Week 12 - fractures Flashcards
What is the thin, tough layer of tissue that covers the outer surface of bones, except at the joints where bones meet?
Periosteum
What is the spongy tissue inside bones that makes blood cells and stores energy?
Bone marrow
What represents a disruption in the continuity of a bone?
Fracture
When more stress is placed on the bone than it is able to absorb, it causes a?
Fracture
(3) General causes of fractures?
- Caused by sudden injury
- Fatigue stress, excess stress to bone
- Pathologic stress
What are (3) main locations of fractures?
- Proximal, midshaft, distal
- Head/neck of bone
- Condyle, malleolus
What is a rounded, smooth area at the end of a bone, typically found in joint?
A condyle
What is a bony bump found on each side of the ankle?
-> It helps stabilize and support the ankle joint
Malleolus
The type of fracture is determined by what (3) characteristics?
- open/closed
- Degree of #
- Character of # pieces
What are (2) Direction/Pattern for a fracture?
- Transverse #
- Spiral
What are manifestations of a fracture? (9) name a few
- pain
- ecchymosis (bruise)
- swelling loss of function
- crepitus
- abnormal mobility
- deformity
- muscle spasm
- numbness
- tenderness
What is the medical term for bruise?
Ecchymosis
What is the crackling, popping, or grinding sound or sensation that occurs when bones, joints, or tissues rub together?
Crepitus
(3) Diagnosis test for fractures?
- X-ray
- CT scan
- Bone scan
(3) treatment goals for fracture?
- Reduction
- Immobilization
- Preserve and restore function
What are (4) principles of bone healing?
- Hematoma formation
- Soft tissue callus
- Ossification
- Remodeling
What play a role in the repair process by bringing in nutrients and cells needed for healing in the periosteum?
Blood vessels
New blood vessels form in the injured area to supply oxygen and nutrients, which are essential for tissue repair and bone regeneration, this is known as?
Neovascularization
What is created to stabilize the area and provide a framework for new bone cells to grow?
Formation of fibrin meshwork
What proteins signal cells to start repairing and rebuilding the damaged bone and tissue?
Growth factors
What is a soft, temporary structure made of connective tissue forms at the fracture site to begin stabilizing the broken bone?
Procallus
What type of cells produce collagen and help form connective tissue?
Fibroblasts
What type of bone-building cells that help regenerate new bone?
Osteoblasts
What (2) cells migrate to the fracture site to start the repair process?
- Fibroblasts
- Osteoblasts
What type of callus develops to connect bone fragments that bridge the gap between the broken bone pieces?
Fibrocartilaginous callus
What are deposited into the soft fibrocartilage callus, turning it into a hard, bony callus?
Mineral salts
Do the osteocytes work outwards to inwards or inwards to outwards?
Osteoblasts start on the outer surface of the bone and progress inward
The initial fibrocartilage callus is gradually replaced by?
Spongy bone
What are cells that break down and remove dead or damaged bone tissue. This helps clean up the area, preparing it for new bone growth.
Osteoclasts
What type of bone replaces spongy bone at periphery over time?
Compact bone
What influences fracture healing? (5)
- Nutritional status
- Age
- Co-morbidities
- Medication
- Smoking
After a fracture, function usually returns how many months later?
6 months
What is a condition of increased
pressure within a limited space?
Compartment syndrome
If the pressure is high in limited space, then tissue circulation is?
Compromised, and permanent damage may occur
Compartment syndrome may develop from (3) things:
- Decreased compartment size (cast, dressing)
- Increase in volume of contents (trauma, bleeding, swelling)
- Combination of both
Manifestations of compartment syndrome? (3)
- severe pain – hallmark symptom
- Paresthesia – nerve compression
- diminished pulses
What is a hallmark symptom of compartment syndrome?
Severe pain
Physician can check pressure of compartment with?
A needle
Muscle necrosis can occur in how many hours?
4-8 hours
Is treatment for compartment syndrome an emergency?
Yes! Check pulses and remove cast or dressing, and elevate limb
What is a surgery to cut open the tissue around muscles to relieve pressure and prevent further damage if compartment syndrome is severe?
Fasciotomy
Presence of fat droplets in small vessels released from bone marrow due to long bone # describes?
Fat Embolism Syndrome
How does fat droplets enter circulation in fat embolism syndrome?
- Via torn veins
What kind of rash will appear on chest after 2 days of fat embolism syndrome?
Petechiae rash
Manifestations of fat embolism syndrome?
- Respiratory failure, cerebral dysfunction and skin/mucosal petechiae
Initial symptoms of fat embolism syndrome begin when?
Within a few hours to 3-4 days after injury
Highest risk period of fat embolism syndrome is when?
within 1 week of injury
What are (2) diagnostics tests for fat embolism syndrome detection?
- Urgent CXR (chest xray)
- ABGs
Fat embolism syndrome treatment? (3)
- Prevent with early stabilization of fractures
- Supportive care: O2, IV fluids etc.
- Corticosteroids to decrease inflammatory response
What are (3) Complications of Fracture Healing?
- Malunion
- Delayed union
- Nonunion
Deformity at fracture (#) site and deformity on Xray describes which fracture healing complication?
Malunion
Not healing in predicted time and
inadequate immobilization or
reduction describes which fracture healing complication?
Delayed union
Failure to heal before process
stops, pain on weight bearing, and
Muscle atrophy/loss ROM describes which fracture healing complication?
Nonunion
What forms when parts of the skin’s epidermis die, causing it to separate from the dermis due to fluid buildup?
Fracture blisters
What is the medical term for blisters?
Skin bullae
Where are (3) places that fracture blisters most commonly occur?
- Ankle
- Elbow
- Knee
What occurs with more severe with motor vehicle accidents & falls and has an increased risk for infection?
Fracture blisters
