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PTA > Pathophysiology III > Flashcards

Pathophysiology III Flashcards

test 1

1
Q

What is the definition of a fracture?

A

any discontinuity of bone - synonymous with break

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2
Q

Define a stress fracture

A

an incomplete fx that may not break bone into two pieces. occurs in absence of specific acute traumatic event. often associated with overuse, over-training, or microtrauma

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3
Q

T or F?
Fractures can occur when normal stress is applied to an (abnormal) bone

A

TRUE. Esp. in instances of diseases such as osteoporosis, etc.

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4
Q

What is it called when a fracture happens in a bone due to poor calcium metabolism, osteopenia, osteoporosis

A

Insufficiency fracture

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5
Q

Is a traumatic or insufficiency fracture more common?

A

Traumatic

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6
Q

Open fractures:

A

bone has protruded thru skin or object has punctures skin AKA compound fracture

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7
Q

Closed fracture:

A

bone is broken all the way through

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8
Q

Types of Complete Fractures

A

transverse, oblique, spiral, comminuted, longitudinal

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9
Q

What kind of fx? One part is broken, the other side is bent. Most common in children

A

Greenstick

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10
Q

What kind of fx? Transverse the length of the bone

A

Transverse

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11
Q

This type of complete fx is splintered or crushed.

A

Comminuted

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12
Q

A fracture in which the bone has been twisted apart

A

Spiral fracture

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13
Q

Define compound fracture?

A

The bone breaks through the skin. Creates a “compound” problem of a broken bone and an open wound.

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14
Q

Define a displaced fracture?

A

The ends of the bones are out of alignment.

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15
Q

Describe compression fractures?

A

Bone appears to be “mashed” down. Common in vertebral column. Incidence increases with aging and decreased bone density.

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16
Q

This fx occurs when one fragment of a bone is firmly driven into another fragment

A

Impacted fracture

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17
Q

When a fragment of bone chipped away from the main bone

A

Avulsion fracture

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18
Q

A fracture that runs parallel to the long axis of the bone

A

Longitudinal fracture

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19
Q

Central point of injury forms a star-like pattern

A

Stellate fracture

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20
Q

How quickly do most bones heal to 80% normal functionality?

A

Within three months but some could take 18 mo

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21
Q

What forms bone matrix during bone remodeling?

A

Fibroblasts

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22
Q

What is the first thing that happens in bone healing?

A

Hematoma - it forms with blood coagulating between broken bone fragments

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23
Q

What brings phagocytes to the area of the broken bone?

A

The blood vessels that grow into the matrix of the blood clot in the healing area

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24
Q

During remodeling, woven bone is replaced by what?

A

Lamella bone (mature)

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25
Q

What age population has the highest incidence of UE fractures?

A

children ages 5-14

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26
Q

What bone fracture is more prevalent after age 50 (and incidence doubles every 5-6 years)?

A

Hip fractures

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27
Q

Etiology of fractures

A

Usually caused by stress trauma or disease

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28
Q

What is osteogenesis imperfecta?

A

An inherited (genetic) bone disorder that is present at birth. AKA brittle bone disease - more susceptible to fractures

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29
Q

How are fractures diagnosed?

A

physical exam, radiologic imaging (x-ray)

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30
Q

Methods of reduction:

A

manipulation, traction, surgery

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31
Q

What is reduction?

A

Attempts to restore integrity of a broken bone

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32
Q

Manipulation (bone reduction):

A

Attempts to restore integrity of a broken bone

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33
Q

Manipulation (bone reduction)

A

hands or straps are used to pull/push dislocated skeleton into place

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34
Q

Traction (bone reduction)

A

slowly pulling, often with straps/weights to pull extremities back in place

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35
Q

ORIF stands for

A

open reduction, internal fixation

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36
Q

3 ways to maintain a bone reduction:

A

external fixation, traction, internal fixation

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37
Q

Stages of bone healing (4)

A
  1. Inflammatory: Hematoma forms
  2. Revascularization: soft callus forms
  3. Modeling phase: hard callus forms
  4. Remodeling phase
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38
Q

During which phase do neutrophils and monocytes invade, cell debris is removed, and the fibrin clot is degraded?

A

Inflammatory phase (hematoma formation)

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39
Q

The reparative or revascularization phase is also called

A

soft callus formation

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40
Q

In the first 7-10 days, what undergoes intramembranous bone formation response?

A

The periosteum

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41
Q

In what stage does osteoclastic and chondroclastic reabsoprtion take place?

