Exam 3 Mobility Flashcards
Hormones of bone formation.
parathyroid hormone
calcitonin
vitamin D
hormones of bone formation also regulate what?
Ca+ levels in the blood
tendons And ligaments are composed of what?
collagen fibers arranged in the same direction
another name for articulations?
joints
nerves of the joints also supply what?
the muscles that move the joints
describe location of joint pain
referred or radiating
what are the stages of bone healing?
there are 4:
hematoma
inflammatory
reparative
remodeling
describe hematoma stage of bone healing
blood clots form within 5 days
describe the inflammatory stage of bone healing
new blood vessels (starts after 1 week)
describe reparative stage of bone healing
callus formation, bridges gaps between bone (during months 1-3)
describe the remodeling stage of bone healing
bone reconstruction (>3 months)
describe stress fracture
bone injury that occurs over time
describe pathologic fractures
bone injury secondary to disease (such as with osteoporosis)
describe the locations of bone injuries
there are three:
proximal, midshaft, distal
describe open bone fracture
comes through the skin (open wound)
what pattern of fracture is common in children?
green stick
symptoms of fractures
- pain/trouble bearing weight
- swelling
- abnormal mobility / loss of function
- deformity of affected part
what complications of fractures can cause limb loss?
pressure from swelling and hemorrhage
what complication do fracture blisters indicate?
increased pressure inside / compartment syndrome
hallmark symptom of compartment syndrome
severe pain out of proportion to physical findings
describe loss of skeletal conntinuity
disconnected bone (it never healed)
list emboli complications of fractures
fat emboli
thrombotic emboli
how to assess for compartment syndrome?
check for:
* missing pulse
* fingers turn white
* cannot feel touch
(ALERT DOCTOR, MIGHT GO RIGHT TO OR)
medication that can delay bone healing
steroids
high serum level of this can delay bone healing (hint: related to diabetes mellitus)
blood glucose
locations of thromboemboli complications of bone fractures
lungs and legs
describe fat embolism syndrome
hypoxia
neurologic abnormalities
petechial rash
doesn’t blanch
describe symptoms of fat emboli and the location of the complication
drowsy/confusion = brain
dyspnea/SOB = lungs
describe time frame of fat embolism syndrome
12-72 hours after injury/surgery (up to 3 days to see symptoms)
describe origins of bone infections
open wounds
blood stream/sepsis
describe osteomyelitis
inflammation or infection of bone
describe hematogenous osteomyelitis
originates with infectious organisms that reach bone through the blood stream
describe symptoms of hematogenous osteomyelitis
vague symptoms of systemic infection
* chills
* fever
* bacteremia
describe contiguous spread osteomyelitis
- direct inoculation from an exogenous source
- from adjacent extraskeletal site (aka: secondary to a contiguous focus of infection)
describe symptoms of contiguous spread osteomyelitis
- persistent fever
- increased pain at site of trauma/surgery
- poor wound healing
which is the most common osteomyelitis?
contiguous spread
what are the causes of osteonecrosis?
there are four:
* mechanical disruption of blood vessels (such as with chemo, radiation)
* thrombosis/emboli
* vessel injury
* increased intraosseous pressure
describe symptoms of osteonecrosis
first seen as pain with activity, progresses to pain even at rest
what are neoplasms?
“new growth” different from surroundings, aka: tumors
symptoms of bone tumors
pain, lump/mass, impaired function
list the types of malignant bone neoplasms
there are three:
* osteosarcoma
* Ewing sarcoma
* chondrosarcoma
which malignant bone neoplasm is highly malignant and likely to metastasize?
osteosarcoma
which malignant bone neoplasm is common in children/adolescents?
osteosarcoma
which malignant bone neoplasm likely is the primary bone tumor?
osteosarcoma
describe PNET - peripheral primitive neuroectodermal tumor
group of underdeveloped brain neurons cause bone tumor to develop
which malignant bone neoplasm is a PNET?
Ewing sarcoma
what is the typical age range for a Ewing sarcoma?
often under 20 years old
which type of malignant bone neoplasm occurs in the cartilage?
chondrosarcoma
which malignant bone neoplasm is common in adults?
chondrosarcoma
which is the second most common primary bone tumor?
chondrosarcoma
what diagnostic is required for malignant bone tumor diagnosis even though it may show up on a scan?
bone biopsy is required for diagnosis
goals for metastatic bone disease
- prevent pathologic fractures
- promote maximum function
- pain control
describe osteopenia
any reduction in bone mass (greater than expected)
causes of osteopenia
decreased bone formation
inadequate mineralization
describe deossification
inadequate bone mineralization
describe the pattern of bone growth
bone grows from the ends
describe osteoporosis
loss of bone mass with increased bone fragility (also increased spongey bone)
lifestyle risk factors for osteoporosis
sedentary
calcium deficient
excessive alcohol, caffeine
smoking
drugs
educate patients to do these things to reduce risk of osteopenia
ambulate, increase calcium intake
list some disorders that soften bones
osteomalacia, rickets
describe osteomalacia
inadequate mineralization of bone resulting from calcium or phosphate deficiency
describe rickets
vitamin D deficiency (in adequate calcium absorption, impaired mineralization of bone in children)
describe symptoms of osteomalacia
bone pain, bone tenderness, fractures
symptoms of rickets
bone deformity,
lumbar lordosis (inward curvature),
bowing of the legs
pathophysiology of Rheumatoid Arthritis
autoimmune disorder, attacks joints
Rheumatoid Arthritis is associated with what manifestations?
extra-articular and articular manifestations
describe the insidious onset of Rheumatoid Arthritis
RA is invisible for a long time because it first presents with vague systemic manifestations
describe the periods of symptoms of Rheumatoid Arthritis
Rheumatoid Arthritis is characterized by periods of exacerbations and remissions
describe the exacerbations of Rheumatoid Arthritis
may only involve a few joints of brief duration
or it may become relentless, progressive, and debilitating
