Ortho - Trauma Healing and Shoulders
1. What occurs with primary fracture healing?: - also known as osteonal or haversian healing
- occurs with bone anatomically reduced, blood supply preserved, fracture stabilized
2. What is a bone reduction?: - putting a bone right back into place and securing with a cast or splint
3. What is the leading cause of death for people aged 1-34?: - trauma from motor vehicle
accidents
4. What occurs with secondary fracture healing?: - a hard callous is formed
5. What are the 4 steps of biological secondary fracture healing?: 1. Hematoma
formation
- inflammation occurs and osteoBLASTS work
2. Cartilage formation
- calcification
- soft callous forms
3. Cartilage removal
- bone formation
,- hard callous forms
4. Bone remodeling
- osteoCLASTS work
6. What is articular cartilage made of?: - extracellular matrix (ECM) and chondrocytes
- ECM is made of water, collagen, and proteoglycans
7. Is cartilage vascularized tissue?: NO, but bone is
8. Where does cartilage receive nutrition from?: - synovial fluid
9. What is the function of synovial fluid?: - to lubricate joints and prevent bones from "rubbing
against each other"
10. How does cartilage healing occur?: - improves with passive or active motion of the joint, as
fibrocartilage is made
11. What is the function of tendons and what do they consist of?: - tendons attach muscle
to bone and extend a muscle's contractile action
- consist of long collagen bundles with fibrocytes and a synovial membrane
,12. What are type 1 muscle fibers?: - slow twitch
- strong contraction
- example: marathon runner
13. What are type 2 muscle fibers?: - fast twitch
- fatigable
- high strength
- high speed of contraction
- example: sprinter
14. How do tendons and muscles heal?: - heal through regeneration (inflammation, formation of
connective tissue, and muscle regeneration)
15. How do nerves heal?: - multiple nerve fibers form a fascicle surrounded by perineurium, then epineurium
16. How are nerves injured?: - injured through stretch, ischemia, or laceration
- graded 1-5th degree
17. What is neuropraxia?: - injury to a nerve caused by trauma
18. How does prognosis of nerve injury change with age?: - prognosis diminishes with age
, - children have more optimistic recovery than adults from nerve injury
19. What is the ABCDE of orthopedic assessment and management of multiply
injured patients?: Airway maintenance (with C spine protection)
Breathing and ventilation
Circulation (with hemorrhage control)
Disability (neurologic status)
Exposure and environmental control (undress the patient but prevent hypothermia)
20. How should you mobilize fractures and what is its function?: Mobilize fractures, joints
above and below injury,
- align bones with gentle traction
- stop obvious bleeding with bandages and direct pressure
- avoid tourniquets, unless life-threatening injury
Functions to avoid pain and excess bleeding
21. What is the required components of an orthopedic history for MVA injuries?-
: 1. MVA
1. What occurs with primary fracture healing?: - also known as osteonal or haversian healing
- occurs with bone anatomically reduced, blood supply preserved, fracture stabilized
2. What is a bone reduction?: - putting a bone right back into place and securing with a cast or splint
3. What is the leading cause of death for people aged 1-34?: - trauma from motor vehicle
accidents
4. What occurs with secondary fracture healing?: - a hard callous is formed
5. What are the 4 steps of biological secondary fracture healing?: 1. Hematoma
formation
- inflammation occurs and osteoBLASTS work
2. Cartilage formation
- calcification
- soft callous forms
3. Cartilage removal
- bone formation
,- hard callous forms
4. Bone remodeling
- osteoCLASTS work
6. What is articular cartilage made of?: - extracellular matrix (ECM) and chondrocytes
- ECM is made of water, collagen, and proteoglycans
7. Is cartilage vascularized tissue?: NO, but bone is
8. Where does cartilage receive nutrition from?: - synovial fluid
9. What is the function of synovial fluid?: - to lubricate joints and prevent bones from "rubbing
against each other"
10. How does cartilage healing occur?: - improves with passive or active motion of the joint, as
fibrocartilage is made
11. What is the function of tendons and what do they consist of?: - tendons attach muscle
to bone and extend a muscle's contractile action
- consist of long collagen bundles with fibrocytes and a synovial membrane
,12. What are type 1 muscle fibers?: - slow twitch
- strong contraction
- example: marathon runner
13. What are type 2 muscle fibers?: - fast twitch
- fatigable
- high strength
- high speed of contraction
- example: sprinter
14. How do tendons and muscles heal?: - heal through regeneration (inflammation, formation of
connective tissue, and muscle regeneration)
15. How do nerves heal?: - multiple nerve fibers form a fascicle surrounded by perineurium, then epineurium
16. How are nerves injured?: - injured through stretch, ischemia, or laceration
- graded 1-5th degree
17. What is neuropraxia?: - injury to a nerve caused by trauma
18. How does prognosis of nerve injury change with age?: - prognosis diminishes with age
, - children have more optimistic recovery than adults from nerve injury
19. What is the ABCDE of orthopedic assessment and management of multiply
injured patients?: Airway maintenance (with C spine protection)
Breathing and ventilation
Circulation (with hemorrhage control)
Disability (neurologic status)
Exposure and environmental control (undress the patient but prevent hypothermia)
20. How should you mobilize fractures and what is its function?: Mobilize fractures, joints
above and below injury,
- align bones with gentle traction
- stop obvious bleeding with bandages and direct pressure
- avoid tourniquets, unless life-threatening injury
Functions to avoid pain and excess bleeding
21. What is the required components of an orthopedic history for MVA injuries?-
: 1. MVA
