patho test 1 Flashcards
1
Q
what type of bone fracture is only seen in children
A
greenstick
2
Q
what type of bone fracture increases the risk of infection
A
open fracture (skin is open)
3
Q
what type of bone fracture is caused by force applied to both ends
A
compression fracture
4
Q
what is the treatment for bone fractures
A
casting, surgery or noninvasive reduction, physical therapy
5
Q
what are some potential complications that are associated with bone fractures
A
loss of skeletal continuity, injury from bone fragments, pressure from edema and hemorrhage (compartment syndrome), nerve fiber involvement (reflex sympathetic dystrophy and causalgia), development of fat emboli
6
Q
what are the classifications of bones
A
long bone, short bone, flat bone, irregular bone, sesamoid bones
7
Q
describe long bones
A
structure and movement, surface is compact bone but spongy throughout ex) femur and humerus
8
Q
describe short bones
A
stability and limited motion, surface is compact but spongy throughout ex) carpals and tarsals
9
Q
describe flat bones
A
protective bones, consists of a spongy bone layer between two compact bone layers ex) skull and sternum
10
Q
describe irregular bone
A
complex shape ex) vertebrae
11
Q
describe sesamoid bone
A
embedded in tendons and reduce friction ex) patella
12
Q
describe osteoblasts
A
responsible for the formation of the bone matrix, secrete growth hormones, and secrete alkaline phosphatase
13
Q
describe osteoclasts
A
cleans out the bone, is responsible for the reabsorption of bone matrix, and releases calcium and phosphate from the bone. It is affected by PTH, calcitonin, and estrogen. (think c= chippers)
14
Q
describe osteocyte
A
maintenance of the bone matrix, releases calcium into the blood, found in lacuna
15
Q
what are the types of soft tissue injuries? (7)
A
contusion, hematoma, laceration, dislocation, loose bodies, sprain, and strain
16
Q
what is a contusion
A
aka bruise caused by direct trauma, ecchymosis will occur followed by other skin color changes as the blood absorbs
17
Q
what is a hematoma
A
a large localized area of hemorrhage, stop bleeding and elevate, cool compresses for 20 minutes every 4 hours, and aspiration may be necessary
18
Q
what is a laceration
A
torn skin or disruption in the continuity, close the wound after cleaning, minimize contamination
19
Q
what is dislocation
A
displacement of the bone ends of a joint, loss of movement
20
Q
what are loose bodies
A
small pieces of bone or cartilage within a joint space, not huge concern and usually contained
21
Q
what are the two types of bone tissue
A
lamellar and woven
22
Q
when/ where is lamellar bone tissue found
A
in mature adults
23
Q
when/ where is woven tissue found
A
usually in a fetus, if found in adults, it’s abnormal but could be found around healing fractures or tumors
24
Q
what are the types of joints
A
Diarthroses (Synovial) and Synarthroses (Solid)
25
define diarthroses/synovial joints
Most prevalent type of joint in the body is freely moveable, Joint cavity present
26
define synarthroses/solid joints
Little to no movement, No joint cavity, Fibrous (skull, teeth to jaw, or ligament connecting adjacent bones) or cartilaginous (i.e., growth plate and two ossification centers)
27
explain tendon vs ligament
*tendon connects muscle to bone relatively inextensible because of richness of colagen fibers. enveloped in loose connective tissue, blood vessels, and nerves.
*while ligament connects bone to bone, ligament injury is more serious. fibrous thickening of the articular capsule. Will tear rather than stretch if excessive force
28
what things can you identify that would increase a person's risk of fractures
age (children and older adults), smokers, osteoporosis, Vitamin D or calcium deficiency
29
Understand bone healing and what all would contribute to delayed bone healing processes?
hematoma formation, cellular proliferation (cells multiplying), callus formation, ossification, and remodeling. delayed healing could be from smoking, age, medications, debilitating diseases, localized stress at the fracture site, circulatory problems, coagulation disease, poor nutrition
30
How would you identify and explain a sprain vs. a strain?
sprain: visible evidence is present, pain, rapid swelling, heat, disability, discoloration, and limited function
strain: usually no external evidence just pain stiffness and mild swelling (lower back is common)
* RICE treatment!
