Bone Mass Flashcards
do men or women have a lower peak density?
Women
What is the peak age range for bone mass?
30-40
T/F younger ages are more at risk for fractures
False, older
T/F postmenopausal women have a greater bone mass loss
True
osteopenia
thinning of trabecular matrix of bone before osteoporosis
T score -1-2.5
Osteoporosis
bone mineral density -2.5 below peak bone mass
Increased bone fragility more susceptible for fractures
What scan is used to diagnose osteoporosis
DEXA
T score
risk factors for osteoporosis
Increased age
History of fractures, adult
Postmenopausal women
Family History
Asian, Caucasian
Low weight– thin frame
Smoking, alcohol
Lack of weight-bearing exercise
Decreased calcium, vitamin D, estrogen, testosterone
Increase caffeine
Long-term corticosteroid therapy
Immunosuppressive drugs
Eating disorders
Gastric bypass surgery
FRAX tool
prediction to assess risk of a fracture
Provides treatment guidelines
Calculates ten year risk score
Patho of osteoporosis
bone resorption – osteoclasts
bone formation – osteoblasts
Inability to make new bone
Increased resorption
Or both
T/F there are many early signs and symptoms of osteoporosis
False
Later S/SX osteoporosis
fracture
Pain
Decreased height
Stooped posture – kyphosis
common Types of fractures
Most common – vertebrae
Hip – upper end of femur
Wrist
Is there a high likelihood of death after a fall?
Yes, for older women
Hospitalized over 65 years
risk factors for hip fracture
Over 65
Female
Osteoporosis
Frequent falls
Femoral neck injury
s/sx hip fracture
Sudden onset hip pain before or after fall
Inability to walk
Severe groin pain
Affected leg, externally, rotated, and shorter
What are complications of hip fractures?
infection – UTI/pneumonia
VTE
Prevention of hip fractures
calcium/vitamin D, supplements
Elemental Calcium – 1200–2000 Daily
Vitamin D – 800–1000 daily
Exercise 30 minutes three times a week
Fracture
Any break in continuity of bone that occurs when more stress is placed on bone then it can absorb
causes of fractures
Trauma
Fatigue, prolonged stress
Weak bone – spontaneous break – high risk in elderly
Description of fracture
name of bone
Location
Orientation of fracture
Alignment – displaced/not
Condition of overlying tissue – open/closed
T/F a closed fracture breaks through the skin
False
s/sx fracture
PED
PAIN
EDEMA – supportive
Deformity – loss of function, abnormal mobility
complications of fractures
Delayed healing
Bone growth impairment
Compartment syndrome
Fat embolism syndrome
delayed union
Pain and tender increased
Risk factor – smoking, malnutrition – decreased perfusion
Malunion
In proper alignment, not fully healed
No union
no healing 4–6 months post fracture
Causes – poor circulation, blood supply, repetitive stress
compartment syndrome causes
Due to crush type injuries
Cast – too tight, swelling tissue
Long bone injuries
Severe thermal burns
Animal bites
compartment syndrome
Increased pressure within limited anatomic space
what is the tourniquet affect?
Edema at fracture site puts intense pressure on soft tissue
Decreases perfusion
Leads to hypoxia of muscles and nerves
s/sx compartment syndrome
Extreme pain, rapid onset
can compartment syndrome be relieved with a fasciotomy
Yes
fat embolism syndrome
Fat molecules in lung with long bone fracture
24 – 48 after injury
Fat molecules from bone marrow/trauma tissue released in bloodstream and enter lungs
triad of symptoms for fat embolism syndrome
Hypoxemia
Altered LOC
Petechiae/rash
Will the embolism dissolve on its own?
yes
osteomyelitis
Acute/chronic pyogenic infection of bone
(Pus)
T/F osteomyelitis does not require immediate treatment
False
what is the usual cause of osteomyelitis?
Bacteria – staph Aureas on skin
risk factors for osteomyelitis
Recent trauma, bite wound
Diabetes – poor circulation, decreased immune response
Hemodialysis
IV. Drug use.
Splenectomy
PVD – poor circulation
routes of contamination
Open wound – open fracture, gunshot, puncture, surgery, insertion of metal plate/screws
Indirect- hematogenesis, blood-borne bacteremia
Who is more at risk for indirect contamination?
Kids less than 16 years old
Patho of hematogenous route
Arterial blood flow brings bacteria into bone
Infection results in inflammation, bone destruction, pus, edema
pressure increases
Ischemial necrosis
Osteoblasts lay new bone around old
Infection is isolated
osteomyelitis s/sx
local – Tender, warm, red, wound drainage, restricted movement, spontaneous fractures
Systemic – fever, positive blood culture, leukocytosis
