cuff is involved in what shoulder motions | essentially all |
| rotator cuff injury usually occurs with | sports-related injuries as a result of direct trauma and/or overuse |
| overuse may occur with | throwing motions |
| acute trauma may result in | partial or complete tear of the rotator cuff, dislocation, subluxation, spearation or fracture |
| acromioclavicular separation is one of the most | common shoulder injuries |
| what is the most common shoulder injury? | acromioclavicular separation |
| injuries to the rotator cuff usually occur from chronic use in persons over the age of | 40 |
| surgical intervention for a torn rotator cuff is indicated if | conservative treatment fails or the patient is active |
| conservative treatment of a torn rotator cuff include | nsaids, ice; immobilization; pt to promote strengthening of the rotator cuff and the surrounding muscles and cortisone injections |
| the use of cortisone injections is | limited |
| what type of surgery is done to the rotator cuff? | arthroscopic |
| surgery is successful at relieving what in the shoulder? | pain |
| surgery is less predictable at | returning strength to the shoulder |
| recovery time often depends on | the extent of the tear |
| how should the patient be positioned after shoulder surgery? | elevate the affected arm |
| to reduce swelling to the affected shoulder what should be done postoperatively? | elevate and ice |
| what type of device is used to secure the affected shoulder after RC surgery? | immobilizer/splint |
| discharge teaching for the RC surgical patient should include | wound care, signs of infection, activity restrictions and medication instruction |
| signs of complications include | decreased sensation or coolness in the affected arm, increased pain, unusual swelling, increased drainage |
| if a patient experiences swelling and increased pain post-operatively, what else should you assess for on the affected arm? | decreased sensation or coolness |
| 75% of all ankle injuries are | sprains |
| ankle sprains usually result from | inversion and plantar flexion force on the ankle |
| s/s of ankle sprains include | swelling, tenderness, reluctance to use extremity fully, ecchymosis |
| ecchymosis is | bruising |
| treatment for ankle sprains normally involves | RICE; rest, ice, compression, elevation |
| ice should be applied to the sprained ankle for how long? | 48-72 hours |
| what is used for compression r/t treatment of a sprained ankle? | elastic bandages, splints or casts |
| elevation of the extremity involved in the ankle sprain will | increase venous return and decrease swelling |
| CTD stands for | cumulative trauma disorders |
| CTD is a term used to describe cumulative trauma and overuse of the | neck and upper extremities in the workplace |
| what has increased the occurence of CTD? | wide-spread computer use |
| what has been implemented in many workplaces to combat CTD? | ergonomic standards |
| CTD can occur in any muscle group that is used | repeatedly for long, uninterrupted periods with the body in a relatively fixed posture |
| what is the most common CTD? | carpal tunnel |
| CTS stands for | carpal tunnel syndrome |
| carpal tunnel syndrome is associated with pressure exerted on what nerve | median nerve of the wrist |
| what age and gender are more commonly affected with CTS | women ages 30-50 |
| work related injuries as well as what other situations may cause CTS? | burns, fractures, pregnancy |
| inflammation caused by repetitive motions, fluid retention, bleeding into the space and what other two things can contribute to CTS | scarring or contractures |
| s/s of carpal tunnel syndrome include | |
| parasthesia is | numbness, tingling or pins and needles feeling |
| hypoesthesia is | decreased sensation |
| CTS pain can be referred to the | upper extremity and neck |
| what are the two tests that be performed during assessment to assist in diagnosing CTS | tinel's test and phalen's test |
| which test reproduces symptoms of CTS by tapping on the median nerve at the wrist? | Tinel's test |
| which test reproduces symptoms of CTS by holding the wrist in acute flexion for 60 seconds | phalen's test |
| what test is ran to evaluate nerve function | electromyography (EMG) |
| conservative management of CTS includes | rest and splinting of wrist |
| rest and splinting of the wrist is usually more effective if it is begun when? | within 3 months of the onset of symptoms |
| what vitamin deficiency has been seen in some persons with CTS | vitamin b6 |
| the short-term use of what type of drug is used in the treatment of CTS | diuretics |
| what kind of injections are used on a limited basis for tx of CTS | local steroid injections |
| surgical tx of CTS involves decompression of the ______ or _______ release of decompression | decompression of the median nerve, endoscopic release of decompression |
| one of the most important things to be aware of when establishing correct typing habits is that the | arm, wrist, and hand remain in a straight line |
| what actions can be taken to prevent carpal tunnel syndrome | on-the-job conditioning, perform stretching exercises, frequent rest breaks, wear splints to keep wrists straight, use correct posture and wrist position |
| wearing fingerless gloves can preven carpal tunnel syndrome by | keeping hands warm and flexible |
Created by:
Lori Dobrisky
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