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Intro to Ortho
Clinical Medicine II
Question | Answer |
---|---|
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 |