31
What are congenital deformities associated with the musculoskeletal system?
mild limb deformities: syndactyly- webbing of fingers and toes, polydactyly- extra digit, absence of bone or digit
major limb malformations: joint contractures and dislocations, absence of entire bones, joints, or limbs
32
describe osteogenesis imperfecta
* hereditary disease characterized by defective synthesis of Type I collagen
* pt might have hearing loss
* no treatment
* stage 2 baby may not live
* think "imperfect in beginning of bone"
* Bisphosphonates may help
33
describe club foot
feet are turned inward, may require surgery, but if treatment starts early enough, it may be healed by casting overtime
34
describe hip dysplasia
abnormality in hip development, usually in infants and children, determined by the Ortolanli click test
35
describe juvenile osteochondrosis
A group of children’s diseases in which one or more growth
ossification centers undergo a period of degeneration, necrosis,
or inactivity that is followed by regeneration and usually
deformity
36
what are the type of juvenile osteochondrosis
legg-calve-perthes disease, osgood-schlatter disease, slipped capital femoral epiphysis
37
what is leg-clave-perthes disease
osteonecrosis of an apophyseal or epiphyseal center of the femoral head
38
what is osgood schlatter disease
involves microfractures in the area where the patellar tendon inserts into the tibial tubercle
39
red vs yellow bone marrow
red bone marrow produces blood cells, while yellow bone marrow stores adipose tissue. red is found in spongy bones like the pelvis. yellow is held in the medullary cavity and serves as an energy reservoir
40
Identify Paget’s Disease
a progressive skeletal disorder that involves excessive bone destruction and repair
* characterized by increasing structural changes of the long bones, spine, pelvis, and cranium (HINT: bones in overdrive)
41
Benign bone tumor vs. malignant bone tumor
benign is usually circular and not cancerous while malignant is irregular and cancerous
42
benign tumor characteristics
limited to the confines of the bone, circular, surrounded by a thin rim of sclerotic bone
43
malignant tumor characteristics
irregular, lack sharp boarders, extend beyond confines of bone, end in SARCOMA, more common in men
44
what is the role of vitamin D
helps absorb calcium, supports osteoclasts and osteoblasts, increases renal excretion of phosphate
45
vitamin D and calcium relationship
while calcium strengthens the bones, the bones cannot absorb calcium unless it's aided by vitamin D therefore, taking a calcium supplement is not useful unless paired with vitamin D
46
what are ways to increase vitamin D intake
sunlight exposure, supplements, foods high in vitamin D
47
what is PTH?
Parathyroid Hormone increases SERUM calcium levels and decreases phosphate
48
What is the effect of PTH on calcium levels?
PTH increases calcium blood levels
49
What effect does PTH have on the
bones?
PTH stimulates osteoclasts to break down bone tissue so calcium and phosphate are released from the bone matrix into the bloodstream
50
what effect does PTH have on the renal system
PTH increases calcium reabsorption in the kidney tubules, and less calcium is lost in the urine. also promotes the conversion of vitamin D. Active vitamin D is essential for calcium absorption in the GI system
51
what effect does PTH have on the GI system
Active vitamin D (stimulated by PTH) increases calcium absorption from food in the small intestine. more calcium enters the bloodstream from food sources
52
What is calcitonin?
hormone
53
What effect does calcitonin have on calcium?
decreases blood calcium levels
54
What effect does calcitonin have on
the bones?
Inhibits Osteoclasts. Osteoclasts break down bone to release calcium.
Calcitonin suppresses this process, keeping calcium stored in the bones
55
what effect does calcitonin have on the renal system?
helps the kidneys eliminate calcium and phosphate, lowering blood calcium levels.
56
What assessment and assessment findings are related to hip dysplasia?
a ortolanli click test is used to determine if an infant has hip dysplasia. If a hip makes a clicking noise, the test is positive. One leg may be longer/ shorter than the other as well.
57
What is club foot and how is this treated?
club feet are when a (usually) infant's feet are turned inward. some cases can be treated with continuous casting but more severe cases may require surgical intervention.
58
What is the prevention and treatment of osteoporosis?
*patients who are not active, calcium deficient, high protein, excessive alcohol or caffeine intake, or smoke are at high risk.
* treatment is weight-bearing exercises, anabolic agents, antiresorptive agents, and vitamin D supplements
59
what is osteoporosis
skeletal disorder that results in loss of bone mass and deterioration of the architecture of cancellous bone HINT: think pores
60
what is cell atrophy
reduction in cell size and reduced functioning
ex) disuse and decreased blood flow
61
what is cell hypertrophy
increased cell size
ex) increased muscle mass that is associated with exercise
62
what is cell hyperplasia
increase in the number of cells
ex) breast and uterine enlargement due to pregnancy
63
what is cell metaplasia
reversible change where one adult cell type replaces another
ex) replacement of stratified squamous cells in trachea by ciliated columnar epithelial cells in a smoker
64
what is cell dysplasia
deranged cell growth of a specific tissue that results in cells that vary in size shape and organization
ex) negative pap smear results
65
What body system is most important in the role of balancing electrolytes?
the renal system
66
What are the Chvostek’s and Trousseau’s signs? How are these performed? What do positive
findings indicate?
