Disorders of the skeletal system; Trauma, Infections, Neoplasms and Childhood Disorders Chapter 43 Flashcards
Support Structure Injuries
Strain
Sprain
Avulsion
Strain
Tear or injury to a tendon
Sprain
Tear or injury to a ligament
Abnormal or excessive movement of joint Pain & swelling slow to resolve Ankle, knee & elbow joints most common Healing involves capillary→fibroblasts→collagen
8 weeks for a sprain to heal
Avulsion
Complete separation of a tendon or ligament from its bony attachment site
Muscle Strain
- Sudden, forced motion causing the muscle to become stretched beyond its normal capacity
- Local muscle damage
- Muscle strains can also involve the tendons
2 important Bone Fractures
Greenstick (children get this usually) bone does not break all the way through
Spiral- have to have twisting motion
Fractures
Disruption in the continuity of a bone
Sudden injury fractures:
Most common
Direct (fall) or indirect (radiating trauma)
Fatigue stress fractures
commonly seen in athletes
apply excess stress to a notmal bone
Pathologic stress fractures
have disease or a condition behind the fracture that causes the bone to be weak, such as osteoporosis
~ 4 ______ (acute inflammation) with a bone fracture
days
________ forms in medullary canal and surrounding soft tissue in first 48-72 hours
Hematoma
Phase 1 of bone formation-
- Hematoma Formation; Blood vessels torn, blood forms clot, Fibrin Mesh, Inflammatory cells, fibroblasts, new vessels
Phase 2 of bone formation-
- Fibrocartilaginous Callus Formation; Capillaries infiltrate & form Procallus, Fibrocartilaginous soft callus bridge connects bone fragments
(not strong enough to put weight on it)
Phase 3 of bone formation-
- Bony Callus Formation; Ossification, osteogenic cells → osteoblasts → spongy bone trabeculae, forms outside in, bony callus calcifies becomes mature bone
usually seen 3-4 weeks out from injury
more bone like formation
lasts from 3weeks-1-2 months and gains more strength
6-8 weeks can be strong enough to place weight on it
Phase 4 of bone formation-
- Remodeling; Dead portions of bone removed by osteoclasts, compact bone replaces spongy bone, mineralized bone laid along mechanical stress lines, healed fracture
Complications of Fractures & Healing
Poor blood supply to the fractured area; could lead to avascular or aseptic necrosis
Compartment Syndrome
Fat Embolism
Infection – more common with open fractures
Compartment Syndrome-
Swelling against muscle, vessels and nerves
Leads to ischemia & tissue death
Causes:
Injury or Repetition
Common sites:
Lower leg and forearm
(runners can get in large muscles)
Fat Embolism Syndrome
Usually occurs with Long bone fractures
Fat released from bone marrow or adipose
DVT or Pulmonary Embolism, neurological manifestations
Bone Infections
Osteomyelitis is most often caused by a staphylococcal infection
Open wound (exogenous)
Blood-borne (endogenous) infection
Pyogenic Bacteria & mycobacteria
Staph aureus
Spread & produce further destruction
(very painful)
Osteomyelitis
Usually caused by a staphylococcal infection
Pyogenic = from wound
Hematogenous = from the bloodstream
Acute or Chronic
