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Patho: Nursing > exam 2- bones > Flashcards

exam 2- bones Flashcards

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1
Q

3 major function of bones

A

give form to body
support tissues
permit movemnt

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2
Q

epiphysis

A

ends of bone
made of spongy
articular cartilage covers

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3
Q

diaphysis

A

shaft of bone
compact
covered by periosteum
blood V inside

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4
Q

fractures

A

break in a bone due to a force that exceeds the strength of the bone

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5
Q

incidence of fractures

A

highest in young males and elderly (osteoporosis)

upper femur, upper humerus, vertebrae and hip (femoral neck)

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6
Q

complete fracture

A

bone broken all the way through bone

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7
Q

incomplete greenstick fracture

A

damaged but in one piece

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8
Q

open (compound) fracture

A

fractured bone breaks through skin

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9
Q

closed (simple) fracture

A

skin not broken by bone

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10
Q

comminuted fracture

A

several pieces fractured

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11
Q

linear fracture

A

parallel to bone

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12
Q

oblique fracture

A

45 degree angle to shaft of bone

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13
Q

spiral fracture

A

encircles bone, displaced by twist

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14
Q

transverse fracture

A

straight across (horizonatal) bone

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15
Q

pathologic fracture

A

fracture at site of disease (tumor, osteoporosis)

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16
Q

stress fracture

A

from repeated stress on bone (athletes)

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17
Q

if children fracture the epiphysis what happens

A

interruption of normal growth

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18
Q

patho of fractures

A 
bleeding of broken ends of bone
hematoma (clot)-> fibrous network
osteoblasts, collagen strands and deposit Ca
callus formation (new bone)
"remodeling" (mature bone formed)
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19
Q

manifestations of fractures

A 
abnormal alignment
immediate pain
loss of function/sensation
swelling/spasm
blood loss
crepitus with movement
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20
Q

management of fractures

A

return the bone to nrmal alignment
closed/open reduction
cast, splint
external traction

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21
Q

complications of fratures

A

nonunion/malunion of bones
delayed growth (children)
osteomyelitis (bone infection)
fat emboli

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22
Q

paget’s disease (osteitis deformans)

A

localized abnormal and excessive bone remodeling (bone formation and resorption) which eventually enlarges and softens the affected bone

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23
Q

which areas do paget’s disease affect most

A

vertebrae, skull, sacrum, sternum, pelvis

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24
Q

etiology of paget’s disease

A

unknown (may follow inflamation, virus bone tumors, autoimmune dysfunction)

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25
Q

patho of paget’s

A

excessive resorption of spongy bone
fibrous tissue replace bone marrow
abnormal new bone forms

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26
Q

mani of paget’s

A

bone deformity (barrel chest, bowing of legs, kyphosis)
bone pain
fractures

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27
Q

managemnt of paget’s

A

pain managemnt
prevention of deformity/fracture and loss of function
drugs to slow bone resorption

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28
Q

gout

A

a disorder that disrupts the body’s control of uric acid production or excretion
may follow traumatic injury or joint strain

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29
Q

etiology of gout

A

excessive serum uric acid (lack of excretion or excessive production

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30
Q

what causes increased production of uric acid

A

increased rate of purines synthesis
purines break down to uric acid
increased production of uric acid

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31
Q

what causes decreased excretion of uric acid

A

renal failure- urate crystals

form and deposit in kidneys

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32
Q

patho of gout

A

when uric acid reaches a certain concentration it crystalizes
urate crystals cause joint inflammation and renal stones

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33
Q

mani of gout

A

increased serum uric acid (urate)

hot, red, tender joint (usually periphreal)

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34
Q

management of gout

A

meds to help excrete uric acid
ice on area
no weight bearing
low purine (protein) diet and increased fluids

35
Q

osteomyelitis

A

bacterial, fungal, parasitic or viral bone infection

36
Q

etiology of osteomyelitis

A

open bone form surgery, trauma

blood borne from other sites of infection

37
Q

patho of osteomyelitis

A

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

38
Q

mani of osteomyelitis

A

acute: fever, chills, bone pain, weightloss
chronic: if inadequate antibiotics, drug resistant bcteria

39
Q

management of osteomyetlitis

A

antibotics

irrigation and drainage

40
Q

why is osteomyeletitis hard to cure

A

bone has multiple microscopic channels

impermeable to blood cells so there is decreased phagocytosis

41
Q

osteoporosis

A

reduced bone density

42
Q

incidence of osteoporosis

A

most common metabolic bone disease
incidence increases with age
most common in white females

