Professional Documents
Culture Documents
Introduction To Orthopaedics
Introduction To Orthopaedics
Test Yourself
List the bones of the body. (More pts more
bones!)
Bone forming cells are called ______.
Local stress stimulates bone formation. T
or F?
The knee is a/an _______joint.
Periosteum
Diaphysis
Epiphysis
Periosteum
Endosteum
Epiphyseal plates;
bone growth, injury
Estrogen
What effect of low Ca? Glucocorticoids
Calcitonin
What effect on bones
Effect on Ca?
Source?
Thyroxin
Vit C & D
Diarthroidal Joint
Othropaedic Terminology
Hallus
Genu varus
Genu valgus
pes varus
metatarus valgus
metatarus varus
Hallus valgus
How do you
describe this
foot deformity?
Stressors of the
Musculoskeletal System
Trauma
Infection
Altered Metabolism
Peripheral neurovascular
dysfunction
Pain (acute, chronic)
Impaired skin integrity
Infection, high risk for
Disuse syndrome
Activity intolerance
Trauma. high risk for
Knowledge deficit
Impaired adjustment
Fear, anxiety
Components of Assessment
Chief Complaint
Why seeking care
Acute and chronic problem
Pain
Associated conditions
Complicatio
ns!
Principles of Assessment
Normal first
Test your skills
Bilateral comparision
Changes with age
Inspect then gentle
Nurtitional status
palpation
Skin integrity
shape, size , contour
signs inflammation,
ecchymosis
muscle condition
deformity
Rashes
Color changes, esp with
cold; arterial vs. venous
Character of joints
Bruises, swelling
Specific Sites.......
Hand, extremities
Herberden nodes,
Bouchards nodes
Subcutaneous
nodules
Bursal swelling
Synovial cysts
Tophaceous cysts
Deformities
Ulnar drifts
valgus and varus deformities
atrophy
hypertrophy
general hygiene
Subcutaneous
nodules (Rheumatoid
arthritis)
Tophaceous cysts
(gout)
Urate cystals in
kidney (gout)
Herberdens
nodes
Knee Stability
Anterior cruciate ligament: limits anterior
motion
Posterior cruciate ligament: limits posterior
motion
Lateral collateral ligament: limits adduction
Medial collateral ligament: limits abduction
Meniscal injury: McMurrays sign
McMurrays sign
Diagnostic Tests
CT Scan
Bone Scan
MRI
Dual-Photon Absorptiometry
Arthrography
Arthrocenthesis
Arthroscopy
Diagnostic Tests
Arthrography
Radiographic exam,
use air or contrast
medium:; 90-95%
accuracy
Teaching
Complications:
infection, allergy
Post-op: Rest joint 612 hrs, use ice
Arthrocenthesis
Aspiration synovial
fluid; reduce pain; dx;
treatment
Analysis joint fluid:
usual clear, high
viscosity, scant fluid
Teaching: no
restrictions; consent
form; slight pain
Post-op: RICE
Arthroscopy
Therapeutic /diagnostic
Visual recording; surgical removal of
meniscus, foreign bodies, etc
Rare complications; depends on
procedure, operative length, use of
tourniquet
Teaching
Post-op care
Orthopaedic Interventions!
Traction
Casts
External Fixators
Pin, plates and screws
CPM
Crutch-walking
Assistive Devices
Traction
Definition
Uses
Types
Counter traction is
provided by:
a. body weight
b. pulleys
c. traction weight
d. splints
Crutch-walking
Two-point
Three-point
Four-point
Swing-through
swing-to
Safety in crutchwalking
Cane
CPM
Purpose
Guidelines
for Use
Teaching
Bone Stimulators
Indications
Electronegativ
ity
Bone
Remodeling
Internal
Percutaneous
External
Cell Savers
Autologous Blood
Pins, plates,
screws
ORIF (open
reduction,
internal fixation)
Casts, Casting!
Purposes
Casting Material
Plaster
Fiberglass
Casts
External Fixator
Application of Cast
Principles
Skin
Assessment
Skin
Protection
Heat
Generated
Time to Dry
Cast Types
Sugar
Tong/Splint
Spica Type
Body Cast
Hip spica
Gauntlet
Cast-Brace
Nursing Interventions
Amy, a 24 yr
old is
discharged
from the ER
with a long
arm cast.
What INITIAL
care?
What
discharge
teaching
should you
do?
Can you
delegate this?
External Fixators
How They Work
Principles of Care
The Iliazarov
External Fixator