ONC flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Five Ps of neurovascular assessment

Pain, pallor, pulselessness, paresthesia, and paralysis are checked along with temperature, capillary refill, and edema to detect impaired perfusion or nerve function after injury or casting.

Normal capillary refill time

Capillary refill of 2 seconds or less indicates adequate peripheral perfusion, while a delay beyond 2 seconds suggests reduced arterial flow or hypovolemia and warrants further assessment.

Compartment pressure diagnostic threshold

An absolute intracompartmental pressure above 30 mmHg, or a diastolic-to-compartment difference under 30 mmHg, supports compartment syndrome and warrants urgent surgical fasciotomy.

Muscle strength grading scale

Grade 0 is no visible contraction and grade 5 is normal strength against full resistance; grades 1 through 4 describe trace motion up to movement against gravity with some resistance.

Fat embolism syndrome timing

It typically appears 24 to 72 hours after a long-bone fracture and presents with hypoxemia, neurologic changes, and a petechial rash over the chest, axillae, and conjunctivae.

Classic signs of fracture

Deformity, swelling, discoloration, tenderness, crepitus, and loss of function are classic findings; definitive diagnosis requires imaging, usually plain radiographs in two views.

Open fracture initial priorities

Cover the wound, give intravenous antibiotics within 1 hour, update tetanus prophylaxis, and proceed to surgical irrigation and debridement while stabilizing the fracture without delay.

Salter-Harris fracture classification

Types I to V follow SALTR: slip through the physis, above the physis into metaphysis, lower through the epiphysis, through both physis and epiphysis, and crush injury of the growth plate.

Osteoarthritis radiographic features

Joint-space narrowing, subchondral sclerosis, osteophyte formation, and subchondral cysts appear on x-ray; Heberden nodes affect distal and Bouchard nodes proximal interphalangeal joints.

Rheumatoid arthritis hallmark features

Symmetric polyarthritis of small joints, morning stiffness lasting over 1 hour, ulnar deviation, and positive rheumatoid factor or anti-CCP antibodies characterize the disease, which also affects other organs.

Osteoporosis T-score thresholds

A T-score of -2.5 or lower defines osteoporosis, while -1.0 to -2.5 defines osteopenia; bone density is measured by dual-energy x-ray absorptiometry, usually at spine and hip.

Gout crystal identification

Monosodium urate crystals are needle-shaped and negatively birefringent under polarized light, whereas calcium pyrophosphate crystals of pseudogout are rhomboid and positively birefringent.

Autonomic dysreflexia trigger and signs

In cord injuries at T6 or above, noxious stimuli such as a distended bladder cause severe hypertension, bradycardia, and pounding headache; sit the patient up and remove the stimulus.

Neurogenic shock presentation

Hypotension with bradycardia and warm, dry skin results from loss of sympathetic tone after cervical or high thoracic cord injury and is treated with fluids and vasopressors.

Cauda equina syndrome red flags

Saddle anesthesia, new bladder or bowel dysfunction, bilateral leg weakness, and severe back pain require emergency imaging and surgical decompression to prevent permanent neurologic deficit.

Straight leg raise test

With the patient supine, passively raising the extended leg between 30 and 70 degrees that reproduces radicular pain suggests lumbar disc herniation or nerve root irritation.

Pavlik harness purpose

Used in infants under 6 months with developmental dysplasia of the hip, it holds the hips in flexion and abduction so the femoral head seats and stimulates acetabular development.

Slipped capital femoral epiphysis presentation

Obese adolescents often report groin or referred knee pain with an out-toeing gait; the patient must remain non-weight-bearing until the physis is stabilized with surgical pinning.

Ortolani and Barlow maneuvers

Ortolani reduces a dislocated hip with a palpable clunk during abduction, while Barlow dislocates a reducible hip using adduction and posterior pressure in infant dysplasia screening.

Ponseti method for clubfoot

Serial gentle manipulation and casting begin in the first weeks of life, usually followed by percutaneous Achilles tenotomy and a foot-abduction orthosis worn to prevent relapse.

Cast care in first 24 hours

Handle a wet cast with the palms to avoid dents, elevate the limb to limit swelling, apply ice, and report burning, odor, drainage, or pain unrelieved by medication.

Posterior hip replacement precautions

Avoid hip flexion beyond 90 degrees, adduction past midline, and internal rotation; an abduction pillow and raised toilet seat help prevent prosthetic dislocation after posterior-approach surgery.

Buck's traction typical weight

Skin traction applied to the lower leg for temporary fracture stabilization usually uses 5 to 10 pounds, with weights hanging free and never resting on the floor.

Surgical site infection prevention

Administer prophylactic antibiotics within 60 minutes of incision, maintain normothermia and glucose control, and use chlorhexidine skin preparation to reduce orthopaedic surgical infection risk.

Compartment syndrome nursing actions

Remove constricting bandages, keep the limb at heart level rather than elevated, provide analgesia, and notify the surgeon immediately; fasciotomy is the definitive treatment.

Deep vein thrombosis signs

Unilateral calf pain, swelling, warmth, and erythema suggest deep vein thrombosis; Homan sign is unreliable, and diagnosis is confirmed with duplex ultrasound before anticoagulation begins.

Pulmonary embolism classic findings

Sudden dyspnea, pleuritic chest pain, tachycardia, and hypoxemia after orthopaedic surgery or immobility require urgent evaluation with oxygen, anticoagulation, and hemodynamic support.

PCA opioid adverse effects

Monitor for sedation, respiratory depression, nausea, pruritus, and constipation; naloxone reverses opioids, and a sudden increase in demand may signal a surgical complication.

Crutch height fitting

Handgrips should sit at wrist level with arms at the sides, and the axillary pad should rest 2 to 3 finger widths below the axilla to prevent nerve compression.

Cane use on which side

A cane is held in the hand opposite the affected leg and advanced together with the involved limb to widen the base of support and reduce joint loading.

Three-point gait pattern

Used with non-weight-bearing status: both crutches and the involved leg advance first, then the uninvolved leg bears full weight while the crutches remain stationary.

Teach-back method purpose

The clinician asks the patient to explain or demonstrate the instruction in their own words, confirming understanding and revealing gaps before discharge teaching is completed.