43
Q

etiology of osteoporosis

A

decreased estrogen after menopause
decreased dietary calcium and VD
increased caffeine, nicotine, alcohol (loss of ca from bone)
renal failure

44
Q

why is decreased estrogen an etiology of osteoporosis

A

estrogen normally inhibits bone resorption

45
Q

why is renal failure an etiology of osteoporosis

A

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)

46
Q

patho of osteoporosis

A

increased rate of resorption of osteoclasts
decreases rate of bone formation by osteoblasts
net decrease in bone density

47
Q

mani of osteoporosis

A

bone pain
bone deformity (kyphoscololiosis– hunch back)
fractures
loss of height

48
Q

management of osteoporosis

A

weight bearing exercises
estrogen
dietary Ca and v. D
prevention is best treatment

49
Q

degenerative joint disease (osteoarthritis)

A

degeneration and loss of articular surfaces in synovial joints

50
Q

etiology of osteoarthritis

A

mechanical joint stress
trauma
age
wear and tear

51
Q

patho of osteoarthritis

A

loss of articular cartilage
bone becomes dense and hard
bone spurs form grow outward from bone

52
Q

mani of osteoarthritis

A

joint pain and stiffness
swelling
decreased ROM in joint
deformity

53
Q

managemtn of osteoarthritis

A 
weight loss
NSAID's
ROM exercises 
cain/ crutches to decrease weight bearing
joint replacement surgery
54
Q

osteogenic sarcoma

A

1/3 bone tumors
large, destructive, malignant bone tumor found in the metaphyses of long bones
can be rapidly fatal with lung metastasis

55
Q

incidence of osteogenic sarcoma

A

adolescent (oven overlooked as sports injury)

56
Q

patho of osteogenic sarcoma

A

bonemarrow- moth eaten pattern
anaplastic cells- abnormal cells
tumor destroys bone
tumor breaks through periosteum and can form soft tissue mass

57
Q

mani of osteogenic sarcoma

A

bone pain worse at night

increases alkaline phosphatase (enzyme produced by osteoblasts)

58
Q

management of osteogenic sarcoma

A

cemo, radiation
amputation
combination therapy

59
Q

scoliosis

A

a s or c curve to entire spine when which the vertebrae twist

60
Q

etiology of scoliosis

A 
congenital skeletal disorders
neuromusclular disease
trauma
rickets
idioppathic
61
Q

incidence of scoliosis

A

can occur between ages 4-14 during growth spurts, common in girls

62
Q

patho of scoliosis

A

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

63
Q

mani of scoliosis

A

spinal curvature
prominance of shoulder and hip
advanced can lead to restricted expansion of lungs and pressure on heart eventually leading to heart failure

64
Q

managemet of scoliosis

A

braces

surgery if curvature is greater than 40 degrees

65
Q

osteomalacia/rickets

A

mineral calcification and deposition in mature compact and spongy bone doesn not occure; results in soft bones

66
Q

osteomalacia

A

refers to adult bones

67
Q

rickets

A

growing bones of children

68
Q

etiology of osteomalacia/rickets

A

deficiency of VD, dietary and malabsorptive

69
Q

patho of o/e

A

decreased vd- decreased ca
decreased ca- PTH activation
loss of ca and po4 from bones
mineralizatio of bone decreased

70
Q

clinical mani of o/e

A

skeletal pain and tenderness
bone deformities
pathological fractures

71
Q

treatment of O/E

A

vd and ca supplements

72
Q

congenital hip dysplasia

A

abnormal development of proximal femur or acetablum or both

73
Q

etiology of congenital hip dysplasia

A

family, breech presentation

74
Q

patho of congential hip dysplasia

A

dysplasio- contact but easily dislocated
subluxation- contact but not well seated
dislocation- no contact

75
Q

clinical mani of congenital hip dysplasia

A

pain
leg lenght
asymmetry of gluteal/thigh folds

76
Q

treatment for congenital hip dysplasia

A

braces
casts
surgery

77
Q

talipes equinovarus (club foot)

A

deformity of the foot

78
Q

etiology of talipes equinovarus

A

abnormal embryonic development of foot

79
Q

patho of talipes equinovarus

A

foot normally goes through stage of flection and inversion

arrested development results in rigid defority

80
Q

mani of talipes equinovarus

A

feet in position of flexion and inverion

81
Q

treatment of talpies equinovarus

A

surgery to release sight structures

shoes to maintain correct position

82
Q

dislocation

A

the temp displacemnt of the entire articular surface of two bones

83
Q

subluxation

A

partial loss of articulation

Patho: Nursing (4 decks)

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