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Pathophysiology PH1002 > Bone fracture and fracture healing > Flashcards

Bone fracture and fracture healing Flashcards

1
Q

Disorder of development- osteogenesis imperfecta

A

brittle bones- less collagen

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2
Q

Disorder of development- spina bifida

A

to do with arches that grow amd arch to form spinal processes- doesn’t form properly- spinal cord could go out- risk of damage

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3
Q

Disorder of development- achondroplasias

A

long bones don’t form properly, they are shorter

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4
Q

Endocrine disorders- gigantism

A

produce too much growth hormone, occurs and causes problems pre puberty, people larger than average

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5
Q

Endocrine disorders- acromegaly

A

too much growth hormone after the formation of epithelial plates have formed, means there is an increase in density rather than length, affects face more

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6
Q

Endocrine disorders- pituitary dwarfism

A

inadequate production of growth hormone

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7
Q

Endocrine disorders- postmenopausal osteoporosis

A

Postmenopausal women are susceptible to primary osteoporosis since osteoporosis is closely related to estrogen deficiency.

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8
Q

Endocrine disorders- hyper/ hypoparathyroidism

A

controls calcium- too much/ little can affect the levels calcium- effects amount laid down or destroyed at bone level

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9
Q

Nutritional problems- rickets

A

lack of vitamin D, reduces amount of calcitriol produced- involved in calcium homeostasis, not enough calcium is laid down or destroyed at bone level, in adults it causes

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10
Q

Nutritional problems- osteomalacia

A

causes bones to become soft

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11
Q

Nutritional problems- scurvy

A

vitamin C- needed for collagen production and stimulation of osteoblasts- effects building of bones, symptoms include bleeding gums

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12
Q

Disorders of the bones linking to ageing- ostopina

A

bones get weaker as we age, to do with disposition and reabsorption, cell building properties are lost- inadequate ossification, osteoblasts activity declines, whereas osteoclasts stays the same (mainly affects the jaw)

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13
Q

Disorders of the bones linking to ageing- osteoporosis

A

reduction in bone mass happens and effects the function, the reduction in bone mass is greater than at expected at that age, lack of weight bearing can cause it , can be classified as primary and secondary

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14
Q

who does osteoporosis affect the most

A

mostly females over 70%, if menopause happens early or goes on too long

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15
Q

What is primary osteoporosis

A

simple form seen in older people and women past menopause, it is accelerated bone loss but is predicted

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16
Q

What is secondary osteoporosis

A

not necessarily related to older people, menopause, osteoporosis can be caused by metabolic bone disease, or cancerous, maligins, severe malnutrition, certain drugs can lead to it for example corticosteroids, can lead to lack of ability to weight bear

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17
Q

Modifiable risk of osteoporosis

A

smoking increases risk, alcohol abuse, excessive caffeine , excessive dietary production, lack of dietary calcium, lack of sunlight exposure

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18
Q

Changes in bone mass with ageing

A

after mid 30’s, you begin to lose bone mass, women loss bone mass faster after menopause, but happens in men too
bones can weaken early in life without a healthy diet and right kinds of physical activity

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19
Q

when is osteoporosis usually found

A

usually found after fracture

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20
Q

What are fractures

A

fractures are breaks were mechanical stress is placed on this are it create excessive amount of force and bone cannot cope

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21
Q

Classification of fractures- severity- open/compound

A

bone has broken through skin, lots of skin tissue trauma

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22
Q

Classification of fractures- severity- impacted

A

one fragment is driven into another with such force that the 2 bones breaks. are forced into each other

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23
Q

Classification of fractures- severity- comminated

A

lots of different fracture pieces- broken into

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24
Q

Classification of fractures- severity- close/ simple

A

skin is not broken and soft tissue involvement is less

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25
Q

Classification of fractures- severity- displaced

A

normally 2 fragments, they have moved from original position, usually involve muscle spasm

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26
Q

Classification of fractures- severity- compressed

A

A compression fracture is a type of fracture or break in your vertebrae.

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27
Q

Classification of fractures- shape- spiral

A

twisting forces causes spiral forces along long axis of bones

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28
Q

Classification of fractures- shape- oblique

A

combination of twisting and direct force

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29
Q

what are fractures named according to

A

severity, shape, position, physicians name

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30
Q

Classification of fractures- shape- greenstick

A

only seen in children, bone doesn’t snap, and then a couple of bits splinter of

31
Q

Classification of fractures- shape- depressed

A

skull fracture- a bit of the skull has depressed downwards

32
Q

Classification of fractures- shape- transverse

A

direct blow in horizontal axis

33
Q

Classification of fractures- positions

A

Distal/ proximal, neck, shaft, epiphyseal

34
Q

Classification of fractures- physicians name

A

Colle’s- distal end of radius fracture, Pott’s- one or both ends of malleoli fracture

35
Q

4 stages of fracture healing

A

Haematoma formation, fibrocartilaginous callus formation, bony callus formation, bone remodelling

