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Musculoskeletal Physiopathology > Fracture Lab > Flashcards

Fracture Lab Flashcards

1
Q

What are the organic to inroganic ratios for the following?
Children:
Adults:
Elderly:

A

Children: 1:1
Adults: 1:4
Elderly: 1:7

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2
Q

More organic material means more ___

A

elasticity

children have more elastic bones

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3
Q

Less organic material means less ___

A

elasticity

increased risk of fracture

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4
Q

What is elasticity?

A

Ability of bone to bend and return shape

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5
Q

What is the term for bone’s ability to bend and return shape?

A

Elasticity

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6
Q

What is plasticity?

A

Yield point surpassed; permanent deformity without fracture

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7
Q

stress strain curve

What is yield point?

A

Permanent physical changes begin

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8
Q

stress strain curve

What is the term for the point where permanent physical changes begin?

A

Yield point

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9
Q

stress strain curve

What is the ultimate yield point?

A

Point of failure/fracture

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10
Q

stress strain curve

What is the term for the point of failure/fracture?

A

Ultimate yield point

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11
Q

stress strain curve

What types of fractures are more common in children because of these differences in elasticity and plasticity?

A

Salter-Harris (fracture of growth plate)

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12
Q

View:
Anatomy:
Mature/immature:

A

View: AP ankle
Anatomy: tibia and fibula
Mature/immature: mature

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13
Q

What notes can be made about the bone in this ankle?

A

Black areas in bone; cortical disruption and necrosis

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14
Q

What stage of fracture repair is shown in this ankle specimen?

A

Inflammatory stage (necrosis is present)

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15
Q

What cellular events occur during the inflammatory phase of fracture repair shown in this ankle specimen?

A
  • Blood vessel rupture
  • Hematoma fills gap
  • Periosteum tears
  • Necrosis
  • Fibrin mesh develops
  • Procallus
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16
Q

View:
Anatomy:
Mature/immature:

A

View: AP diaphysis of long bone
Anatomy: diaphysis
Mature/immature: unknown (growth plate not visualized)

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17
Q

What observations can be made about the bone in this specimen?

A

Complete closed fracture through diaphysis

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18
Q

What stage of fracture repair is shown in this long bone?

A

Reparative stage (rounding of broken edges)

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19
Q

What cellular events occur during the reparative stage of fracture repair shown in this long bone?

A
  • Osteoclasts and macrophages clean up debris
  • Extensive neovascularization/angiogenesis
  • Callus formation (chondrocytes)
  • Significant osteoblastic activity
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20
Q

View:
Anatomy:
Mature/immature:

A

View: lateral ulna
Anatomy: proximal ulna, olecranon, diaphysis, metaphysis
Mature/immature: mature

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21
Q

What notes can be made about this ulna?

A

Dilated mid diaphysis

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22
Q

What stage of fracture repair is shown in this ulna?

A

Remodeling stage (callus has sealed bone and bone has adjusted strength and shape)

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23
Q

What cells are involved in the remodeling stage of fracture shown in this ulna?

A

Osteoblasts, osteocytes, and osteoclasts

24
Q

Anatomy:

A

Anatomy: clavicle, head of humerus, scapula, sternum

25
Q

What stage of fracture repair is shown?

A

Redomeling stage

26
Q

What has not occured in this fracture repair to lead to pseudoarthrosis?

A

No formation of procallus; non-union fracture led to pseudojoint

27
Q

What terminology describes the outcome of fracture in this image?

A

Pseudoarthrosis

28
Q

What cellular changes or events explain this pseudoarthrosis?

A

Lack of debris clean up by osteoclasts and mononuclear cells

29
Q

View:
Anatomy:
Mature/immature:

A

View: medial oblique forearm (left), lateral forearm (right)
Anatomy: radius, ulna (accounted for but broken)
Mature/immature: mature

30
Q

Is this lesion local or systemic?

A

Local

31
Q

What notes can be made about the alignment in this forearm?

A

Medial superior dislocation of proximal radioulnar joint (ulna) and lateral superior dislocation of proximal radiohumeral joint (radius)

32
Q

What notes can be made about the bones of this forearm?

A

Complete open fracture of proximal ulnar diaphysis

33
Q

What notes can be made about the connective tissue and soft tissue in this forearm?

A

Whiter (radiodense) soft tissue

34
Q

What stage of fracture repair is shown in this forearm?

A

Inflammatory stage; radiopacity in soft tissue can be debris or hemorrhage with swelling

35
Q

What cellular events would explain the radiographic findings in this forearm?

A

Neutrophils and macrophages present

36
Q

What specific names apply to this type of fracture?

A

Complete, transverse, open, noncomminuted

37
Q

View:
Anatomy:
Mature/immature:

A

View: AP foot (left), medial oblique foot (right)
Anatomy: accounted for
Mature/immature: mature

38
Q

Is this foot lesion local or systemic?

A

Local

39
Q

What can be noted about the aligment of this foot?
What about connective and soft tissue?

A

Bunion
Connective and soft tissue are normal

40
Q

What notes can be made about the bones in this foot?

A

Cloudy, hazy patch around 3rd metatarsal

41
Q

What stage of fracture repair is shown in this foot?

A

Reparative stage

callus forming

42
Q

What cellular events would explain the radiographic findings in this foot?

A
  • Osteoclasts and mononuclear cells cleaning up debris
  • PMNs present
  • Neovascularization/angiogenesis
  • Osteoblastic activity
  • Chondrocytes making callus

reparative stage of fracture repair

43
Q

What specific names apply to this type of foot fracture?

A

March fracture (fatigue stress fracture), closed fracture

44
Q

View:
Anatomy:
Mature/immature:

A

View: AP knee
Anatomy: accounted for, no patella yet
Mature/immature: immature/young

45
Q

Is this knee lesion local or systemic?

A

Local

46
Q

What can be noted about the alignment of this knee?
What about connective and soft tissue?

A

Normal alignment
Soft tissue swelling that is radiopaque

47
Q

What stage of fracture repair is shown in this knee?

A

Inflammatory stage

hematoma visible, blood vessels ruptured

48
Q

What cellular events would explain your radiographic findings in this knee?

A

PMNs/neutrophils and macrophages present with necrosis

inflammatory stage of fracture repair

49
Q

What specific names apply to this type of knee fracture?

A

Salter-Harris fracture A (type II)
(A for above)
Complete, open, noncomminuted fracture

50
Q

A 71 year-old woman reported to the emergency room with pain in her hip and thigh after stumbling while in the grocery store. The patient had a previous history of breast cancer that was treated and went into remission 40 years prior. She has also been receiving drug therapy for high blood pressure for the past 8 years. This is her radiograph.

How would you treat this patient?

A

Passive care and reference to orthopedic

51
Q

View:
Anatomy:
Alignment:

A

View: AP pelvis
Anatomy: all present
Alignment: antalgic lean, superior lateral femur in relation to acetabulum

52
Q

What notes can be made about the bones in this radiograph?

A

Thinning of cortical bone, fracture of femoral neck, radiolucent medullary cavity

osteoporosis

53
Q

Additional tests confirm that this patient suffered from osteoporosis
Given this information, what type of fracture is this?

A

Pathological insufficiency (stress) fracture due to diseased bone

54
Q

View:
Anatomy:
Alignment:

A

View: AP pelvis
Anatomy: all present
Alignment: normal

55
Q

What is another name for a fracture that isn’t initially visible radiographically?

A

Occult fracture

Musculoskeletal Physiopathology (13 decks)

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