Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
66 Cards in this Set
- Front
- Back
|
Why do we worry about fractures in children?
|
If is in the growth plate, may compromise growth
|
|
|
T or F: Fractures heal slowly in children.
|
False, quickly
|
|
|
What’s the mainstay for diagnosing fractures?
|
Xray
|
|
|
Where do you need to take xrays?
|
Above and below pain
|
|
|
What’s a type 1 Salter fracture?
|
Separation, growth plate a little wider
|
|
|
What’s a type 2 Salter fracture?
|
Above the growth plate
|
|
|
What’s a type 3 Salter fracture?
|
Below the growth plate
|
|
|
What’s a type 4 Salter fracture?
|
Through the growth plate
|
|
|
What’s a type 5 Salter fracture?
|
Crushing injury, most serious
|
|
|
What’s tricky about type 5 Salter fractures?
|
They are difficult to see on Xray so you need a comparison view
|
|
|
Which types of fractures do you worry about?
|
3,4,5
|
|
|
What is the treatment for soft tissue fractures?
|
RICE, progress as tolerated, no rigorous activity for 3 weeks, PREVENTION
|
|
|
Adults get more ____ _____ _____ and _____ than children.
|
Soft tissue injuries and dislocations
|
|
|
Children get more _____ than adults.
|
Bruises
|
|
|
Positive point tenderness over a growth plate is what? What should you do?
|
Likely a Salter 1, splint
|
|
|
T or F: You can see a sprain or a strain on Xray?
|
No
|
|
|
What is a sprain?
|
Overstretch and partial tear of ligament (usually at joint)
|
|
|
What is a strain?
|
Muscle injuries caused by exposure stretching that results in pain and swelling of the muscle (usually long muscle)
|
|
|
What is subluxation?
|
Incomplete separation of a joint in which there is still a partial contact between each bone articulation cartilage
|
|
|
What is a dislocation?
|
Complete separation in which all contact is lost between articulation surfaces
|
|
|
An indirect to tendons or muscles is what?
|
Strain
|
|
|
What is a strain caused by?
|
Excess use of force
|
|
|
Strains usually happen in what sports?
|
Running, tennis players
|
|
|
What are the predisposing factors for strains?
|
Fatigue, previous injury, inadequate warm up
|
|
|
What is a contusion?
|
Blunt injury to soft tissue and muscle, damage and disruption of soft tissue and muscle fibers
|
|
|
What does capillary disruption in a contusion cause?
|
Bleeding and hematoma
|
|
|
What is a sprain?
|
Injury to ligaments, tearing of fibers, bleeding, inflammation, hematoma
|
|
|
What sports lead to sprains?
|
Basketball, hockey
|
|
|
What’s a grade 1 sprain?
|
25% of fibers torn, no instability, mild pain and tenderness, little or no soft tissue swelling
|
|
|
What’s a grade 2 sprain?
|
25-75% fibers torn, slight to moderate instability, moderate pain and tenderness, moderate swelling and ecchymosis
|
|
|
What’s a grade 3 sprain?
|
More than 75% fibers torn, marked pain and swelling, marked swelling and ecchymosis, can’t really stand up, falls and doesn’t get up
|
|
|
What hx questions to ask about injuries?
|
How, what when, previous injuries, invert in or out
|
|
|
Eversion of the heal is more/less likely to break?
|
I have more in notes but confused
|
|
|
What should you ask about how the injury happened?
|
Inversion vs eversion, distance injuries may have traveled, the probability factor
|
|
|
What should you inspect for with injuries?
|
Swelling, ecchymosis, deformity and always compare to other limb
|
|
|
What should you palpate for with injuries?
|
Pulse, sensation, capillary refill, point tenderness and always feel area below injury
|
|
|
What are the Ottowa Ankle Rules for Xray?
|
Bone tenderness at posterior edge or tip of lateral malleolus, bone tenderness at posterior edge or tip of medial malleolus, inability to bear weight immediately after injury or at time of visit
|
|
|
What are the general rules for ankle management?
