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PATHOLOGY II > quiz #2 - sprains, strains, fractures, CT pathologies > Flashcards

quiz #2 - sprains, strains, fractures, CT pathologies Flashcards

1
Q

grade of SPRAIN:
-minor stretch & tear
-no joint instability on passive testing
-minimal P & swelling
-able to complete ADLs with minor discomfort
-can weight bear
-bruising absent/ slight

A

grade 1

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2
Q

grade of SPRAIN:
-partial tear of lig.
-increased P
-bruising & swelling
-loss of function due to P
-P on weight bearing
-snapping sound & joints gives way
-passing testing shows hypermobile but stable

A

grade 2

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3
Q

grade of SPRAIN:
-complete tear
-surgery required
-immobilization in cast
-severe injury
-synovial inflammation & accumulation of synovial fluid = joint effusion
-hemarthrosis if bleeding into joint
-X-ray to rule out avulsion fracture (bone fragment pulls away from bone by lig.)

A

grade 3

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4
Q

overstretch / tear of ligament

A

sprain

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5
Q

type ankle sprain: lateral ligaments torn (anterior talofibular, calcaneofibular, calcaneocuboid)
*most common of all sprains

A

inversion sprain

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6
Q

type of ankle sprain: deltoid ligament torn (anterior tibiotalar, tibiocalcaneal, posterior tibiotalar & tibionavicular – also has two sets of fibers superficial & deep), may cause avulsion fracture if Grade III sprain

A

eversion sprain

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7
Q

most commonly sprained knee ligament

A

anterior cruciate ligament (ACL)

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8
Q

most common cause of an injury to the knee affecting all 3 structures: medial meniscus, ACL, MCL

A

foot is fixed on ground, knee is truck by medial or lateral force

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9
Q

most common cause of a wrist sprain

A

FOOSH

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10
Q

most common wrist ligament sprained

A

palmar radiocarpal

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11
Q

most common shoulder ligament sprained

A

acromioclavicular (AC)

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12
Q

“loose ligaments” – may cause chronic body pain
-when condition affects joints in entire body, it is called generalized joint hypermobility

A

ligamentous laxity

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13
Q

ligamentous laxity - genetic disease causing abnormal fibrillin

A

Marfan syndrome

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14
Q

ligamentous laxity - defect in synthesis of collagen, causes progressive deterioration of collagen in different parts of body such as joints, heart valves, organ walls or arterial walls

A

Ehlers-Danlos syndrome

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15
Q

ligamentous laxity - insufficient production of normal collagen to produce healthy, strong bones

A

osteogenesis imperfecta (brittle bone disease)

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16
Q

ligamentous laxity - affects collagen, may have distinctive facial appearance, eye abnormalities, hearing loss & joint problems

A

Stickler syndrome

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17
Q

ligamentous laxity - defects in collagen, found in renal basement membrane, inner ear & eyes, leading to glomerulonephritis, hearing loss & eye disease

A

Alport syndrome

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18
Q

ligamentous laxity - Beal’s syndrome, similar to Marfan syndrome but with contractures of hip, knee, elbows & ankle joint, crumpled ear

A

congenital contractural arachnodactyly

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19
Q

ligamentous laxity - a collagen vascular disease

A

psoriatic arthritis

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20
Q

tear of mm or tendon, commonly affecting lower back, neck & hamstrings

A

strain

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21
Q

grade of STRAIN:
-few mm fibers damaged
-mild pain at time of injury
-mild swelling, if any
-minimal loss of strength
-P when tissue is stressed
-ADLs can be completed
-heals within 3 weeks

A

grade 1

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22
Q

grade of STRAIN:
-more extensive damage to fibers or tendon, but mm not completely ruptured
-snapping sound may or may not be present, can sometimes feel gap at injury site
-edema, P (moderate), tenderness at site
-difficulty with ADLs
-loss of strength
-heals in 3-6 weeks

A

grade 2

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23
Q

grade of STRAIN:
-severe injury with complete mm rupture
-snapping sound accompanies injury
-severe P, edema, bruising
-ADLs cannot be continued

A

grade 3

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24
Q

complications with grade 3 strains

A

joint effusion (synovial fluid accumulation) or hemarthrosis (bleeding into joint)

generally sprains heal slowly, 6 weeks to develop fibrotic scar tissue, 6 months for healed tissue to mature fully & regain max strength – radiographs frequently taken to rule out avulsion fracture

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25
Q

crush injury to mm with bleeding into mm & subcutaneous tissues, bruising minor or severe – can track along fascial plane, appearing at distant site – caused by blow or crushing injury to mm & does not break skin

A

contusion

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26
Q

complications of a contusion

A

rapid accumulation of mm-derived proteins (like myoglobin) in bloodstream that can lead to damage to kidney & possible kidney failure or shock, called rhabdomyolysis

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27
Q

solid swelling of clotted blood that collects in tissue, outside of blood vessel – damage to wall of artery, vein or capillary causes blood to leak into adjacent tissues & cause inflammation & bruising – violent sneeze/ cough may cause

A

hematoma

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28
Q

why is a hematoma different from a bruise?

