Orthopedics Final

Ligament

- is composed of Type I collagen.

- has rich innervation for proprioception and pain.

- While it is hypovascular, there is some vascularity at its origin and insertion.

Sprain

2. Mystery Disease

-Common

-Ligament

-Injury

Phase I Extra-articular Ligament Healing

3. Mystery Disease

- Phases of ligament healing

- Inflammation occurs in response to injury

- Phagocytosis takes place during this phase

Phase II Extra-Articular Ligament Healing

4. Mystery Disease

- Phase of ligament healing

- Fibroblasts are highly active

- Mainly composed of Type III collagen

Phase III Extra-Articular Ligament Healing

5. Mystery Disease

-Phase of Ligament healing

-Increased Tensile Strength

-Increased Type I Collagen

Common Ligament Injuries

6. Mystery Disease

-Sprain

-MCL

-Knee/Ankle

Approximation

7. Mystery Disease

-Helps healing process

-Both ends in contact

-A part of surgical procedure called reduction

Keys to Ligament Healing

8. Mystery Disease

-Torn Ligament Ends in Contact

-Progressive controlled Stress

-Protect against excessive force

Reduction

9. Mystery Disease

-Surgical procedure

-Bones are aligned and approximated

-Used to help Fxs heal

Grade I Ligament Injury

10. Mystery Disease

-Ligament injury grade

-Has microscopic tears

-No Joint Laxity

Grade II Ligament injury

11. Mystery Disease

-Ligament Injury Grade

-Some ligament fiber tearing

-Moderate Joint Laxity

Grade III Ligament Injury

12. Mystery Disease

-Ligament Injury grade

-Complete rupture

-Marked Instability

Synovial Fluid

13. Mystery Disease

-Seen between joints

-Limits Healing Mechanism of intraarticular ligaments

-Prevents Fibrin Clotting

Effects of Immobilization

14. Mystery Disease

-Altered Joint

-Decreased H2O content

-Loss of Bone

Effects of Immobilization

15. Mystery Disease

-Stiff Joints

-Joint Adhesion

-Decreased Strength

Effects of Immobilization

16. Mystery Disease

-Weak Cartilage

-Weak Tendon

-Muscle Atrophy

Effects of Immobilization

17. Mystery Disease

-Shortened Ligament

-Stress Deprivation

-Negative effects begins at 2 weeks

CPM: Continuous Passive Motion

18. Mystery Disease

-Machine

-Common used in the Knee

-Helps Lube Joint w/ Mobility

Fracture

19. Mystery Disease

-Bone

-Injury

-Healing is dependent on how its stabilized post insult

ORIF: Open Reduction Internal Fixation

20. Mystery Disease

-Type of Surgery

-Incision done to access Fx

-Inside

CRIF: Closed Reduction Internal Fixation

21. Mystery Disease

-Type of Surgery

-Bones are manipulated into place

-No incisions done

OREF: Open Reduction External Fixation

22. Mystery Disease

-Surgical procedure

-Sticks outside of the body

-Incision done to access joint

CREF: Closed Reduction External Fixation

23. Mystery Disease

-Surgical procedure

-Sticks outside of the body

-No incisions done

Wollf's Law

24. Mystery Disease

-Bones

-Ability to adapt

-Mechanical Load

Delayed Union

25. Mystery Disease

-Bone

-Fx

-Takes a longer time to heal

Nonunion

26. Mystery Disease

-Bone

-Fx

-Does not heal

Malunion

27. Mystery Disease

-Bone

-Fx

-Did not heal correctly

Used for Bone Stimulation for Repair

28. Mystery Disease

-Autografts

-E-stim

-US

Simple Fracture

29. Mystery Disease

-Bone

-Injury

-Closed

Compound Fracture

30. Mystery Disease

-Bone

-Injury

-Open

Hairline Fx

31. Mystery Disease

-Incomplete

-Fracture

-Adult

Greenstick Fracture

32. Mystery Disease

-Incomplete

-Bone Injury

-Children

Comminuted Fx

33. Mystery Disease

-Bone

-More than 2 pieces

-Broken

Nondisplaced Fracture

34. Mystery Disease

-Bone

