Exam 3 Mobility

Question 1

Hormones of bone formation.

Answer 1

parathyroid hormone
calcitonin
vitamin D

Question 2

hormones of bone formation also regulate what?

Answer 2

Ca+ levels in the blood

Question 3

tendons And ligaments are composed of what?

Answer 3

collagen fibers arranged in the same direction

Question 4

another name for articulations?

Answer 4

joints

Question 5

nerves of the joints also supply what?

Answer 5

the muscles that move the joints

Question 6

describe location of joint pain

Answer 6

referred or radiating

Question 7

what are the stages of bone healing?

Answer 7

there are 4:
hematoma
inflammatory
reparative
remodeling

Question 8

describe hematoma stage of bone healing

Answer 8

blood clots form within 5 days

Question 9

describe the inflammatory stage of bone healing

Answer 9

new blood vessels (starts after 1 week)

Question 10

describe reparative stage of bone healing

Answer 10

callus formation, bridges gaps between bone (during months 1-3)

Question 11

describe the remodeling stage of bone healing

Answer 11

bone reconstruction (>3 months)

Question 11

describe stress fracture

Answer 11

bone injury that occurs over time

Question 12

describe pathologic fractures

Answer 12

bone injury secondary to disease (such as with osteoporosis)

Question 13

describe the locations of bone injuries

Answer 13

there are three:
proximal, midshaft, distal

Question 14

describe open bone fracture

Answer 14

comes through the skin (open wound)

Question 15

what pattern of fracture is common in children?

Answer 15

green stick

Question 16

symptoms of fractures

Answer 16

• pain/trouble bearing weight
• swelling
• abnormal mobility / loss of function
• deformity of affected part

Question 17

what complications of fractures can cause limb loss?

Answer 17

pressure from swelling and hemorrhage

Question 18

what complication do fracture blisters indicate?

Answer 18

increased pressure inside / compartment syndrome

Question 19

hallmark symptom of compartment syndrome

Answer 19

severe pain out of proportion to physical findings

Question 20

describe loss of skeletal conntinuity

Answer 20

disconnected bone (it never healed)

Question 21

list emboli complications of fractures

Answer 21

fat emboli
thrombotic emboli

Question 22

how to assess for compartment syndrome?

Answer 22

check for:
* missing pulse
* fingers turn white
* cannot feel touch

(ALERT DOCTOR, MIGHT GO RIGHT TO OR)

Question 23

medication that can delay bone healing

Answer 23

steroids

Question 24

high serum level of this can delay bone healing (hint: related to diabetes mellitus)

Answer 24

blood glucose

Question 25

locations of thromboemboli complications of bone fractures

Answer 25

lungs and legs

Question 26

describe fat embolism syndrome

Answer 26

hypoxia neurologic abnormalities petechial rash doesn't blanch

Question 27

describe symptoms of fat emboli and the location of the complication

Answer 27

drowsy/confusion = brain dyspnea/SOB = lungs

Question 28

describe time frame of fat embolism syndrome

Answer 28

12-72 hours after injury/surgery (up to 3 days to see symptoms)

Question 29

describe origins of bone infections

Answer 29

open wounds blood stream/sepsis

Question 30

describe osteomyelitis

Answer 30

inflammation or infection of bone

Question 31

describe hematogenous osteomyelitis

Answer 31

originates with infectious organisms that reach bone through the blood stream

Question 32

describe symptoms of hematogenous osteomyelitis

Answer 32

vague symptoms of systemic infection * chills * fever * bacteremia

Question 33

describe contiguous spread osteomyelitis

Answer 33

* direct inoculation from an exogenous source * from adjacent extraskeletal site (aka: secondary to a contiguous focus of infection)

Question 34

describe symptoms of contiguous spread osteomyelitis

Answer 34

* persistent fever * increased pain at site of trauma/surgery * poor wound healing

Question 35

which is the most common osteomyelitis?

