Disorders of the Skeletal System: Chapter 43 Flashcards

Question

Fractures diagnosis and treatment

Answer 1

> Diagnosis Assessment X-ray > Treatment Reduction of fracture Closed or open Immobilization: splint, cast, external fixation devices, traction Preservation & restoration of function Physiotherapy

Answer 2

``` 1. Hematoma formation First 1-2 days Bone/tissue blood vessel rupture Fibrin network (clot) forms - Provides foundation for inflammatory cells ``` 2. Fibrocartilaginous callus formation Fibroblasts begin repair Takes 2-3 weeks, but still weak

Answer 3

``` 3. Bony callus formation: ossification Osteoblasts form; calcium salts deposit Cartilage converts to bony callus Begins 3-4 weeks after injury, takes months 4. Remodelling Dead cells removed Compact bone replaces spongy bone; callus shrinks Possible “scar”. ```

Answer 4

``` 1. Delayed union Failure to heal in usual time, but eventually does 2. Malunion Deformity 3. Nonunion Failure to heal ```

Answer 5

- Epidermal necrosis d/t fluid separating it from dermis - Often where minimal s/c tissue between epidermis and bone - Chance of infection if broken

Answer 6

``` > Increased intra-osseus pressure within a limited space due to: Decreased size Constrictive dressings Casts Burns Increased volume of contents Trauma Fluid/edema Vascular injury/bleeding Venous obstruction Both ```

Answer 7

``` > Amount of pressure dependent upon: Duration Metabolic rate Vascular tone Local blood pressure ``` > Result of increased pressure Compression of vessels = ischemia, necrosis Compression of nerves = paresthesis, paralysis

Answer 8

``` > Manifestations Severe pain Sensation change: burning/tingling/loss Diminished reflexes, motor function loss Decreases/loss peripheral pulses > Assessment Pain Sensory Motor function ```

Answer 9

1. Pain 2. Pulselessness 3. Paralysis 4. Paresthesia 5. Polar (temp) 6. Pallor (colour)

Answer 10

Common but few people have symptoms or complications Fat droplets from bone & adipose tissue circulate though venous system to body Not the same as a “fat emboli”

Answer 11

``` Respiratory failure Dyspnea, pallor, cyanosis Angina, tachycardia, diaphoresis Cerebral dysfunction Early or late sign Mentation/behaviour changes Focal deficits, encephalopathy, seizures Skin/mucosa petechiae Rash 2-3 days post event ```

Answer 12

``` > Skin injury - Fracture blisters > Muscle injury - Compartment syndrome > Nerve injury - Paresthesia, paralysis > Adipose/bone injury - Fat emboli, FES ```

Answer 13

> Infection of bone Direct contamination Hematogenous (thru blood) Via skin lesion > Staphylococcus aureus most common Adheres to bone, attacks cells Evades host defenses and colonizes

Answer 14

``` > In children Affects long bones Purulent exudate inside bone Damages arteries supplying bone May penetrate skin or involve joints > In adults In vertebrae, sternoclavicular and sacroiliac joints, or pubic symphysis Tends to affect joint space ```

Answer 15

``` Manifestations Signs of bacteremia Fever, chills, malaise Pain on movement of area Tenderness Erythema Edema ```

Answer 16

``` Usually adults Usually secondary to open wound Sequestrum Infected dead bone Separated by sheath Difficult to detect when near a joint prosthesis. ```

Answer 17

``` > Bone destruction d/t interruption in blood flow Idiopathic Bone injury Thrombosis/embolism Vessel injury Increased intraosseous pressure Corticosteroid associated (unclear) ```

Answer 18

> Manifestations Chronic pain, unrelated to movement > Treatment Dependent on cause Immobilization, anti-inflammatories, exercise Surgery often needed for hip involvement

Answer 19

``` Confined to bone Well-defined borders Seldom cause fractures Seldom require treatment or surgery 1. Osteoma Small bony tumor (new bone tissue) on bone surface 2. Fibrous tumors Common in growing bones Usually asymptomatic Resolve in 2-3 years ```

Answer 20

3. Chondroma (tumor made of cartilage) Short bones; solitary lesion Onset @ 20-40 years of age Asymptomatic or painful ``` 4. Osteochondroma (cartilage-capped tumor) Bony stalk attaches it to bone Most common Slow-growing, solitary mass Knee is common ``` ``` 5. Osteoclastoma (giant cell tumor) Behaves like malignant Metastasizes via bloodstream Recurs after removal May invade bone and cause bone destruction Knee is common Pathological fractures common ```

Answer 21

``` 1. Osteosarcoma (most common) Tends to be in areas with fastest bone growth Unknown etiology, but genetic connection Peak ages: women Metastasizes early, often to lung 2. Chondrosarcoma Can arise from pre-existing benign cartilaginous tumor Mid to late adulthood Slow-growing Responds to early excision 3. Ewing sarcoma Densely packed small cells Children & young adults Men > women ```

Answer 22

Skeletal metastasis is the most common bone cancer 50% of all cancers metastasize to the bone Most often in trunk bones Manifestations Pain Pathologic fracture Hypercalcemia d/t bone destruction

Answer 23

- Changes in organ function (organ damage, inflammation, and failure): - Local effects of tumors (e.g., compression of nerves or veins, stretching of periosteum): - Nonspecific signs of tissue breakdown (e.g., protein wasting, bone breakdown):