-Fracture

-Stays in place

Displaced Fx

35. Mystery Disease

-Bone

-Fracture

-Unaligned

Avulsion Fx

36. Mystery Disease

-Bone

-Breaks off

-Part attached to tendon

Angulated Fracture

37. Mystery Disease

-Bone

-Fracture

-Angled

Overriding Fracture

38. Mystery Disease

-Bone

-Fracture

-Overlaps

Pathological Fx

39. Mystery Disease

-Bone

-Fracture

-2/2 disease

Compression Fracture

40. Mystery Disease

-Bone

-Break

-Vertebrae

Hyaline Cartilage

41. Mystery Disease

-Covers the ends of bone

-Non homogenous

-Tensile strength from Type II collagen

Hyaline Cartilage

42. Mystery Disease

-Primarily composed of water

-Its avascular and aneural

-Superficial wounds do not heal spontaneously

Hyaline Cartilage

43. Mystery Disease

-Is unable to stimulate intrinsic repair

-Frictionless

-Takes large compressive loads

Hyaline Cartilage

44. Mystery Disease

-Articular

-Compression needed to function properly

-Nutrients provided by Synovial Fluid

Hyaline Cartilage

45. Mystery Disease

-Resistant to wear

-Durable

-Lubrication by diffusion/convection

Effects of Lack of Stress/Load to Hyaline Cartilage

46. Mystery Disease

-Atrophy

-Chondrocyte Necrosis

-Subchondral bone degeneration

Deep Hyaline Injury

47. Mystery Disease

-Exposed Subchondral Bone

-Inflammatory Response

-Better Cartilage healing

Superficial Hyaline Injury

48. Mystery Disease

-No inflammatory Response

-Proteoglycans and Chondroctye proliferation

-Weak Cartilage Healing

Meniscus

49. Mystery Disease

-Fibroelastic Cartilage

-Shock Absorbers

-Limits knee hyper extension

Meniscus

50. Mystery Disease

-Has a role in joint Lubrication

-Manages loads between tibia and femur

-Primarily Type 1 Collagen

Traumatic Meniscus Injury

51. Mystery Disease

-Type of Meniscus Injury

-Caused by compression forces

-Younger Population

Degeneration Meniscus Injury

52. Mystery Disease

-Type of Meniscus Injury

-Caused by insignificant events

-Older population

Zone I Meniscus Healing

53. Mystery Disease

-Zone of meniscus healing

-Vascular

-Red on Red

Zone II Meniscus Healing

54. Mystery Disease

-Zone of meniscus healing

-Partly vascular

-Red on White

Zone III Meniscus Healing

55. Mystery Disease

-Zone of meniscus healing

-No area within Vascular area

-White on White

Strain

56. Mystery Disease

-Muscle

-Tear

-Injury

Contusion

57. Mystery Disease

-Muscle

-Injury

-Blunt Trauma

DOMS: Delayed Onset Muscle Soreness

58. Mystery Disease

-Indirect

-Muscle injury

-2/2 sudden muscle stretch or contraction

Myositis Ossificans

59. Mystery Disease

-Severe Contusion

-Bone deposits within muscle tissue

-Heterotopic Ossification

Type I muscle injury

60. Mystery Disease

-Classification of Muscle injury

-Only Muscle Fibers

-Damaged

Type II muscle injury

61. Mystery Disease

-Classification of Muscle injury

-Muscle tissue and nerve supply

-Damaged

Type III muscle injury

62. Mystery Disease

-Classification of Muscle injury

-Muscle fibers, Matrix, nerve and vascular

-Damaged

Effects of Muscle Immobilization

63. Mystery Disease

-Atrophy

-1st Week

-Decreased sarcomeres

Lengthened position for immobilization

64. Mystery Disease

-Position

-When immobilized

-Prevents Muscle Atrophy

Tendon

65. Mystery Disease

-Mostly composed of Type I collagen

-Injured often w/ muscle

-Heals slowly

Effects of immobilization for Tendon

66. Mystery Disease

-Decreased Water content

-Decreased Tensile Strength

-Reduced strength at tendon-bone junction

Osteoporosis

67. Mystery Disease

-Bone formation < bone resorption

-Metabolic Disorder

-Susceptible to fracture

Osteoporosis

