2.1 Cs Exam3: Orthopedics

Front 1

Fractures considered highly specific for child abuse include: _

Back 1

posterior rib fractures*

Front 2

Fractures considered to be of moderate specificity include:

Back 2

Multiple, especially bilateral fractures, fractures of various stages of healing

Front 3

Compartment syndrome is when a group of muscles, their nerves, and vessels undergo _

Back 3

compressive forces resulting in vascular and nerve compression

Front 4

Compartment syndrome occurs when _

Back 4

vascular perfusion of the muscles and other tissues within a compartment decreases to a level that is inadequate to sustain the viability of these tissues.*

Front 5

What is the end result of compartment syndrome? When does this occur?

Back 5

The end result is necrosis of muscle and nerve tissues that can occur in as few as 4 to 8 hours.**

Front 6

Compartment syndrome most commonly occurs after _, and it may occur if _

Back 6

trauma, especially following crush injuries.*

if cast is too tight*

Front 7

Failure to treat compartment syndrome may lead to:

Back 7

necrotic muscle, fibrotic scar tissue, muscular contracture and permanent dysfunction of all nerves traveling through the compartment.*

Front 8

What are the symptoms associated with compartment syndrome?

Back 8

5 P's

Pain,
Hypoesthesia (paresthesias)
Paralysis
Pallor
Pulselessness

Only need 1 or 2 for diagnosis

Front 9

How can you test for compartment syndrome?

Back 9

Extreme pain on stretching the long muscles that pass through the compartment

Inability to actively contract these muscles (making a fist or dorsiflexing the toes) is an indication of paralysis.*

*measure pressure by inserting tool into compartment

Front 10

How do you treat compartment syndrome?

Back 10

Surgical Fasciotomy of the compartment

(open compartment & keep open until swelling resolveds)

Front 11

Swelling, pain aggravated by movement*, deformity, pain on palpation, and decreased function...all are symptoms of what?

Back 11

Fracture

Front 12

When diagnosing a fracture, be sure you document intact _, _ and _

Back 12

neuro, vascular, motor

Front 13

What do you do if a patient has the clinical appearance of a fracture but no fracture is seen on the x-ray?

Back 13

CT scan* (if high risk area, neck, spine, etc)

Splint then Repeat x-ray in 7-10 days* (if low risk, extremity)

*if fracture is seen, split & send to specialist*

Front 14

Nonunion is an adverse outcome of a fracture and is the _

Back 14

Failure to heal to bone.*

Front 15

Malunion is an adverse outcome of a fracture and is _

Back 15

Healing with unacceptable deformity

Front 16

Osteomyelitis may develop from _. It is usually _

Back 16

an open fracture (or hematogenous spread)

pyogenic (bacterial)

Front 17

What are the two most common organisms responsible for osteomyelitis?

Back 17

Staphylococcus aureus is the most common, Hemolytic streptococci

Front 18

What are a few symptoms associated with osteomyelitis?

Back 18

Unrelenting pain*
Fever*
Reluctance to move the limb.*

Front 19

What's the treatment for osteomyelitis?

Back 19

Parenteral Antibiotics!** (for a long time!)

Surgery

Front 20

A sprain is the _

A strain is _

Back 20

Stretching or tearing of a ligament or joint capsule.*

a stretching or partial tear of a muscle.*

Front 21

What part of the body is a rupture most likely to occur in?

Back 21

Achilles,

This is the complete tear of a muscle or tendon typically described as a rupture

Front 22

Where do you splint in case of a fracture or sprain?

Back 22

Btwn a joint above and a joint below

Front 23

A splint will reduce _, _, and _.

Back 23

pain, bleeding, and swelling

it may help prevent further damage to muscles, nerves, and blood vessels (& contamination of open wounds)

Front 24

Where is the proper location for crutches?

Back 24

A few inches below the axilla.

the handgrips should be even with the hips

Front 25

What are the details you look at to describe fractures?

Back 25

Rotation, Overlap, Anguation, Displacement, Dislocation

(ROAD)

Front 26

Displacement is the _

Back 26

amount of off-set of the distal fracture fragment relative to the proximal (answer in % of bone that is displaced)

Front 27

Angulation is the _

Back 27

angle away from the normal that the distal fragment makes with the proximal

Front 28

What are the cancers that are likely to be associated with bone cancer?

Back 28

LBPMKT
Lung, Breast, Prostate, Metastatic, Meyloma, Kidney, Throid

Lytic bone probably means killing tumor