Ch 37 Musculoskeletal Trauma and Complications

Question 3 of 10 This or That? It is important to be able to differentiate different types of musculoskeletal trauma and complications. For each patient, select the appropriate trauma or complication. During a basketball game, Shawn suffers a severe ankle sprain that will likely sideline him for several games. What tissues are injured in a sprain? LIGAMENTS TENDONS AND MUSCLES

LIGAMENTS CORRECT. Sprains are ligamentous damage.

Question 9 of 10 This or That? It is important to be able to differentiate different types of musculoskeletal trauma and complications. For each patient, select the appropriate trauma or complication. Having fallen from her swing set, Julie, age 7, suffered the most common of all childhood fractures. What type of fracture did Julie experience? CLAVICLE FRACTURE VERTEBRAL COMPRESSION FRACTURE

CLAVICLE FRACTURE CORRECT. The clavicle is the most common bone to be fractured in children. Often, this results from some type of impact to the shoulder area, which is transmitted to the clavicle bone. Vertebral compression fractures appear, normally, in elderly individuals, the result of osteoporotic damage to the vertebrae.

Question 1 of 10 This or That? It is important to be able to differentiate different types of musculoskeletal trauma and complications. For each patient, select the appropriate trauma or complication. Mary, age 58, complains that every time she walks up the stairs, her joints "pop" and "click." What is Mary describing? CREPITUS BURSITIS

CREPITUS CORRECT. Crepitus refers to the sound made when joints "click." Bursitis is inflammation of the bursae, fluid-filled sacs located in some joints.

Question 2 of 5 Common distal radial fractures include ____________ fracture. Select all that apply. Grey Turner Starling Colles Smith Langerhans

Colles Smith

Question 7 of 10 This or That? It is important to be able to differentiate different types of musculoskeletal trauma and complications. For each patient, select the appropriate trauma or complication. Kevin injured his hip when he began running longer distances. As his hip hurt every time he took a step, Kevin went to see his physician, who suggested Kevin work with a physical therapist. While at physical therapy, the physical therapist had Kevin relax his leg, while the physical therapist manipulated the leg to determine the range of motion. What type of range of motion was being tested? PASSIVE ACTIVE

PASSIVE CORRECT. Passive range of motion is assessed while the patient relaxes and the examiner moves the joint. In active range of motion testing, the patient contracts the muscles and moves the joint without assistance.

Question 6 of 10 This or That? It is important to be able to differentiate different types of musculoskeletal trauma and complications. For each patient, select the appropriate trauma or complication. Every time Leslie stepped out of bed in the morning, she would sense pain in both feet. The bottoms of her feet were particularly painful on the mornings following days in which she had been standing on her feet a great deal. Once Leslie began moving, her feet seemed to relax, and she was able to walk more easily. What condition is Leslie suffering from? PLANTAR FASCIITIS CALCANEAL SPUR

PLANTAR FASCIITIS CORRECT. Plantar fasciitis is a condition in which the plantar fascia, located at the base of the foot, becomes inflamed. Soreness when walking is common, especially in the morning. Calcaneal spur refers to a heel spur.

Question 10 of 10 This or That? It is important to be able to differentiate different types of musculoskeletal trauma and complications. For each patient, select the appropriate trauma or complication. Sara has been training for her first marathon. She has begun running more frequently and for greater distances. She feels she needs to cut back her training, though, as she had developed a sharp pain in her foot. Every time her foot strikes the pavement while running, the pain appears in the same location. What may be causing Sara's pain? STRESS FRACTURE MALUNION

STRESS FRACTURE CORRECT. A stress fracture develops from repetitive microdamage. In Sara's case, her increase in training likely stimulated damage to her bones. Malunion is when a bone heals in an unacceptable position.

Question 4 of 10 This or That? It is important to be able to differentiate different types of musculoskeletal trauma and complications. For each patient, select the appropriate trauma or complication. Cole was skiing a route that was beyond his capabilities. As he lost control of his skis, Cole crashed into a tree, resulting in a compound fracture of his right femur. What type of femoral shaft fracture did Cole experience? TYPE I FEMORAL SHAFT FRACTURE TYPE III FEMORAL SHAFT FRACTURE

TYPE III FEMORAL SHAFT FRACTURE CORRECT. A type I femoral shaft fracture is a spiral or transverse fracture. In a type III femoral shaft fracture, an open, or compound, fracture occurs.

Question 5 of 10 This or That? It is important to be able to differentiate different types of musculoskeletal trauma and complications. For each patient, select the appropriate trauma or complication. While pitching for his college team, Randy suffered injury to his subscapularis. Which type of injury does Randy have? ROTATOR CUFF INJURY BRACHIAL PLEXUS INJURY

ROTATOR CUFF INJURY CORRECT. The rotator cuff is a group of four muscles (teres minor, subscapularis, supraspinatus, infraspinatus) that enable rotation of the shoulder. Movements, such as pitching in baseball, place extensive strain on these muscles and may cause rotator cuff injury.

