chapter 4(18)

Question 1

what is a fracture?

Answer 1

A fracture is a break in the integrity of a bone.

Question 2

what causes a fracture?

Answer 2

Fractures occur due to trauma, neoplasms, or increased stress on bones.

Question 3

when is pain of OA felt?

Answer 3

weight bearing/walking

Question 4

inflammatory response non-specific response to…

Answer 4

any tissue injury

Question 5

in inflammatory response, warmth, redness results in…

Answer 5

increase blood flow

Question 6

systemic effects are…

Answer 6

fatique, anerexia

Question 7

change in tissue marked by cells of diff shape and show increase in mitotic acitivity…

Answer 7

displaysa

Question 8

complete fractor

Answer 8

bone broken forming separate pieces

Question 9

incomplete fracture

Answer 9

bone only partially broken

Question 10

open fracture

Answer 10

skin is broken

Question 11

closed fracture

Answer 11

skin is not broken

Question 12

simple fracture

Answer 12

single break, maintain alignment and position

Question 13

Comminuted fracture

Answer 13

multiple fractures and bone fragments

Question 14

impacted fracture (trauma fracture)

Answer 14

one end forced into adjacent bone, femur into pelvis

Question 15

Pathologic fracture (trauma fracture)

Answer 15

results from weakness, occurs with little stress

Question 16

Stress fracture (trauma fracture)

Answer 16

– fatigue fractures

Question 17

Depressed fracture (trauma fracture)

Answer 17

skull fractured and forced into brain

Question 18

Hematoma (healing of bone fracture)

Answer 18

fibrin network is formed

Question 19

Factors Affecting Bone Healing

Answer 19

Amount of local damage
Proximity of bone ends
Presence of foreign material or infection
Blood supply to fracture site
Systemic factors – age, nutrition, anemia, etc.

Question 20

Closed reduction (treatment for fractures)

Answer 20

pressure to restore bone position

Question 21

Open reduction (treatment for fractures)

Answer 21

– surgery to align and/or insert pins, crews rods, or plates to align

Question 22

Osteoporosis

Answer 22

Metabolic bone disorder, Decrease in bone mass and density

Question 23

Primary osteoporosis

Answer 23

Idiopathic
Age 50+ years
Decreased sex hormones-post menopause- loss ovarian function, estrogen deficiency *need estrogen to inhibit bone resorption
Decreased calcium intake

Question 24

secondary osteoporosis

Answer 24

As a complication of another disorder

Question 25

what can osteoporosis lead to?

Answer 25

Can lead to kyphosis and scoliosis

Question 26

Treatments for osteoporosis?

Answer 26

Dietary supplements Exercise that is weight bearing Physiotherapy to reduce pain and maintain function Bisphosphonates & Selective estrogen receptor modulators: inhibit bone resorption, taken orally(i.e. boniva, fosamax Calcitonin- nasal spray Human parathyroid hormone- injection to stimulate osteoblast formation (i.e. Forteo)

Question 27

Fibromyalgia

Answer 27

A syndrome characterized by: Pain in soft tissues Stiffness affecting muscles, tendons, and soft tissue No obvious inflammation or atrophy Sleep disturbance and fatigue++ Anxiety and/or depression may be present Cause is not known but is hypothesized to be an imbalance in serotonin and other neurotransmitters or increased production of substance P

Question 28

Predisposing and aggravating factors for fibromyalgia

Answer 28

Onset is higher in women age 20 to 50 years. History of physical or psychological trauma or chronic pain Sleep deprivation Stress Fatigue

Question 29

Treatment for fibromyalgia

Answer 29

``` Stress avoidance or reduction Regular exercise in the morning Pace activity and rest as needed Applications of heat or massage, swimming Analgesic drugs Low doses of antidepressants NSAIDs New drugs – Lyrica (pregabalin) ```

Question 30

Rickets and Osteomalacia

Answer 30

Result from deficit of vitamin D and phosphates Causes – dietary deficits, malabsorption, intake of phenobarbitol, lack of sun exposure In children, leads to weak bones and other skeletal deformities In adults, may lead to soft bones, resulting in compression fractures

Question 31

Muscular Dystrophy (MD)

Answer 31

A group of autosomal recessive disorders Degeneration of skeletal muscle over time Duchenne or pseudohypertrophic MD is most common type – affects young boys

Question 32

Osteoarthritis (pathophisiology)

Answer 32

Articular cartilage is damaged. Surface of cartilage becomes rough and worn. Tissue damage causes release of enzymes, accelerating disintegration of cartilage. Subchondral bone may be exposed.

Question 33

Rheumatoid Arthritis

Answer 33

Considered an autoimmune disorder, RF antibody Causes chronic systemic inflammatory disease Higher incidence in women than in men Affects all age groups

Question 34

Rheumatoid Arthritis (pathophisiology)

Answer 34

Synovitis – marked inflammation, cell proliferation Pannus formation – granulation tissue spreads Cartilage erosion – creates unstable joint Fibrosis – calcifies and obliterates joint space Ankylosis – joint fixation and deformity develop if untreated

Question 35

what is the etiology of RA?

Answer 35

Exact cause not known Genetic factor is present. Familial predisposition Some links to viral infections

Question 36

Systemic signs of RA

Answer 36

``` Fatigue Anorexia Mild fever Generalized lymphadenopathy Generalized aching ```

Question 37

Spondyloarthropathies affecting the spine

Answer 37

Ankylosing spondylitis Reactive arthritis or reiter syndrome Enteritis-associated arthritis Psoriatic arthritis Related autoimmune, genetically influenced, vertebral arthritis in patients who are seronegative(no specific antibody)

Question 38

Ankylosing Spondylitis

Answer 38

A chronic progressive inflammatory condition Affects sacroiliac joints, intervertebral spaces, costovertebral joints More common in men age 20 to 40 years Cause has not yet been determined – deemed an autoimmune disorder with genetic basis

Question 39

Systemic signs of ankylosing spondylitis

Answer 39

fatigue, fever, weight loss, uveitis

Question 40

avulsion

Answer 40

complete deatchment from lgament or tendon from bone