Disorders of the skeletal system; Trauma, Infections, Neoplasms and Childhood Disorders Chapter 43

Question 1

Support Structure Injuries

Answer 1

Strain

Sprain

Avulsion

Question 2

Strain

Answer 2

Tear or injury to a tendon

Question 3

Sprain

Answer 3

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

Question 4

Avulsion

Answer 4

Complete separation of a tendon or ligament from its bony attachment site

Question 5

Muscle Strain

Answer 5

• Sudden, forced motion causing the muscle to become stretched beyond its normal capacity
• Local muscle damage
• Muscle strains can also involve the tendons

Question 6

2 important Bone Fractures

Answer 6

Greenstick (children get this usually) bone does not break all the way through

Spiral- have to have twisting motion

Question 7

Fractures

Answer 7

Disruption in the continuity of a bone

Question 8

Sudden injury fractures:

Answer 8

Most common

Direct (fall) or indirect (radiating trauma)

Question 9

Fatigue stress fractures

Answer 9

commonly seen in athletes

apply excess stress to a notmal bone

Question 10

Pathologic stress fractures

Answer 10

have disease or a condition behind the fracture that causes the bone to be weak, such as osteoporosis

Question 11

~ 4 ______ (acute inflammation) with a bone fracture

Answer 11

days

Question 12

________ forms in medullary canal and surrounding soft tissue in first 48-72 hours

Answer 12

Hematoma

Question 13

Phase 1 of bone formation-

Answer 13

1. Hematoma Formation; Blood vessels torn, blood forms clot, Fibrin Mesh, Inflammatory cells, fibroblasts, new vessels

Question 14

Phase 2 of bone formation-

Answer 14

2. Fibrocartilaginous Callus Formation; Capillaries infiltrate & form Procallus, Fibrocartilaginous soft callus bridge connects bone fragments

(not strong enough to put weight on it)

Question 15

Phase 3 of bone formation-

Answer 15

3. 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

Question 16

Phase 4 of bone formation-

Answer 16

4. Remodeling; Dead portions of bone removed by osteoclasts, compact bone replaces spongy bone, mineralized bone laid along mechanical stress lines, healed fracture

Question 17

Complications of Fractures & Healing

Answer 17

Poor blood supply to the fractured area; could lead to avascular or aseptic necrosis
Compartment Syndrome

Fat Embolism

Infection – more common with open fractures

Question 18

Compartment Syndrome-

Answer 18

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)

Question 19

Fat Embolism Syndrome

Answer 19

Usually occurs with Long bone fractures
Fat released from bone marrow or adipose
DVT or Pulmonary Embolism, neurological manifestations

Question 20

Bone Infections

Answer 20

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)

Question 21

Osteomyelitis

Answer 21

Usually caused by a staphylococcal infection

Pyogenic = from wound

Hematogenous = from the bloodstream

Acute or Chronic