exam 2- bones Flashcards
3 major function of bones
give form to body
support tissues
permit movemnt
epiphysis
ends of bone
made of spongy
articular cartilage covers
diaphysis
shaft of bone
compact
covered by periosteum
blood V inside
fractures
break in a bone due to a force that exceeds the strength of the bone
incidence of fractures
highest in young males and elderly (osteoporosis)
upper femur, upper humerus, vertebrae and hip (femoral neck)
complete fracture
bone broken all the way through bone
incomplete greenstick fracture
damaged but in one piece
open (compound) fracture
fractured bone breaks through skin
closed (simple) fracture
skin not broken by bone
comminuted fracture
several pieces fractured
linear fracture
parallel to bone
oblique fracture
45 degree angle to shaft of bone
spiral fracture
encircles bone, displaced by twist
transverse fracture
straight across (horizonatal) bone
pathologic fracture
fracture at site of disease (tumor, osteoporosis)
stress fracture
from repeated stress on bone (athletes)
if children fracture the epiphysis what happens
interruption of normal growth
patho of fractures
bleeding of broken ends of bone hematoma (clot)-> fibrous network osteoblasts, collagen strands and deposit Ca callus formation (new bone) "remodeling" (mature bone formed)
manifestations of fractures
abnormal alignment immediate pain loss of function/sensation swelling/spasm blood loss crepitus with movement
management of fractures
return the bone to nrmal alignment
closed/open reduction
cast, splint
external traction
complications of fratures
nonunion/malunion of bones
delayed growth (children)
osteomyelitis (bone infection)
fat emboli
paget’s disease (osteitis deformans)
localized abnormal and excessive bone remodeling (bone formation and resorption) which eventually enlarges and softens the affected bone
which areas do paget’s disease affect most
vertebrae, skull, sacrum, sternum, pelvis
etiology of paget’s disease
unknown (may follow inflamation, virus bone tumors, autoimmune dysfunction)
patho of paget’s
excessive resorption of spongy bone
fibrous tissue replace bone marrow
abnormal new bone forms
mani of paget’s
bone deformity (barrel chest, bowing of legs, kyphosis)
bone pain
fractures
managemnt of paget’s
pain managemnt
prevention of deformity/fracture and loss of function
drugs to slow bone resorption
gout
a disorder that disrupts the body’s control of uric acid production or excretion
may follow traumatic injury or joint strain
etiology of gout
excessive serum uric acid (lack of excretion or excessive production
what causes increased production of uric acid
increased rate of purines synthesis
purines break down to uric acid
increased production of uric acid
what causes decreased excretion of uric acid
renal failure- urate crystals
form and deposit in kidneys
patho of gout
when uric acid reaches a certain concentration it crystalizes
urate crystals cause joint inflammation and renal stones
mani of gout
increased serum uric acid (urate)
hot, red, tender joint (usually periphreal)
management of gout
meds to help excrete uric acid
ice on area
no weight bearing
low purine (protein) diet and increased fluids
osteomyelitis
bacterial, fungal, parasitic or viral bone infection
etiology of osteomyelitis
open bone form surgery, trauma
blood borne from other sites of infection
patho of osteomyelitis
pathogen in bone causes inflammatory response
abscesses form (lifts periosteum off underlying bone)
pressure from abscess causes decreased blood supply to bone – necrosis
osteoblasts form new bone
mani of osteomyelitis
acute: fever, chills, bone pain, weightloss
chronic: if inadequate antibiotics, drug resistant bcteria
management of osteomyetlitis
antibotics
irrigation and drainage
why is osteomyeletitis hard to cure
bone has multiple microscopic channels
impermeable to blood cells so there is decreased phagocytosis
osteoporosis
reduced bone density
incidence of osteoporosis
most common metabolic bone disease
incidence increases with age
most common in white females
etiology of osteoporosis
decreased estrogen after menopause
decreased dietary calcium and VD
