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D&D Final > Disorders of the Skeletal System : Trauma, Infection, Neoplasms, Childhood Disoders > Flashcards

Disorders of the Skeletal System : Trauma, Infection, Neoplasms, Childhood Disoders Flashcards

1
Q

How are bones Classified? What are they?

A

by shape and size

Long, Short, Flat, Irregular

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2
Q

What are the functions of bone?

A

support
help determine our size and proportion
protection
Metabolic Function (hematopoiesis and Calcium storage)

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3
Q

Bone are made of

A

living connective tissue

intracellular matrix made of collagen fibers and calcium phosphate salts and together they form a rigid structure

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4
Q

Describe the shape of Long Bones and give examples.

A

hollow shaft and two bulbous ends

humerous, radius, ulna, femur, metacarpals, metatarsals, clavicles

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5
Q

Describe the shape of Short Bones and give examples.

What are the function of Short Bones?

A

square (as wide as they are long)
ankles and wrists (tarsals and carpals)

function: to support, add stability don’t have movement

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6
Q

Describe the shape of Flat Bones and give examples.

A

thin and curved

the bones of the skull

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7
Q

Describe the shape of Irregular Bones and give examples.

A

vary in shape
often have projections

mandible, vertebrae

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8
Q

Articulation

A

between bones, forming a joint

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9
Q

What are the 3 types of joints?

A

Synarthroses
Ampiarthroses
Diarthroses

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10
Q

Synarthroses

A

immovable moveable joints

Ex: sutures in the skull

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11
Q

Amphiarthroses

A

slightly moveable joints, connection with cartilage

Ex: junction between ribs and sternum

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12
Q

Diarthroses

A

freely moving joints

most common type

Ex: knees elbows

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13
Q

What are the functions of skeletal muscle

A

movement (by muscle contraction)
body position and tone (constant partial muscle contractions)
Stabilization (helps prevent excessive movements)
temperature (heat produced by muscle contraction)

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14
Q

tendons

A

attach muscle to bone

composed of collagen fibers arranged in bundles

cant stand significant stress

little blood supply

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15
Q

Ligaments

A

attach bone to bone

little blood supple

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16
Q

skeletal muscles are…

A

voluntary muscles

bundles of muscle fibers covered in connective tissue

involuntary…with out deliberate intent (happening without thinking about it but still voluntary… respiratory movement, postural adjustments, blinking eyes, shivering, facial expressions)

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17
Q

Why is recovery for damaged ligaments and tendons slow?

A

lack of blood supply

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18
Q

contusion

A

bruise

generally from direct trauma

true disability isn’t usual, it just hurts

skin intact, swelling

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19
Q

muscle bruising

A

deeper injury, more force required to get bruising here

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20
Q

ecchymotic area

A

bruise

microscopic rupture of blood vessels

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21
Q

Hematoma

A

larger area of local hemorrhage

can push on nerve endings, more pain

“blood blister”

longer to heal

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22
Q

Strain

A

partial tear in muscle or muscle tendon union , often from a sudden stretch
inflammation at site of injury, as it repairs itself it will form fibrous tissue (scar)

presents with pain, more with stretch, stiff, swelling

more common in middle age adults because they have less elasticity

common places : lower back, shoulders

athletes: quadriceps and hamstrings

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23
Q

Sprain

A

involve ligaments
S/S resemble a strain
but pain and swelling subsides more slowly

abnormal or excessive movement of joint

ankles, knees elbows

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24
Q

dislocation

A

displacement of the articulating surfaces (joints) where the bone ends and the joint are partially in contact

S/S: pain and deformity , limited movement

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25
Q

shoulder

A

one of the largest and most complex joints in the body

ball in socket

humerous fits loosely in shoulder giving wide range of motion and move vulnerable to injury

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26
Q

rotator cuff

A

collection of muscles in the shoulder

gives support allowing for wide ROM

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27
Q

bursa

A

a small sac of fluid that cushions and protects the tendons

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28
Q

4 muscles of the rotator cuff

A

Supraspinatous muscle
Subscapularis Muscle
Infraspinatous muscle
Teres Minor Muscle

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29
Q

what is the rotator cuff vulnerable to?

A

Fractures, dislocations, degenerative processes (more we move)

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30
Q

Rotator Cuff injuries commonly result from

A

excessive use, a direct blow or stretch injury usually involving throwing, swinging

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31
Q

acromioclavicular joint

A

a common site of sprains in athletes and physically active persons

usually Injured by Direct Blow
falling on outstretched arm or elbow

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32
Q

glenohumoral

A

one of the most commonly displaced joint

Usually injured by stretch
hurt by being abducted and forcefully extended

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33
Q

knee injuries

A

common site of injury, esp with sports

repetition leads to degenerative joint disease

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34
Q

ligament injuries

A

most serious

forceful stress against the knee

“popping” sound, tearing, sudden pain, cant bare weight, can hemorrhage

35
Q

Meniscus

A

C shaped cartilage between the condyle of the femur and the tibia

major role player in weight baring, shock absorbing, stabilizing the knee and assists with lubrication

36
Q

how do we injure meniscus

A

rotational injuries…..

often in conjunction with something else

37
Q

Subluxation

A

incomplete or partial dislocations

ex: young kids who dislocate the patella

38
Q

Hip injuries

A

dislocation of the femoral head - the femoral head is displaced from the acetabulum

often from severe trauma

knee being struck while hip and knee in FLEXED position (sitting driving..and POOF..car wreck… ouch! the dashboard hit my legs and dislocated my hip! call the ambulance!)

