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Musculoskeletal > Path 4 > Flashcards

Path 4 Flashcards

1
Q

Stress Fracture

A

bone fractures after repeated extra stress

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2
Q

Incomplete Fracture

A

bone is cracked, but not broken into two pieces

ex: greenstick fracture to childs long bone

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3
Q

Closed Fracture

A

overlying tissues are intact

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4
Q

Compound Fracture

A

“Open” “complicated”

-the bacteria have a route from the surface to the bone, bone can stick out

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5
Q

Multifragmented Fracture

A

“comminuted”

-the bone is broken into several pieces

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6
Q

Complex Fracture

A

ends of the bone fragments have done serious damage to the surrounding tissue

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7
Q

Pathologic Fracture

A

intrinsic disease of the bone, force would not have broken normal bone
ex: osteoporosis, cancer, osteogenesis imperfects

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8
Q

Skull Fracture

A
  • flat bone

- not depressed, not displaced

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9
Q

Callus Formation

A

1st: bleeding and formation of blood clot (dead bone b/c devascularization at edges of fracture)
2nd: recruitment & neovascularization, neutrophils, fibroblasts organize
3rd: ingrowth of osteocytes & new or woven bone formation, cartilage produced at surface of callus
4th: after many months, continued remodeling of bone with reduction of callus over time until complete healing

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10
Q

Fibrous Nonunion

A

-pathological bone healing where fractured bones are not closely aligned with each other to form callus and to continue the remodeling process to make a perfectly healed bone

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11
Q

How do we repair a fracture?

A

metal devices, plates, nails, screws

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12
Q

Osteonecrosis

A
  • spongy bone can be infarcted easily wherever it has an end-artery pattern of vascularization & the artery is compromised. Near convex surfaces of joints, feared result is detachment of the articular cartilage
  • overlying cartilage & synovium/joint space will be spared. Infarction & necrosis in the shaft is more difficult b/c of collateral circulation - usually trauma
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13
Q

Osteonecrosis of Femoral Head related to?

A
  • sickle cell disease
  • decompression sickness
  • femoral neck fracture/dislocation
  • alcohol abuse/glucocorticoid use
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14
Q

Osteonecrosis in Sickle Cell

A
  • Sickle is most common inherited blood disorder in US
  • more than 70,000 people have it
  • 1 in 500 AA
  • 8% AA are carriers
  • 2 million have trait
  • 1 in 12 AA has trait
  • multiple painful bone infarcts resulting in osteonecrosis
  • **hypercellular marrow that interferes with blood low in the marrow and can lead to infarct and necrosis
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15
Q

Osteomyelitis

A

bone infection

  • often by pyogenic organisms (any can be)
  • hematogenous spread(kids 2-5y/o), contiguous spread, or in patients with vascular insufficiency (poor wound healing)

no organism identified in 50%

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16
Q

Risk Factors in Osteomyelitis

A

-presence of foreign materials, diabetes, orthopedic surgery, adjacent infection, peripheral vascular disease, sickle cell disease, congenital phagocyte function defect

17
Q

Pyogenic Osteomyelitis

A

begins in metaphysis and can spread hematogenously

  • staph in 80-90%
  • mixed bacteria in trauma/surgery
  • Salmonella - Sickle Cell
18
Q

Tuberculous Osteomyelitis

A

Pott disease, vertebrae

19
Q

Syphilitic Osteomyelitis

A

neonates, saddle nose, saber shins

20
Q

Squamous cell carcinoma in Osteomyelitis

A

-develop in bone or sinus tract of long standing chronic osteomyelitis

21
Q

Involucrum

A

Subperiosteal shell of viable new bone, surrounding reactive bone

22
Q

Sequestrum

A

Inner native necrotic cortex, remaining fragment inside involucrum

23
Q

Osteomyelitis Micrograph of Dead Bone

A
  • lots of polymorphoneclear leukocytes
  • fibrin and old blood
  • bony spicule have no osteocytes in lacunae-dead bone
  • no lymphocytes present
24
Q

Osteomyelitis in Diabetes

A

-ulceration & necrosis

25
Q

Pott Disease

A

“tuberculous spondylitis”

  • oldest demonstrated disease
  • infection of vertebral bodies(spondylitis) and joint spaces (spondylarthritis)
26
Q

Syphilis

A
  • spirochete “Treponema palidum”

- late disease affects skeletal system

27
Q

Primary Syphilis

A
  • sexual contact with infectious lesions on a person with syphilis
  • 10-90 days after initial exposure, skin lesion appears at point of contact (genitalia)
28
Q

Secondary Syphilis

A

1-6 months ofter primary

29
Q

Tertiary Syphilis

A

1-10 years after primary

30
Q

Congenital Syphilis

A

“saber shin”
-anterior deformity of the tibia due to periostits and an inflammatory reaction at the outside bony cortex
“saddle nose” -destruction of nasal bone
-result of transmission from a mother to her fetus

31
Q

Osteoarthritis

A
  • degenerative joint disease, characterized by joint cartilage breakdown causing painful and stiff joints
  • “inflammation of joints” causes disability
  • no cure
  • only strikes one joint - stress like hip, back, knee, hand
  • painful use of joint, painful periods after use, joint discomfort after weather changes, swelling, stiffness, bony lumps in hands/fingers, decreased flexibility
32
Q

Bony Growth in Osteoarthritis

A
  • result of body’s attempt to repair the joint

- body makes it more difficult with the addition of these bony growths

33
Q

Risk Factors for Osteoarthritis

A
  • female gender
  • age >45y/o
  • joint injuries
  • obesity
  • diseases that cause malformation/disfigurement of bone structure
  • weakened quads
  • other arthritis
34
Q

Rheumatoid Arthritis Pathology

A

-severe ulnar deviation with subluxation (incomplete luxation or dislocation
“swan-neck” abnormality
-small joints affected first (hands/feet) followed by wrists, elbows, ankles, knees

35
Q

Rheumatoid Nodule

A

-occur in 20% of patients
-acellular center of eosinophilic material “fibrinoid”
surrounded by palisaded histiocytes and other cells, maybe with a rim of granulation tissue
-occur anywhere-extensor surfaces, pericardium, aortic valve (rare), lung perenchyma

36
Q

Pannus

A

“membrane of granulation tissue”
forms in RA
-after years, can proliferate and contribute to joint destruction, spreads over and erodes articular cartilage and bone leading to fibrosis of joint

37
Q

What do urate crystals look like under microscope?

A

Needle shaped, under parallel polarized light YELLOW

38
Q

What do Calcium Phosphate Crystals look like under microscope?

A

-polarize yellow when Perpendicular to long axis of crystals

39
Q

Pigmented Villonodular Synovitis

A
  • localized, destructive lesion within a single joint (knee), with proliferation of synovium, hemosiderin pigmentation, and destruction of joint.
  • clonal
  • excision is usually curative - may recur

Musculoskeletal (19 decks)

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