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MS > fractures and bone radiology > Flashcards

fractures and bone radiology Flashcards

0
Q

comminuted

A

type of simple fracture- >line, >2 pieces

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1
Q

simple

A

simple- one line cuts bone to 2 pieces

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2
Q

Open (compound) fractures

A

skin is violated by broken bone ends or by external trauma, increasing contaimination risk

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3
Q

how to take care of open fractures

A

sterile dressing (saline not betadine)
splint
tetanus and IV abx prophylaxis
surgical emergency- irr & debride

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4
Q

transverse fracture pattern

A

tension

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5
Q

oblique fracture pattern

A

compression

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6
Q

spiral fracture pattern

A

torque

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7
Q

butterfly fracture pattern

A

bending (center fragment is triangular shaped)

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8
Q

valgus

A

distal part is deviated laterally–>fibula

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9
Q

Healing

A

produces healthy tissue that is identical to the original instead of the scar

  • inflammatory: 0-2 weeks
  • reparative: 2-12 weeks
  • remodeling
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10
Q

inflammatory phase

A

hematoma and acute inflammation response to dead bone by surrounding the peri/endosteum

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11
Q

reparative phase

A

organized hematoma–>mesenchymal precursors from periosteum and endosteum–>callus (fibrous, cartilage, immature bone)–>collagen increases–>Ca hydroxyapatite deposits

callous engulfs bone ends–>union

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12
Q

remodeling phase

A

balance of osteoclast and osteoblast activity

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13
Q

TGF beta

A

transforming growth factor that promotes proliferation and differentiation of mesenchymal precursors to osteoblasts, osteoclasts, and chondrocytes–>endochondral and intramembranous bone growth–> synthesis of cartilage specific proteoglycans and collagen type II–>collagen synthesis by osteoblasts

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14
Q

BMPs

A

dimeric ligands that seem to stimulate cartilage growth
crucial in all 3 healing steps as well as secondary effects (regulate HPsis, increase ECM synthesis, and cell survial and death)

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15
Q

BMP3

A

mesenchyme differentiation to bone

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16
Q

BMP 2 and 7

A

endochondrial bone formation (ossification) in segmental defects

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17
Q

BMP 1

A

regulates ECM production

18
Q

FGF1 and FGF 2 (fibroblast growth factors)

A

increase proliferation of chondrocytes and osteoblasts, enhance callus formation

19
Q

FGF2

A

angiogenesis

20
Q

PDGF

A

dimer of PDGFA and B–>MC forms in circulation are BB abd AB–>increases bone growth by increasing osteoblatss–>increases collagen 1 synthesis

21
Q

dimer BB also

A

increases osteoclasrts–>increases bone resorption

22
Q

IGF1

A

produced by liver secondary to GH stimulation–>increases B collagen and matrix syntehsis, increases osteoblasts and decreases bone degeneration

23
Q

Interleukins

A

increase bone resorption

IL1 most potent

24
Q

estrogen

A

function in healing and to release IL1 inhibitor

25
Q

thyroid hormone

A

osteoclastic bone resorption

26
Q

PTH

A

increase bone density in osteoporosis and is used as anabolic rxn for functions

27
Q

glucocorticoids

A

block Ca absorption from gut therefore increase PTH and increase osteoclastic bone resorption

28
Q

local anatomic factors that influence functional healing

A

soft tissue injury
interruption of local blood supply
interposition of soft tissue at fracture site
bone death causes by radiation, thermal or chemical burns or infection

29
Q

reduction

A

realigning a fractured limb by incision (open) or without (closed)

30
Q

immobilization

A

necessary until union occurs
if cast isnt enough, we need to fix the limb
internall- pins, screws, rod
externall-if internal contraindicated, external fixator

31
Q

most common places for fracture

A

wrist (fall on outstretched hand), ankle (twisting)m hip(elderly) femur (major violence in young adults)

32
Q

multiple trauma and window of opportunity

A

make sure to fix the fracture early because it makes mobilization easier and also decreases complication risk (fat emboli, DVT)

33
Q

greenstick fx

A

younger patients, one cortex fractures while the other bends instead of breaking

34
Q

tx of greenstick fx

A

completing the fracture by cracking the unbroken cortex

35
Q

buckle/torus

A

seen in young babies with compression mechanism where one cortex fails by forming a wrinkle while the other appears intact

36
Q

impacted fracture

A

piece of bone is driven into softer metaphyseal bone

37
Q

pathologic fracture

A

fracture in bone thats weakend by a pathology

ex- tumor, mets, osteoporosis

38
Q

joint space narrowing uniform

A

inflammatorry

39
Q

nonuniforn joint space narrowing

A

degenerative–reflects regional loss of articular cartilage

40
Q

marginal erosion

A

destruction of bone by INFy pannus

occurs first at uncovered bone at the margin of the joint

41
Q

sublaxation

A

incomplete or partial dislocation due to laxity of disruptuon of ligament

42
Q

sublax w/ erosions

A

RA

43
Q

sublax w/o erosions

A

SLE

MS (19 decks)

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