36
Q

4 stages of fracture healing- step 1 haematoma

A

clot produced 6-8 hours, one cell does, inflammation bring phagocytic cells- osteoclast cells arrive to clear up debris, new capillaries grow in that area, bleeding occurs- damaged blood vessels and nutrient arteries, disruption in periosteum of bone, blood clot formed in medullary cavity

37
Q

4 stages of fracture healing- step 2 fibrocartilaginous formation

A

fibroblasts invade the procallus and produce/ secrete collagen to make ends of the bones more solid, happens inside (medullary cavity in shaft bone) and outside. Unites 2 ends of the bone- week temporary, chondroblasts produce fibrocartilage, arrival of new capillaries become organised

38
Q

length of fibrocartilaginous callus formation

A

starts after a couple of days- can take months

39
Q

4 stages of fracture healing- step 3 formation of bony callus

A

osteoblasts (differentiate from mesenchymal progenitors) secrete spongy bone (ontop of callus) that joins the broken ends of the bone, bone grows and units until ends are connected with bridge of spongy bone (callus), this is when the fracture site is firmly held

40
Q

Formation of bony callus length

A

last 3-4 months

41
Q

4 stages of fracture healing- step 4 bone remodelling

A

compact bone replaces the spongy bone in the bone callu, osteoblasts take away spongy bones, surface is remodelled back to normal shape, sometimes a palpable lump remains

42
Q

what is needed in the bone remodelling stage

A

normal mechanical stress is needed- immobilisation needs to stop

43
Q

how long does the bone remodelling stage lasts

A

can continue for up to a year

44
Q

type of fracture, location, union, consolidation- Spiral

A

upper limb, union- 3/52, consolidation- 6/52

45
Q

type of fracture, location, union, consolidation- transverse

A

upper limb, union- 6/52, consolidation 12/52

46
Q

type of fracture, location, union, consolidation- spiral (Lower)

A

lower limb, union- 6/52, consolidation- 12/52

47
Q

type of fracture, location, union, consolidation- transverse (lower)

A

lower limb union 12/52, consolidation 24/ 42

48
Q

why do spinal fractures heal quicker

A

due to surface area of bone involved

49
Q

what does union mean

A

fibrocartilaginous formation point

50
Q

what does consolidation phase mean

A

bony callus formation

51
Q

Factors that affect the rate of healing

A

type off, site off, vascular supply, age of patient, movement at, separation of bone ends, infection, bone pathology

52
Q

Clinical feature of a fracture

A

pain and tenderness, swelling and bruising, deformity and angulation, impaired function, shock

53
Q

Test for a fracture

A

X- ray, AP and lateral- more than one angle

54
Q

What is reduction- fracture treatment

A

application of longitudinal force to make sure limb is aligned

55
Q

Reduction- closed/ simple

A

closed= simple fracture with minimal soft tissue damage

56
Q

Reduction- open/ simple

A

open= simple fracture which needs higher level of immobilisation: near the joint and comminuted fractures

57
Q

Reduction- open/ compound

A

open/ compound fractures including damage and at risk of infection

58
Q

What is immobilisation- fracture treatment

A

only want micro movements as big movements can affect callus formation

59
Q

Immobilisation- closed/ simple

A

sling, cast, splint

60
Q

Immobilisation- open/ simple

A

O.R.I.G, open reduction external, fixation

61
Q

Immobilisation- open/ compound

A

O.R.E.F, open reduction external

62
Q

Rehabilitation- closed/ simple

A

once consolidation achieved if necessary

63
Q

Rehabilitation- open/ simple

A

may commence immediately

64
Q

Rehabilitation- open compound

A

fractures including tissue damage and at risk of infection

65
Q

Complications of fracture treatment- delayed

A

not healing in correct time/ mal/ non-union- bone alignment not right, bone won’t heal

66
Q

Complications of fracture treatment- avascular necrosis

A

bone dies due to poor blood supply

67
Q

Complications of fracture treatment- sudek’s atrophy

A

mainly in 40- 60 year old females, disruption in sympathetic nervous system, type 1- no neurological involvement, type 2- nerve involvement, symptoms are disproportionate pain

68
Q

Complications of fracture treatment- Compartment syndrome

A

too much bleeding and swelling of area- increase pressure in compartment- cuts of blood supply

69
Q

Complications of fracture treatment- volkman’s ischaemia

A

increase pressure within forearm due to bleeding and swelling- can affect nerves in hand

70
Q

Complications of fracture treatment- myositis ossification

A

bone laid down in the muscle by accident- usually reabsorbed over time, can require surgery

71
Q

Complications of fracture treatment- blood vessel and tendon

A

blood vessel, nerve or visceral damage,

tendon injury- can tear

72
Q

Complications of fracture treatment- fat embolus

A

log bones- lots of yellow bone marrow, if this gets into blood supply it can cause a stroke or heart attack

73
Q

Complications of fracture treatment- osteoarthritis and growth

A

osteoarthritis, growth impairment

Pathophysiology PH1002 (22 decks)

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