A

The modeling phase (during hard callus formation)

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42
Q

What is clinical union?

A

Bridging of a fracture by woven bone

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43
Q

Spongy bone is AKA

A

cancellous bone or trabecular bone

44
Q

Compact bone is AKA

A

cortical bone

45
Q

PTAs need to know the ____ of the fracture that occurred and ____ immobilization was removed

A

type, when

46
Q

What is normal bone immobilization time frame?

A

3-8 weeks

47
Q

Bone healing continues for how long?

A

Up to 1 year

48
Q

What is Wolff’s law?

A

A bone grows or remodels in response to forces or demands placed upon it. Bone Remodels along lines of stress.

49
Q

Complications to be mindful of when rehabbing broken bone:

A

malunion, non-union, delayed union, associated soft tissue injury, DVT/PE, acute compartment syndrome

50
Q

When a fracture is due to a disease presence, it is termed what?

A

A pathologic fracture

51
Q

Why should PTAs be very aware of red flags when treating fractures? Specifically in OK

A

Because OK is a direct-access state, so they don’t have to see an MD before PT. Red flags could therefore not be seen by other healthcare providers.

52
Q

Define Reduction

A

an attempt to restore the integrity of a broken bone

53
Q

Define osteomyelitis

A

Inflammation or swelling of bone, usually the result of an infection

54
Q

What are three ways to maintain a reduction?

A
  1. External Fixation
  2. Traction
  3. Internal Fixation
55
Q

What is the PTAs role in fracture treatment?

A
  1. slow re-introduction of activities to obtain. 2. Restoration of function
56
Q

Where does bone remodel?

A

Along lines of stress

57
Q

Inflammatory stage of bone healing:

A

2-4 weeks after fx. Hematoma forms within first few days. Granulation tissue, vascular tissue, and immature tissue are formed

58
Q

Repair stage of bone healing

A

1-2 months post fx. The bone ends become joined and stabilized. New bone tissue forms. Cartilage hardens near end of fx. New blood vessels develop

59
Q

Remodeling (or late modeling) stage of bone healing

A

months to year post fracture. Weak material is converted to strong material. Body remodels fx callus. Mechanical stress helps strengthen the new bone.

60
Q

What are the three phases of RA?

A

Initiation phase, amplification phase, chronic inflammatory phase

61
Q

What is pannus and what does it do?

A

It is vascular granulation tissue. It dissolves collagen as it extends over joint cartilage. It leads to adhesions, fibrosis, and bone akylosis

62
Q

Pleuritis, anemia, valvulitis, lung fibrosis, kidney problems, cardiovascular problems, glaucoma…are all related to what?

A

Rheumatoid Arthritis

63
Q

How many joints are in the cervical spine?

A

37 joints

64
Q

Is the C spine more stability or mobility focused?

A

Mobility and therefor more vulnerable to direct/indirect trauma

65
Q

What are the two functional units that make up the C spine?

A

Craniovertebral (CV) complex and Occipitoatlantal (OA) complex

66
Q

What is the CV (craniovertebral) complex in the C spine?

A

the bony structures of the foramen magnum, occiput, atlas, axis, and supporting ligaments

67
Q

What is the OA (occipitoatlantal) functional unit in the C spine?

A

it is formed between the occipital condyles and superior articular facets and atlas *note it is inherently stable

68
Q

What composes the AA (atlantoaxial) joint?

A

it is the two lateral facet joints and median joint (dens) at C1 and C2

69
Q

Intervertebral discs (IVDs), lie between adjacent vertebral bodies and are composed of what:

A

Inner nucleus pulposus and an outer annulus and limiting cartilage

70
Q

What are unconvertebral joints and what do they do?

A

Nonsynovial clefts between uncinate processes of adjacent vertebral bodies. They limit lateral and posterior translation while guiding motions of flexion and extension.

71
Q

What is the zygopophyseal joint?

A

Joint between articular facets of vertebrae. Planar (gliding).

72
Q

What commonly becomes impinged at zygapophyseal joints?

A

fibroadipose meniscoids

73
Q

What are located between vertebrae and contribute to 20-25% of the length of a spinal column?

A

IVDs (intervertebral discs)

74
Q

What is an IVD composed of?

A
  1. An inner nucleus pulposus
  2. Outer annulus fibrosus
  3. Limiting cartilage end plates
75
Q

What anchors an IVD to the vertebral body?

A

Annulus and end plates

76
Q

What is the function of an IVD?

