Advanced Patho: MSK latest
updated version with 100%
correct answers
Malunion - answer healths in an unacceptable position
Nonunion/pseudoarthorsis - answer does not form sufficient callus after six
months
Fracture complications (5) - answer infection, muscle atrophy, muscle
contractures, compartment syndrome, malunion/nonunion
Infection - answer - related to level of contamination (affected by degree of
fracture)
- high risk infection wounds: manure or standing water, high-velocity
mechanism (lawnmower blade, gunshot), deep puncture wounds (ex:
stepping on nail), human bites "fight bites" (dog bites)
- requires IV ABX treatment
Muscle atrophy - answer - loss of muscle bulk
- due to a decrease in muscle protein synthesis and an increase in muscle
protein breakdown
- occurs QUICKLY
- muscles at rest will lose 10-15% of strength per week
- the rate of recovery is 6% per week
Muscle Contracture - answer - shortening of the muscle and tendon due to
loss of sarcomere (ex: malunion that causes shortening)
- changes the length-tension relationship
, - when muscles are shortened the maximum active tension generated is
decreased
- stretching is a helpful preventative
Compartment syndrome - answer - when you have too much pressure in a
compartment of the muscle
- seen in deep anterior or posterior compartment of tibia
- fluid accumulates at a high pressure with a closed space
- associated with a traumatic event that causes hemorrhage and edema
- pressure builds within the compartment causing ischemia that leads to
necrosis
- irreversible skeletal damage in 8 hours and nerve damage in 1 hour and
irreversible nerve damage in 4 hours
Compartment syndrome S/S - answer - first sign: pain is out of proportion to
the injury
- Six P's:
1. pain on stretch
2. pressure
3. pulse present
4. pink color
5. paresis
6. paresthesia
Compartment Syndrome vs. Arterial Occlusion vs. Neurapraxia - answer -
compartment syndrome = positive for all 6 P's
- arterial occlusion = pain on stretch, paresthesia/anesthsia, and
paresis/paralysis
- neurapraxia = paresthesia/anesthesia, paresis/paralysis, and pulses intact,
NO PAIN
** the last two don't have increased pressure
updated version with 100%
correct answers
Malunion - answer healths in an unacceptable position
Nonunion/pseudoarthorsis - answer does not form sufficient callus after six
months
Fracture complications (5) - answer infection, muscle atrophy, muscle
contractures, compartment syndrome, malunion/nonunion
Infection - answer - related to level of contamination (affected by degree of
fracture)
- high risk infection wounds: manure or standing water, high-velocity
mechanism (lawnmower blade, gunshot), deep puncture wounds (ex:
stepping on nail), human bites "fight bites" (dog bites)
- requires IV ABX treatment
Muscle atrophy - answer - loss of muscle bulk
- due to a decrease in muscle protein synthesis and an increase in muscle
protein breakdown
- occurs QUICKLY
- muscles at rest will lose 10-15% of strength per week
- the rate of recovery is 6% per week
Muscle Contracture - answer - shortening of the muscle and tendon due to
loss of sarcomere (ex: malunion that causes shortening)
- changes the length-tension relationship
, - when muscles are shortened the maximum active tension generated is
decreased
- stretching is a helpful preventative
Compartment syndrome - answer - when you have too much pressure in a
compartment of the muscle
- seen in deep anterior or posterior compartment of tibia
- fluid accumulates at a high pressure with a closed space
- associated with a traumatic event that causes hemorrhage and edema
- pressure builds within the compartment causing ischemia that leads to
necrosis
- irreversible skeletal damage in 8 hours and nerve damage in 1 hour and
irreversible nerve damage in 4 hours
Compartment syndrome S/S - answer - first sign: pain is out of proportion to
the injury
- Six P's:
1. pain on stretch
2. pressure
3. pulse present
4. pink color
5. paresis
6. paresthesia
Compartment Syndrome vs. Arterial Occlusion vs. Neurapraxia - answer -
compartment syndrome = positive for all 6 P's
- arterial occlusion = pain on stretch, paresthesia/anesthsia, and
paresis/paralysis
- neurapraxia = paresthesia/anesthesia, paresis/paralysis, and pulses intact,
NO PAIN
** the last two don't have increased pressure