* Chvostek's includes tapping on the side in front of the ear and the same side of the face spasming while Trousseaus is using a BP cuff and watching for hand spasms
* positive tests indicate hypocalcemia (low calcium blood levels)
67
What is the treatment for hyperkalemia and hypokalemia?
hyperkalemia: severe needs IV potassium, mild needs oral or diluted IV potassium
hypokalemia: severe needs IV calcium followed by IV insulin and dextrose, dialysis. mild needs diuretics and kayexalate
68
How does ADH secretion/inhibition change in hypernatremia vs. hyponatremia?
* ADH secretion increases in response to hypernatremia to help the body conserve water and dilute the high sodium concentration
* The body detects low sodium and responds by reducing ADH secretion (or inhibiting it entirely) to prevent further water retention.
69
How do you assess for scoliosis? What assessment findings indicate scoliosis?
can use Adam's forward bend or x-ray. bent spine either when standing or when bending over
70
Understand tonicity and cellular response to hypertonic, hypotonic, and isotonic solutions
*Tonicity refers to the ability of a solution to affect the shape and volume of cells
* hypertonic- higher concentration outside the cell, cell shrinks because water moves out
* hypotonic- higher concentration inside the cell, cell swells because water moves in
* isotonic- equal no cell change
71
What is the relationship with PTH and bone cells?
*PTH stimulates osteoblasts to produce factors that activate osteoclasts.
*Osteoclasts break down bone, releasing calcium into the blood.
*This process is essential for regulating calcium levels but can lead to bone loss if PTH levels are too high over a long period.
72
Know and understand common cations found in extracellular and intracellular fluids
*Sodium (Na⁺): maintains blood volume, blood pressure, and fluid balance
*Potassium (K⁺): maintains heart and muscle contraction
*Calcium (Ca²⁺): aids in blood clotting, helps muscles contract, bone strength
*Magnesium (Mg²⁺): keeps muscle cells relaxed after contracting
73
Understand clinical manifestations (signs and symptoms) of SIADH and Diabetes insipidus
* SIADH- (too much ADH) low urine output, hyponatremia, over hydrated and retaining fluid
* Diabetes Insipidus- (low ADH) lots of urine output, hypernatremia, dehydrated, lose too much fluid
*** both have excessive thirst
74
Magnesium IV administration and signs and symptoms of hypermagnesemia and
hypomagnesemia
hypermagnesemia: lethargy, decreased reflexes, confusion, coma, hypotension HINT low and slow
hypomagnesemia: tachycardia, hypotension, personality changes, muscle spasms HINT increased and hyper
75
Signs and symptoms of hyperkalemia and hypokalemia
potassium levels
* hyperkalemia: nausea and vomiting, stomach cramps, diarrhea, EKG changes, cardiac arrest
* hypokalemia: muscle cramps, confusion, EKG changes, cardiac dysrhythmias
76
What are signs and symptoms specific to hypocalcemia and hypercalcemia?
calcium levels
* hypocalcemia- muscle spams and cramps, chvostek and trousseau signs, numbness and tingling
* hypercalcemia- renal stones, bone pain, cardiac arrest
77
what are the acid-base alterations
respiratory acidosis, respiratory alkalosis, metabolic acidosis, metabolic alkalosis
78
what is seen during respiratory acidosis
* usually cause by COPD, mechanical ventilation, or trauma injury
* pt is slow breathing or not breathing
* pt retains acid
* pH down CO2 up
79
what is seen during respiratory alkalosis
* usually caused by anxiety, fever, or if pt is over-ventilated, aspirin toxicity
* hyperventilation
* pH up and CO2 down
80
what is seen during metabolic acidosis
* usually caused by anorexia, diabetic ketoacidosis
* pt tries to balance their low amount of HCO3 by blowing off CO2 or hyperventilating
* HINT down down down
81
what is seen during metabolic alkalosis
* caused by excessive vomiting or antacid use, diuretics, potassium deficiency
* pt will try to decrease breathing to level out
* HINT up up up
82
What is the acid
related to the respiratory system?
carbonic acid H2CO3
83
What is the acid retained or excreted by the renal system?
hydrogen H2
84
What is the base retained or excreted by the renal system?
bicarbonate HCO₃⁻
85
normal pH level
7.35-7.45
86
normal PaCO2 level
35-45
87
normal HCO3 level
22-26
88
normal sodium (NA+) level
135-145
89
normal potassium (K+) level
3.5-5.0
90
normal chloride (Cl-) level
98-106
91
normal phosphorus (h2PO4-) level
2.5-4.5
92
normal calcium (Ca+) level
8.5-10.5
93
normal magnesium (Mg+) level
1.8-3.0
94
sodium opposite
potassium
95
calcium opposite
phosphate
96
magnesium opposite
phosphate
97
magnesium buddy
potassium and calcium
98
calcium buddy
vitamin D