Question 8 of 10 This or That? It is important to be able to differentiate different types of musculoskeletal trauma and complications. For each patient, select the appropriate trauma or complication. Lori seeks medical attention for "shooting" pain down her left leg. The pain is very sharp and can happen at any time. What condition is Lori suffering from? SCIATICA CERVICAL STRAIN

SCIATICA CORRECT. Sciatica develops when the sciatic nerve, which is the largest nerve in the body, is damaged or injured. The sciatic nerve travels down the back of each leg. Impingement or damage of the nerve can cause severe pain in the leg. Cervical strain is often referred to as whiplash and occurs in the neck area.

Question 2 of 10 This or That? It is important to be able to differentiate different types of musculoskeletal trauma and complications. For each patient, select the appropriate trauma or complication. While learning to snowboard, Madeline falls. She tries to catch herself by placing her hands on the ground. The impact is too great for Madeline's wrist, and anterior displacement of her radius occurs. What type of fracture did Madeline experience? SMITH FRACTURE COLLES FRACTURE

SMITH FRACTURE CORRECT. A Smith fracture is anterior displacement of the radius, while a Colles fracture is posterior displacement.

Question 4 of 5 Carpal tunnel syndrome affects the ___________ nerve. median ulnar glenohumeral axillary obturator

median

Question 1 of 5 Which of the following are common types of femur fractures? Select all that apply. greenstick open compression spiral comminuted

open spiral comminuted

Question 3 of 5 The most common location for joint dislocation is the _____________. patella knee hip shoulder wrist

shoulder

Question 5 of 5 Rotator cuff injuries affect the ______________. knee hip ankle shoulder spine

shoulder

Question 1 of 5 Small bone fractures that develop in response to repetitive, cumulative trauma are known as __________ fractures. compound stress isolated comminuted spiral

stress

Question 5 of 5 Which muscles may be damaged in a rotator cuff injury? Select all that apply. supraspinatous subscapularis bicep brachii infraspinatus teres major

supraspinatous subscapularis infraspinatus

Question 4 of 5 Strains are small tears in a muscle or __________, whereas sprains are injuries to the _______. tendon, ligaments ligament, bones bone, tendons tendon, bones ligament, tendons

tendon, ligaments

Question 2 of 5 Which type of fracture is common in the vertebrae? spiral comminuted compression greenstick transverse

compression

Question 3 of 5 Vertebral compression fractures _________________. Select all that apply. may cause kyphosis. most commonly occur from trauma. are examples of stress fractures. are pathognomonic for osteoporosis. decrease in incidence with advancing age.

may cause kyphosis. are pathognomonic for osteoporosis.

The musculoskeletal system, which includes bones, muscles, cartilage, ligaments, and tendons, can suffer trauma from vehicle accidents, work-related accidents, and sports injuries. Common traumas include bone fractures; nerve trauma; and muscle, tendon, and ligament sprains, strains, and dislocations. Let's begin by looking at bone fractures, which are defined as any disruption, either complete or incomplete, in the continuity of a bone. They occur when forces exceed the bone's capacity. Let's take a closer look at some common fractures. Small bone fractures can develop in response to a repetitive, cumulative trauma. These are known as stress fractures and frequently occur in the lower extremities. A hip fracture is actually a break within the proximal femur. Osteoporosis is a primary risk factor for hip fractures. Unlike hip fractures, femoral shaft fractures are most commonly due to trauma. The femur is the strongest bone in the body, so only a significant amount of traumatic force can fracture it, such as the force exerted in contact or high-speed sports like skiing, football, and hockey, or in motor vehicle accidents. There are three types of femoral shaft fractures. Type one is a spiral or transverse fracture, type two is a comminuted fracture, and type three is a compound fracture. Other types of fractures include compression fractures, which most commonly appear in the vertebrae. Vertebral compression fractures are considered to be pathognomonic for osteoporosis and cause kyphosis. Fractures of the clavicle are the most common fracture in childhood. Fractures of the distal radius are also common, especially as a result of a fall in which a person extends his or her hand to protect the upper body and face. Colles and Smith fractures are examples of such wrist fractures. Nerves near joint structures can also be damaged with either acute or repetitive trauma. Carpal tunnel syndrome affects the median nerve in the wrist. When the ulnar nerve is damaged, a person experiences weakness and tingling. Sometimes more than one nerve may be involved, such as in brachial plexus injury, which often occurs because of a violent pull of the entire arm or shoulder, as can occur in football and wrestling. Muscles, ligaments, and tendons also suffer injuries. Strains result from small tears in muscles or tendons. Sprains are ligament injuries. Traumatic forces applied to the knee joint commonly tear the menisci and ligaments supporting the knee. Two common injuries to muscle, tendons, and ligaments of the shoulder are rotator cuff injury and shoulder dislocation. Rotator cuff injury refers to a strain of one or more of the four rotator cuff muscles that provide stability and rotation to the glenohumeral joint. Davis Advantage for Pathophysiology The shoulder is the most commonly dislocated joint in the body. Shoulder dislocation occurs when a strong force causes the humeral head to separate from the scapula's glenoid cavity.

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