A

Facilitate motion and provide stability

77
Q

Each spinal nerve is named for the vertebra ____ where it exits the spint

A

BELOW

78
Q

The upper C spine is responsible for roughly how much motion in the C spine?

A

Roughly 50%

79
Q

What is the primary motin at the OA joint?

A

flexion and extension

80
Q

What is the primary motion at the AA jt:

A

axial rotation

81
Q

What can also occur at the AA and to how many degrees?

A

flexion/extension for 10-15 degrees

82
Q

The total range of head motion is the sum of what?

A

The range of head movement and the range of neck movement

83
Q

A cervical stain or sprain may be caused by…

A

an overload injury to the cervical muscle tendon unit due to excessive forces

84
Q

T or F?
Many cervical muscles don’t end in tendons but attach directly to bones via myofascial tissue

A

TRUE

85
Q

What are the s&s of cervical strains and sprains?

A

pain, stiffness, tightness in upper back, occipital headaches

86
Q

What is an acceleration-deceleration mechanism of energy transfer to the head and neck through either blunt impact and/or inertial loading?

A

Whiplash-associated disorders

87
Q

Define: Malingering

A

The intentional production of FALSE symptoms or exaggeration of symptoms that truly exist

88
Q

The amount of injury sustained in a whiplash event is dependent on:

A

occupant characteristics, pre-event factors, event-related factors

89
Q

Degenerative disc disease sx:

A

pain in neck and UE, aggravated pain with neck motion, coughing, sneezing, paresthesia in dermatome of nerve root, weak grip, radiating pain, vertigo, blurred vision, decreased ROM, sensory changes

90
Q

Where is the most common site for herniation in DID?

A

C6-C7

91
Q

Excessive anterior positioning of the head with increased upper cervical spine lordosis and decreased lower cervical spin lordosis, sometimes including rounded shoulders with thoracic kyphosis is known as:

A

Impaired Posture

92
Q

Protracted scapulae with tight anterior muscles and stretched posterior muscles, jaw protrusion and cervicothoracic kyphosis between C4 and T4 additional postural adaptions of what condition?

A

Impaired posture. These are in addition to main s&s.

93
Q

For every 1” that the head is anterior to the CoG, the stress load is ____

A

doubled

94
Q

A chronic degenerative condition of the C spine that affects the joint complexes (IVD, facets, vertebral bodies), of the neck as well as contents of the spinal canal, is known as:

A

Cervical Spondylosis

95
Q

Zygapophyseal joint dysfunction is AKA Acute Cervical joint lock (facet impingement)

A

a “crick” in the neck

96
Q

A clinical syndrome characterized by symptoms attributable to compression of neural or vascular anatomic structures (brachial plexus and/or subclavian artery or vein)

A

Thoracic Outlet Syndrome
*this is named based on its potential cause for compression i.e., cervical rib syndrome, scalenus anticus syndrome, etc.

97
Q

Cervical discs may become painful due to degenerative cascade from repetitive microtrauma or from an excessive single load and this can cause:

A

Cervical Disc Lesions

98
Q

What is cervical radiculopathy?

A

A dysfunction involving compression and irritation of the spinal nerve root

99
Q

What is the most common nerve root affected by cervical radiculopathy?

A

7th and 6th nerve roots

100
Q

Acute Torticollis (acute wry neck) usually presents with:

A

painful neck spasms, limited ROM of the neck, may hold head in comfort position toward the affected side

101
Q

T or F?
Acute torticollis can be congenital

A

True. Etiology is not fully clear

102
Q

Define Spontaneous Atlantoaxial Subluxation:

A

the atlas shifts anteriorly on axis. caused by laxity of ligaments

103
Q

In what conditions are spontaneous atlantoaxial subluxation common?

A

Down syndrome, RA of the spine, congenital abnormality

104
Q

What are the symptoms of spontaneous atlantoaxial subluxation?

A

neck stiffness, pain, torticollis, hyperactive reflexes

105
Q

Fibromyalgia:

A

Chronic disease -
nonspecific inflammation of muscles, ligaments, and fascial tissue.

106
Q

What are the three cardinal features of Temporomandibular Joint Dysfunction?

A
  1. Restricted Jaw function (intermittent or progressive limited mouth opening)
  2. Joint noises (soft or hard crepitus)
  3. Orofacial pain (masticatory myalgia)
107
Q

Where are fibroadipose meniscoids commonly found?

A

In the cervical zygapophyseal joints
*these can be impinged

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