S/S
pain, shortening of leg, limited mobility,cant put weight on it

High Risk: Osteoporosis

39
Q

Why is hip dislocation serious

A

great pressure put on vasculature

40
Q

whose at risk for breaking hip

A

osteoporosis (esp post menopausal women)

older people (falls)

41
Q

How are fractures classified?

A

classified by location, direction of the fracture line and type

  • open/closed
  • complete/incomplete
  • pathological stress
  • characteristics of fracture pieces
42
Q

Important factor of fractures…

A

open versus closed

43
Q

what are you at risk for with open fractures?

A

infection (not a sterile environment)

44
Q

complete versus incomplete fractures

A

complete- bone all the way broken

incomplete - cracked

45
Q

cast used with what kind of fractures

A

incomplete fractures

46
Q

Pathological Stress Fractures

A

disease process that weakens area of the bone, cancers, osteoporosis and Degenerative bone diseases can get stress fractures in the spine

47
Q

Manifestations of fractures

A

numbness and tingling if there is nerve damage (could be localized right after injury esp. closed although we don’t know why)

pain, tenderness, swelling

open will have bleeding, closed will have bruising

crepitus- grinding of bone on bone, grading

DEFORMITIES - long bone angulation, rotation, shortening

48
Q

crepitus

A

grading of bone against each other

49
Q

Simple fracture

A

closed

50
Q

Compound fracture

A

open

risk of infections

51
Q

Why do we take Xrays?

A

to see what the chips look like (complete versus incomplete)

52
Q

complete

A

fragments are separated

53
Q

incomplete

A

bone fracutres are partially joined

54
Q

greenstick

A

young soft bone
partially bends and partially breaks

why kids end up with casts a lot of times

55
Q

linear fracture

A

parallel to the bones long axis

56
Q

transverse fracture

A

across

at right angle

57
Q

Spiral Fracture

A

from twisting force

58
Q

Comminuted Fracture

A

broken into several pieces (crumbly), hard to repair

59
Q

Impacted Fracture

A

bone fragments drive into each other

lots of force (POOF)

60
Q

Compression Fracture

A

due to osteoporosis, tumors

61
Q

how do bones heal themselves?

A
  • After fracture hematoma forms in the area of injury -Bleeding into area and forms a clot inbetween the two pieces
  • Then a fibrin mesh seals off fracture site
  • New capilarries forms granulation tissue
  • Start to get fibroblast and bone marrow invades this area which forms a fibrocartiligenous callus —soft but bridges two parts together
  • Fibrocartiligenous callous turns from soft to hard
  • During remodeling damage parts of the bone will be removed and eventually replaced with spongy bone material
62
Q

hematoma

A

must form before anything else happens

63
Q

Fibrocartiliginous

A

soft callus

64
Q

What does healing depend on?

A

fracture its self( how bad where)
how well hematoma forms
stability

65
Q

How does healing of a broken bone in a child differ from the healing of a broken bone in an older adult?

A

in a child it will occur faster (4-6 weeks) than with that of an adult (10-18 weeks)

66
Q

When does function return

A

after 6 months after union is complete

67
Q

How can they tell in child abuse cases if there have been fractures

A

because of the scar tissue on the bone

68
Q

Malunion

A

heal with a deformitiy

when you don’t go to the hospital

69
Q

Delayed

A

failure of it to unite within a decent time frame

b/c of complicated fracture, infection

70
Q

nonunion

A

failure to it to repair

71
Q

What are the factors that can affect bone healing

A

malunion, delayed union, nonunion, fracture blisters

72
Q

Compartment syndrome

A

usually in long bones… increased risk of pressure

vasculature is impeded (patient will complain of …can’t feel my toes, discomfort, loss of sensation)

death of muscle tissue nerves

EMERGENCY

73
Q

long bone fractures are at a greater risk for

A

increased pressure in fixed places

74
Q

What do we check for with fracture patients?

A

capillary refill….sensation (numbness, tingling)

75
Q

how fast can necrosis start?

A

as little as four hours after pressure increases

76
Q

What do they do for compartment syndrome

A

cut open to relieve pressure on vasculature

77
Q

How else can we get compartment syndrome?

A

casts and dressings that are too tight

78
Q

Bone infection

A

with open fracture

surgery (think about infections here too)

79
Q

Osteomallitis

A

Bone infection

can also be caused by bone marrow ischemia

hard to get rid of

people with bone infections usually get central lines.

80
Q

Neoplasms

A

benign - slow, don’t metabolise can weaken bones resulting in stress fragment

maligmnet (osteosarcoma)

81
Q

osteosarcoma

A

worst malignant, most trestment, usually in lower leg and knee

82
Q

Ewing sarcoma

A

teenage years

usually in femur

83
Q

Condrasarcoma

A

second most common of the bone cancer

where the muscles attach to the bone

84
Q

Metastatic bone disease

A

cancer from somewhere else,

most often with breast and prostate cancers

D&D Final (6 decks)

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