68. Mystery Disease

-Inadequate Mechanical Load

-Decreased Bone mass

-Women > Men

Osteoporosis

69. Mystery Disease

-Microdamage to bone structure

-Brittle Bones

-Susceptible to Fractures

Osteomalcia

70. Mystery Disease

-Softening

-Adult Rickets

-Insufficient intestinal calcium absorption

Osteomalcia

71. Mystery Disease

-New bone lacks mineralization

-Calcium, Vit D, Phosphate deficiency

-Increased renal phosphorus losses

Paget's Dz

72. Mystery Disease

-Inherited

-Insidious Onset

-Osteoblastic Sclerotic Plaque

Paget's Dz

73. Mystery Disease

-Fibrous Tissue replaces Bone

-Hypercalcemic

-Can lead to Arthritis

Paget's Dz

74. Mystery Disease

-Steal Syndrome

-Rapid Bone Resorption

-PAIN: HA/Musculoskeletal

Osteochondroses

75. Mystery Disease

-A group of disorders (umbrella term)

-Targets ossification centers

-Epiphyses

Osteochondritis Dissecans

76. Mystery Disease

-Local Subchondral Necrosis=> Recalcification

-Common site: Medial Femoral Condyle

-Wilson's Sign

Osteochondritis Dissecans

77. Mystery Disease

-Repetitive microtrauma in knee

-Loose bodies in the joint

-Can cause necrosis

Osteonecrosis

78. Mystery Disease

-Avascular Necrosis

-Osteochondroses

-permanent loss of bone tissue

Chandler's Dz (Osteonecrosis)

79. Mystery Disease

-Aseptic Necrosis

-Common site: Femoral Head

-After 2 hours of complete ischemia

Legg-Calve-Perthes Disease

80. Mystery Disease

-Children

-Necrosis of proximal femur

-Tx: Seat femoral head

Legg-Calve-Perthes Disease

81. Mystery Disease

-2/2 decreased blood supply to head of femur

-Boys> Girls

-Groin Pain

Legg-Calve-Perthes Disease

82. Mystery Disease

-Insidious Onset

-Aggravated by activity, lessened w/ rest

-Epiphyseal Osteonecrosis

-Coxa Plana

-Osteochondritis Deformans

-Epiphyseal Aseptic Necrosis

-Epiphyseal Osteonecrosis

-Epiphyseal Avascular Necrosis

83. Names for Legg-Calve-Perthes Disease

Osteoarthritis

84. Mystery Disease

-Degenerative Dz

-WB joints

-Condral Bone Exposure

Osteoarthritis

85. Mystery Disease

-Crepitus

-Heberden's Nodes

-Gel time: 20-30 mins

Osteoarthritis

86. Mystery Disease

-Bouchard's Nodes

-Loss of joint function

-Wear and Tear Dz

Osteoarthritis

87. Mystery Disease

-Insidious Onset

-Progressive

-Joint Destruction

Osteoarthritis

88. Mystery Disease

-Synovial Joint

-Loss of articular cartilage

-Osteophytes form

Rheumatoid Arthritis

89. Mystery Disease

-Systemic

-Gel time > 30 minutes

-Pannus formation

Rheumatoid Arthritis

90. Mystery Disease

-Bilateral, symmetrical joints

-Insidious onset

-swollen/painful joints

Rheumatoid Arthritis

91. Mystery Disease

-Extra-articular findings

-Positive Lhermitte's sign

-Cartilage Necrosis

Rheumatoid Arthritis

92. Mystery Disease

-Woman>Men

-Inflammatory

-Ulnar Drift

Rheumatoid Arthritis

93. Mystery Disease

-Nodules

-Remission: <15 mins of stiffness in AM

-Boutonniere

Ulnar Drift

94. Mystery Disease

-Deformity

-Fingers

-Towards little finger

Swan Neck

95. Mystery Disease

-MCP: Flexion

-PIP: Hyperextended

-DIP: Flexion

Boutonniere

96. Mystery Disease

-PIP: Flexed

-DIP: Hyperextended

-Fingers

Stills Disease

97. Mystery Disease

-Children

-Severe extra-articular findings

-Systemic

Stills Disease

98. Mystery Disease

-Intermittent high fever w/ rash

-Boys=Girls

-Joints

Degenerative Intervertebral Disc Dz

99. Mystery Disease

-Segmental Instability

-Decreased Disc space height

-Nucleus pulposus herniates

Degenerative Intervertebral Disc Dz

100. Mystery Disease

-Nucleus Pulposus degenerates

-Segmental Narrowing

-Subluxation of posterior facet joints