Answer 35

contiguous spread

Question 36

what are the causes of osteonecrosis?

Answer 36

there are four: * mechanical disruption of blood vessels (such as with chemo, radiation) * thrombosis/emboli * vessel injury * increased intraosseous pressure

Question 37

describe symptoms of osteonecrosis

Answer 37

first seen as pain with activity, progresses to pain even at rest

Question 38

what are neoplasms?

Answer 38

"new growth" different from surroundings, aka: tumors

Question 39

symptoms of bone tumors

Answer 39

pain, lump/mass, impaired function

Question 40

list the types of malignant bone neoplasms

Answer 40

there are three: * osteosarcoma * Ewing sarcoma * chondrosarcoma

Question 41

which malignant bone neoplasm is highly malignant and likely to metastasize?

Answer 41

osteosarcoma

Question 42

which malignant bone neoplasm is common in children/adolescents?

Answer 42

osteosarcoma

Question 43

which malignant bone neoplasm likely is the primary bone tumor?

Answer 43

osteosarcoma

Question 44

describe PNET - peripheral primitive neuroectodermal tumor

Answer 44

group of underdeveloped brain neurons cause bone tumor to develop

Question 45

which malignant bone neoplasm is a PNET?

Answer 45

Ewing sarcoma

Question 46

what is the typical age range for a Ewing sarcoma?

Answer 46

often under 20 years old

Question 47

which type of malignant bone neoplasm occurs in the cartilage?

Answer 47

chondrosarcoma

Question 48

which malignant bone neoplasm is common in adults?

Answer 48

chondrosarcoma

Question 49

which is the second most common primary bone tumor?

Answer 49

chondrosarcoma

Question 50

what diagnostic is required for malignant bone tumor diagnosis even though it may show up on a scan?

Answer 50

bone biopsy is required for diagnosis

Question 51

goals for metastatic bone disease

Answer 51

* prevent pathologic fractures * promote maximum function * pain control

Question 52

describe osteopenia

Answer 52

any reduction in bone mass (greater than expected)

Question 53

causes of osteopenia

Answer 53

decreased bone formation inadequate mineralization

Question 54

describe deossification

Answer 54

inadequate bone mineralization

Question 55

describe the pattern of bone growth

Answer 55

bone grows from the ends

Question 56

describe osteoporosis

Answer 56

loss of bone mass with increased bone fragility (also increased spongey bone)

Question 57

lifestyle risk factors for osteoporosis

Answer 57

sedentary calcium deficient excessive alcohol, caffeine smoking drugs

Question 58

educate patients to do these things to reduce risk of osteopenia

Answer 58

ambulate, increase calcium intake

Question 59

list some disorders that soften bones

Answer 59

osteomalacia, rickets

Question 60

describe osteomalacia

Answer 60

inadequate mineralization of bone resulting from calcium or phosphate deficiency

Question 61

describe rickets

Answer 61

vitamin D deficiency (in adequate calcium absorption, impaired mineralization of bone in children)

Question 62

describe symptoms of osteomalacia

Answer 62

bone *pain*, bone tenderness, fractures

Question 63

symptoms of rickets

Answer 63

bone deformity, lumbar lordosis (inward curvature), bowing of the legs

Question 64

pathophysiology of Rheumatoid Arthritis

Answer 64

autoimmune disorder, attacks joints

Question 65

Rheumatoid Arthritis is associated with what manifestations?

Answer 65

extra-articular and articular manifestations

Question 66

describe the insidious onset of Rheumatoid Arthritis

Answer 66

RA is invisible for a long time because it first presents with vague systemic manifestations

Question 67

describe the periods of symptoms of Rheumatoid Arthritis

Answer 67

Rheumatoid Arthritis is characterized by periods of exacerbations and remissions

Question 68

describe the exacerbations of Rheumatoid Arthritis

Answer 68

may only involve a few joints of brief duration or it may become relentless, progressive, and debilitating