|
RICE, immobilize, dorsiflexion (toes to nose before wrapping), compression bandage, non bearing for 24 hours
|
|
|
How do you treat a grade 1 sprain?
|
Compression and immobilization for 7-10 days, gradual weight bearing for 24-72 hours, avoid changes in ankle direction, being exercises 72 hours later (dorsiflexion/plantar flexion, standing raises)
|
|
|
When can you go back to sports after a sprain?
|
When you can stand on the foot for 2 minutes with a wabble
|
|
|
How do you treat a grade 2 sprain?
|
Immobilize, non weight bearing 48-72 hours, reevaluate in 72 hours, if crazy pain send to ortho, cast if needed
|
|
|
How do you treat a grade 3 sprain?
|
Posterior splint, non weight bearing, ortho referral
|
|
|
What are the goals of management of a sprain?
|
Minimize chronic disability, retraining exercises, rehab, analgesics and gradual return to sports
|
|
|
What are the 4 conditions that require immediate referral to Ortho?
|
Intra-articular fracture, grade 3 sprain (ligament tear), grade 3 strain (complete muscle/tendon tear), mechanical block of normal knee motion
|
|
|
What are the most common organisms associated with osteomyelitis?
|
Staph, strep, h flu, penetrating injury - pseudomonas
|
|
|
What organisms cause osteomyelitis in kids with hemoglobinopathies?
|
Salmonella, shigella and e coli
|
|
|
What are the signs and symptoms of osteomyelitis?
|
Fever, malaise, swelling, redness of area, irritability, pain and edema
|
|
|
What are the signs of osteo in infants?
|
Irritable, lethargy, pseudoparalysis, swelling, poor feeding, maybe fever, warmth, redness
|
|
|
What are the signs of osteo in kids under 2?
|
Fever, local signs, refusal to walk, toxic, point tenderness
|
|
|
What are signs of osteo in kids over 2?
|
Fever, less toxic appearing, fever, point tenderness
|
|
|
What labs do you do for osteo suspicion?
|
CBC, ESR, CRP, blood culture (want to make sure hasn’t gone to blood), imaging (xray, mri, bone scan)
|
|
|
What’s the gold standard to dx osteo?
|
MRI, xray won’t show process early on
|
|
|
What’s the presentation of osteo?
|
Constitutional signs of infection, irritability, decreased appetite, localized symptoms inflammation of bone, redness, swelling, point tenderness, loss of function
|
|
|
What will labs of osteo show?
|
Elevated ESR or CRP, elevated WBCs
|
|
|
What’s the treatment of osteo?
|
IV antibiotics, Clindamycin and vancomycin
|
|
|
What is septic arthritis?
|
Bacterial infection of joint
|
|
|
T or F: Septic arthritis is an ortho emergency
|
True
|
|
|
What are the symptoms of septic arthritis?
|
Rapid onset, refusal to walk, will not let you move joint
|
|
|
What do the lab results in septic arthritis show?
|
Increased WBC, elevated ESR over 60mm, blood culture usually positive for staph a, salmonella, gonorrhea, tap results positive
|
|
|
What does a u/s of septic arthritis show?
|
Effusion, widening joint space
|
|
|
How is septic arthritis treated?
|
Admission, I&D by ortho, IV abx
|
|
|
What are the most common organisms of septic arthritis in under 3 months?
|
Staph A, group B strep, gram neg bacilli, n gonorrhea
|
|
|
What are the most common organisms of septic arthritis in 3 months to 3 yrs?
|
Staph a, kingella kingae, group a strep, h flu
|
|
|
What are the most common organisms in septic arthritis in over 3 yrs?
|
Staph a, group a strep, s pneumonia, n gonorrhea
|
|
|
What is the treatment of septic arthritis in kids under 3 months?
|
Nafcillin/oxacillin/vanco PLUS gentamycin or cefotaxime
|
|
|
What’s the treatment of septic arthritis in over 3 years?
|
Nafcillin, clindamycin, vancomycin or cefazolin
|