increased caffeine, nicotine, alcohol (loss of ca from bone)
renal failure
why is decreased estrogen an etiology of osteoporosis
estrogen normally inhibits bone resorption
why is renal failure an etiology of osteoporosis
nephrons are unable to remove excess PO4 causes:
increased PO4 – binds to ca
decreased ca stimulates increased parathyroid hormone
pth overstimulates osteoclasts to remodel (loss of Ca from bone)
patho of osteoporosis
increased rate of resorption of osteoclasts
decreases rate of bone formation by osteoblasts
net decrease in bone density
mani of osteoporosis
bone pain
bone deformity (kyphoscololiosis– hunch back)
fractures
loss of height
management of osteoporosis
weight bearing exercises
estrogen
dietary Ca and v. D
prevention is best treatment
degenerative joint disease (osteoarthritis)
degeneration and loss of articular surfaces in synovial joints
etiology of osteoarthritis
mechanical joint stress
trauma
age
wear and tear
patho of osteoarthritis
loss of articular cartilage
bone becomes dense and hard
bone spurs form grow outward from bone
mani of osteoarthritis
joint pain and stiffness
swelling
decreased ROM in joint
deformity
managemtn of osteoarthritis
weight loss NSAID's ROM exercises cain/ crutches to decrease weight bearing joint replacement surgery
osteogenic sarcoma
1/3 bone tumors
large, destructive, malignant bone tumor found in the metaphyses of long bones
can be rapidly fatal with lung metastasis
incidence of osteogenic sarcoma
adolescent (oven overlooked as sports injury)
patho of osteogenic sarcoma
bonemarrow- moth eaten pattern
anaplastic cells- abnormal cells
tumor destroys bone
tumor breaks through periosteum and can form soft tissue mass
mani of osteogenic sarcoma
bone pain worse at night
increases alkaline phosphatase (enzyme produced by osteoblasts)
management of osteogenic sarcoma
cemo, radiation
amputation
combination therapy
scoliosis
a s or c curve to entire spine when which the vertebrae twist
etiology of scoliosis
congenital skeletal disorders neuromusclular disease trauma rickets idioppathic
incidence of scoliosis
can occur between ages 4-14 during growth spurts, common in girls
patho of scoliosis
muscles, ligaments and soft tissues become shortened (concave side)
progressive deformities of vertebral column and limbs develop
curve increases most rapidly during periods of skeletal growth
mani of scoliosis
spinal curvature
prominance of shoulder and hip
advanced can lead to restricted expansion of lungs and pressure on heart eventually leading to heart failure
managemet of scoliosis
braces
surgery if curvature is greater than 40 degrees
osteomalacia/rickets
mineral calcification and deposition in mature compact and spongy bone doesn not occure; results in soft bones
osteomalacia
refers to adult bones
rickets
growing bones of children
etiology of osteomalacia/rickets
deficiency of VD, dietary and malabsorptive
patho of o/e
decreased vd- decreased ca
decreased ca- PTH activation
loss of ca and po4 from bones
mineralizatio of bone decreased
clinical mani of o/e
skeletal pain and tenderness
bone deformities
pathological fractures
treatment of O/E
vd and ca supplements
congenital hip dysplasia
abnormal development of proximal femur or acetablum or both
etiology of congenital hip dysplasia
family, breech presentation
patho of congential hip dysplasia
dysplasio- contact but easily dislocated
subluxation- contact but not well seated
dislocation- no contact
clinical mani of congenital hip dysplasia
pain
leg lenght
asymmetry of gluteal/thigh folds
treatment for congenital hip dysplasia
braces
casts
surgery
talipes equinovarus (club foot)
deformity of the foot
etiology of talipes equinovarus
abnormal embryonic development of foot
patho of talipes equinovarus
foot normally goes through stage of flection and inversion
arrested development results in rigid defority
mani of talipes equinovarus
feet in position of flexion and inverion
treatment of talpies equinovarus
surgery to release sight structures
shoes to maintain correct position
dislocation
the temp displacemnt of the entire articular surface of two bones
subluxation
partial loss of articulation
