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Intro to Ortho

Clinical Medicine II

Function of Orthopedics preservation and restoration of skeletal sxs, its articulation and associated structures
Sub-specialty of internal medicine and peds devoted to diagnosis and therapy of certain diseases Rheumatology
Rheumatologists deal with problems involving these parts of the body joints, soft tissues, connective tissues
Autoimmune disorders Lupus, MS, Rheumatoid Arthritis
Rash associated with lupus “Butterfly Rash” erythematous swelling of eyelids and skin around eyes
Methodology of treatments for Rheumatology immunology, cytokines, t-lymphocytes, B lymphocytes, Stem cells?
Disorder of metabolism of uric acid, builds up in joints Gout:^by alcohol, smoked meats and cheeses, ^purines
Most Common location of gout R big toe, called a Tophus?
Functions of the musculoskeletal sxs movement, support, protection of organs, storage of minerals, hematopoiesis
Leading chronic condition reported by elderly arthritis
End portion of the bone Epiphysis
Long portion of the bone (shaft) Diaphysis
Wider portion of bone bw diaphysis and epiphysis Metaphysis
Growth plate, cartillagenous until ossified physis
Skin like portion of bone w/ blood vessels and pain receptors Periosteum
Living unit of bone osteocytes
Build bone tissue osteoblasts
Break down bone tissue, osteoclasts
Facilitates smooth movement bw two bones Articular cartilage
Synovial Joints Diarthroidial: joints are freely mobile
5 Examples of synovial joints ball and socket: hip/shoulder,Hinge: elbow, Condyloid: knee, Saddle: Thumb, Pivot: radius/ulna
Fibrocartilagenous joints Amphiarthrodial: allows some movement
Examples of Amphiarthrodial joints Costosternal, symphysis pubis, acromioclavicular
Synarthroidial joints have no movement, cranial sutures
Bending of a joint Flexion
Straightening of a joint Extension
Rotating palm downward or feet inward Pronation
Rotating palm upward or feet rotating outward Supination
Move away from midline Abduction
Move toward midline Adduction
Move inward Inversion
Move outward Eversion
Distal extremeity is inward Varus (bowlegged)
Distal extremity is outward Valgus (knock-kneed)
Pediatric physeal injury classifictaions Salter-Harris I-V
Through the metaphysis, physis and epiphysis IV
Through physis w/ extension to epiphysis III
Through the physis I
Crush injury to the physis V
Through physis w/ extension to metaphysis II
DIfferiention bw type I and V Salter-Harris fractures V usually appears smaller on Xray, think of mechanism of injury
Elevated pressure in a closed muscle compartment Compartment Syndrome
MC areas and causes of compartment syndrome Crushing component to the injury, MC tibia and volar forearm
Nl compartment pressure an compartment syndrome pressure the compartment syndrome pressure ~120 vs 20-30,
Diagnosis of Compartment syndrome 7P’s and H & P
7P’s in compartment syndrome diagnosis pain, pallor, parasthesia, paresis, poikilothermia, pressure, pulselessness
Parasthesia numbness
Paresis paralysis
Poikiolothermia cold to the touch
Tx for compartment syndrome emergency fasciotomy, may lead to amputation, must leave open for days, repeat visits to OR for debridement
Painful inflammation of a tendon and/or synovial tissue around the tendon Tendonitis/Synovitis
Common locations for tendonitis shoulder, rotator cuff, elbow? Wrist, knee, ankle
Fluid filled sacs that cushion muscles and tendons during movement bursa
Overuse injuries may cause inflammation of bursa called bursitis: causes pain and swelling
Uses for corticosteroid injections decreases of inflammation of synovial tissue within joints, or extra-articular areas: bursae, tendon sheathes, epidural space
Side effects d/t technique focal skin discoloration, subQ fat atrophy, Tendon rupture,
Other side effects of corticosteroid injections local pain, facial flushing, iatrogenic joint infection
Disruption of Cortex of bone by cracking, splintering, bisecting Fracture “break”
Disruption of supporting ligaments, when joint between two bone separate, usually d/f tension Dislocation
Stretching of ligaments from excessive force Sprain Grades I-III, III being joint opening when stressed
Stretching or partial tearing of muscle-tendon unit from excessive force Strain
Connects bones to bones ligament
Connects bones to muscle tendons
Opened fracture puncture through the skin
Created by: becker15
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