A

blood vessels that are damaged are larger & damage is worse

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29
Q

injury to joint where surfaces are not congruent or separated – very painful & causes immobilization of joint – most common in shoulders & fingers, also elbows, knees & hips – most return to normal function after healing

A

dislocation

*subluxation = partial dislocation

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30
Q

break in the bone
-can be due to trauma, overuse, microtrauma or stress

A

fracture

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31
Q

causes of fractures

A

falls, sports, accidents & low bone density caused by disease

increased forces on bones that exceed limits

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32
Q

fractures affecting epiphyseal growth plates – applies to children only before plate fusion

A

Salter-Harris fracture

33
Q

type I-V: salter-harris fracture

A

Type I: transverse fracture through growth plate (also known as physis)
Type II: fracture through plate & metaphysis
Type III: fracture through plate & epiphysis
Type IV: fracture through plate, epiphysis & metaphysis
Type V: compression fracture of growth plate

34
Q

fracture: parallel to long axis of bone

A

linear

35
Q

fracture: right angle to bone’s long axis

A

transverse

36
Q

fracture: twisting of bone, causing a fracture

A

spiral

37
Q

fracture: two or more fragments of bone from fracture

A

comminuted

38
Q

fracture: bone/bone fragments crushed into each other

A

impacted

39
Q

fracture: bone compressed as in vertebral body

A

compression

40
Q

fracture: usually of skull

A

depression

41
Q

complications of fractures

A

nerve compression, vascular damage, infection, disuse atrophy, joint stiffness & limitation of ROM, delayed union, non-union, malunion

42
Q

bone does not unite (heal) within expected time frame – may be caused by inadequate circulation, hypermobility, infection, drugs or smoking

A

delayed union

43
Q

bone does not heal, even after repair process has “given up” – large gap, bone destruction & general poor bone health

A

non-union

44
Q

union of bone, unacceptable deformity leading to altered biomechanics

A

malunion

45
Q

Osteoma
Osteochondroma
Endochondroma
Osteoid osteoma
Giant cell tumour
Aneurysmal bone cyst
Fibrous dysplasia

A

benign bone tumors

46
Q

Osteosarcoma
Chondrosarcoma
Fibrosarcoma
Malignant fibrous histocytoma
Ewings’ sarcoma
Multiple myeloma

A

malignant bone tumors

47
Q

benign slow growing bone tumor, usually around 1.5 cm in size – usually found in cortex of long bones (osteoid osteoma) or more commonly in skin (jaw & sinuses) – often in young men – X-rays used to diagnose & main symptom is pain
– 3 types: compact, spongy combined

A

osteoma (osteoid osteoma)

48
Q

benign tumor affect children & adolescents 1-2 cm in size – abnormal growth or outgrowth at surface of bone near metaphyseal region of growth plate – made up of bone & cartilage – may be one tumor or many – continues to grow as child grows & stops when child stops growing

A

osteochondroma

49
Q

benign tumor of cartilage often affects long bones of hands & feet, but also femur, humerus or tibia – mostly affects adults

A

enchondroma

50
Q

rare, aggressive benign tumor, in young adults 20-40 years, often occurs near a joint at end of a long bone in metaphysis – common at knee, & in general in arms & legs or breastbone or pelvis

A

giant cell tumor

51
Q

benign blood filled cyst inside a bone that grows & expands quickly while destroying bone tissue – cysts are fragile & fracture easily – may occur anywhere, but commonly in knee, pelvis & spine

A

aneurysmal bone cyst

52
Q

replacement of normal bone with fibrous bone tissue, may affect one bone (most often) or multiple bones – common in femur, tibia, humerus, skull, ribs & pelvis – weakens normal bone tissue & may cause deformity or fracture – common in children & adolescents

A

fibrous dysplasia

53
Q

cancer of bone forming cells, common in 10-30 years, commonly affects long bones of legs mostly & arms – Terry Fox had this type of bone cancer (malignant)

A

osteosarcoma

54
Q

begins in bones or in soft tissue surrounding bones, very rare – often in pelvis, hip & shoulder – these cancer cells produce cartilage (malignant)

A

chondrosarcoma

55
Q

effects fibroblasts, cells that produce collagen in fibrous tissue or soft tissue, creating fibrous tissue where it doesn’t belong – may affect nerves, tendons, ligaments, blood vessels, lymphatic vessels, fat or mm – most common in legs or trunk (malignant)

A

fibrosarcoma

56
Q

cancer found in soft tissues like mm & tendons (may sometimes invade bone also), mostly in adults, often occurs late in life – common in arms & legs (specifically metaphysis of long bones) but may occur anywhere (malignant)

A

malignant fibrous histiocytoma

57
Q

in bones or soft tissue surrounding bones, commonly in leg & pelvis bones, less common soft tissues of chest, abdomen or limbs – most common in children & adolescents but can occur at any age (malignant)

A

Ewing’s sarcoma

58
Q

cancer of a specialized white blood cell called a plasma cell - normal plasma cells make antibodies that attack pathogens, but these cancerous plasma cells make abnormal proteins - cells accumulate in bone marrow & crowd out healthy cells

A

multiple myeloma

59
Q

form of skeletal dysplasia, arm & leg bones are shorter than normal, average adult height of 4’ - 4’4” – also have an enlarged head with prominent forehead

A

achondroplasia / dwarfism

60
Q

brittle bone disease from gene mutation inherited or present at birth, bones soft & fracture easily – gene is responsible for collagen production in bone tissue, with dysfunctional or less collagen, bones are weakened

A

osteogenesis imperfecta

61
Q

foot abnormalities present at birth (congenital), foot is twisted or out of position – 50% of children have it in both feet – tendons & ligaments in foot are shorter than normal – may be mild or severe

A

club foot

62
Q

also known as “lupus” – chronic, inflammatory autoimmune disease that affects skin, bones, joints, nervous system & brain, kidneys, lungs & other organs – blood vessels also affected leading to Raynaud’s phenomenon with lowered levels of RBCs & platelets – butterfly rash is most distinctive symptom

A

systemic lupus erythematosus (SLE)

63
Q

what triggers lupus (SLE) if you are genetically predisposed?

A

sunlight, infections & medications

64
Q

syndrome involving a complication of diabetes & neuropathy – uncontrolled inflammation causes destruction of tissues due to impaired nerve pain perception

A

neurogenic arthritis - Charcot’s disease

65
Q

chronic disease that affects CTs & internal organs – main effect is overproduction & accumulation of collagen leads to fibrosis or scarring & inflammation causing skin & superficial fascia to thicken & harden

A

scleroderma

66
Q

clinical features of scleroderma

A

tightness of skin of face “mask-like” appearance, mouth may not open or close completely, hands red, pale & swollen & fingers become tapered and flexed, skin is hard, shiny & stretched

67
Q

clinical features of scleroderma going deeper & affecting internal organs

A

may affect heart; cause arrhythmias or respiratory failure, renal failure, esophageal or intestinal blockage or perforation and damage to vascular walls (Raynaud’s phenomenon)

68
Q

scleroderma - types & subtypes

A

localized: affects skin, fascia, mm & sometimes bone

generalized: affects multiple systems
-limited: affects skin of face & fingers, slow onset (5-10 years), milder, symptoms are C.R.E.S.T.
-diffuse: affects more areas of skin & may involve organs, sudden onset, more severe

69
Q

what does CREST stand for? (scleroderma)

A

C - calcinosis
R - raynaud’s phenomenon
E - esophageal dysfunction
S - sclerodactyly
T - telangiectasias

70
Q

blood vessel disease characterized by inflammation of medium sized arteries or muscular arteries, also called vasculitis
-prevents adequate oxygenation of tissues & organs, causes hypoxia and ischemia

A

polyarteritis nodosa (PAN) or vasculitis

71
Q

polyarteritis nodosa (PAN) or vasculitis is strongly associated with…

A

hepatitis B infection

72
Q

inflammation of blood vessels (vasculitis) in nose, eyes, ears, sinuses, throat, lungs, heart, skin & kidneys – prevents adequate oxygenation of tissues and organs and causes hypoxia and ischemia

A

Wegener’s granulomatosis or granulomatosis with polyangiitis

73
Q

genetic disorder that affects proteins that contribute to elasticity & strength of CTs – most commonly affects heart, eyes, blood vessels & skeleton – person tall in stature with abnormally long extremities – normal lifespan with medical intervention

A

Marfan’s syndrome

74
Q

bands of scar like tissue, causing nearby organs & tissues to stick together

A

adhesions

75
Q

fibrotic scarring, dysfunctional wound healing process where CT or fibrotic tissue replaces normal tissues – excess deposition of extracellular matrix mostly collagen

A

fibrosis

76
Q

tightening of CT in mm, tendon, ligaments or skin, preventing normal movements, often caused by severe burns – skin becomes scarred & loses its elasticity

A

contractures

77
Q

inflammation of plantar fascia – often due to repetitive sports & inadequate stretching

A

plantar fasciitis

78
Q

chronic pain syndrome characterized by heightened pain response with diffuse soft tissue pain that feels muscular in nature with multiple tender points – pain lasts longer than 3 months & often accompanied by insomnia & memory problems – total of 18 tender points in body, diagnosis is made if 11 – commonly, there are periods of remission & exacerbation – mostly affects women in middle age

A

fibromyalgia

79
Q

pressure within fascial compartments around mm builds to dangerous levels & causes pain and swelling that may decrease blood flow to area, damaging tissues & causing hypoxia and ischemia

A

compartment syndrome

PATHOLOGY II (10 decks)

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