Worksheet: MSP Lab 1 - Fracture Flashcards
what is the normal organic:inorganic ratio for children?
1:1
what is the normal organic:inorganic ratio for adults?
1:4
what is the normal organic:inorganic ratio for elderly?
1:7
what is elasticity in bone?
ability of bone to return to its original shape on removal of force
what is plasticity in bone?
property of bone being permanently deformed by a force w/o breaking
what does the yield point indicate?
point of stress where plastic deformation begins
what happens when stress exceeds the ultimate yield point?
Fracture
how does elasticity and plasticity change from normal adult bone to elderly bone?
decreases (amount of stress before yield point/ultimate yield point decreases)
how does elasticity and plasticity change between normal adult bone and pediatric bone?
children have higher elasticity + plastcity; require increased stress to reach yield points compared to adults
what Fxs in children are more common because of their elasticity/plasticity levels? give 2 examples of this type of Fx.
Incomplete Fxs; Greenstick; Torus
The organic component of bone contributes to ___?
elasticity, plasticity, and tensile strength
The inorganic component of bone contributes to ___?
rigidity and compressive strength
an increased organic:inorganic ratio results in (increase/decrease) brittleness
decreased
an decreased organic:inorganic ratio results in (increase/decrease) brittleness
increased
(Station 2, Gross image 1) what stage of Fx repair is shown? what features can be seen in this stage? explain the cellular events that occur in this stage.
Inflammatory; Sharp, jagged fx line begins to smooth; Necrosis + macrophage activity, fibroblasts migrate, lay down cartilage, hematomas ‘filling gaps’, Procallus
(Station 2, Gross image 2) what stage of Fx repair is shown? what features can be seen in this stage? explain the cellular events that occur in this stage.
Reparative; procallus conversion to boney callus produces “hazy cloud”, smoothes edges of fx; Neurovascularization/angiogenesis introduces O2 into anoxic cartilage/procallus, Osteoblasts migrate + convert procallus -> boney callus, Necrotic debri clean-up
(Station 2, Gross image 3) what stage of Fx repair is shown? what features can be seen in this stage? explain the cellular events that occur in this stage.
Remodeling; adjusts strength + shape via Wolff’s law; Callus formed around fx begins remodeling
(Station 3, CT scan) what stage of Fx repair is shown? what has NOT occured? describe the outcome of the Fx and the cellular events that are occuring.
Remodeling; Clinical union has NOT occured most likely due to inadequate formation of blood supply (lack of immobilization/stabilization); Pseudoarthrosis; Callus formation w/ osteoblastic activity (seals bone while Fx is unstable), Wolff’s law
(Station 4, Radiograph 1) what specific name(s) apply to this Fx? what stage of Fx repair is shown? Explain the cellular events that are occuring,including the type of cells involved.
Complete, Transverse, Non-comminuted, Open (?); Inflammatory; Necrosis, ruptured BVs, hematoma, torn periosteum = pain; PMNs, Osteoclasts, Macrophages
(Station 4, Radiograph 2) what specific name(s) apply to this Fx? what stage of Fx repair is shown? Explain the cellular events that are occuring,including the type of cells involved.
March Fx; Reparative; Osteoclasts + mononuclear cells clean-up debris, neovascularization/angiogenesis, callus begins = Hazy cloud osteoblastic activity
(Station 4, Radiograph 3) what specific name(s) apply to this Fx? what stage of Fx repair is shown? Explain the cellular events that are occuring,including the type of cells involved.
Salter-Harris Fx Type II, Complete, Open; Inflammatory; Necrosis, ruptured BVs, hematoma, torn periosteum = pain; PMNs, Osteoclasts, Macrophages
What is a March Fx?
Fatigue Stress Fx of 2nd or 3rd Metatarsals
What is a Fatigue Fx?
Abnormal stress on normal bone (repetitive stress causes gradual micro-fracture formation)
What is a Salter-Harris Fx?
Fx involving the Physis (growth plate)
What type of Salter-Harris Fx goes straight across the physis?
Type I
What type of Salter-Harris Fx goes across + above the physis?
Type II
What type of Salter-Harris Fx goes across + lower/below the physis?
Type III
What type of Salter-Harris Fx goes through the physis, or in other words splits the physis in two?
Type IV
What type of Salter-Harris Fx creates an erasure of the physis/growth plate, or in other words crushes the physis?
Type V
(Station 5, Case Study 1) A 71 year old woman reported to the ER w/ pain in her hip and thigh after stumbling at the grocery store. She has a Hx of Breast cancer that was treated and went into remission 40 years prior. She has also been receiving drug therapy for high blood pressure for the past 8 years. Examine radiograph 1. What evidence of bone abnormalities are seen? How would you treat this patient? She returns 12 days later citing continued pain in her hip and thigh along with mobility issues. Examine radiograph 2. Any alignment or bone abnormalities? What is the name for a Fx that isn’t initially visible radiographically? Additional tests confirm that she has osteoporosis; knowing this, what type of Fx is this?
(Gotta fill in when/if I have time); Occult Fx; Stress Insufficiency Fx
What is an Occult Fx?
Fx that isn’t initially visible radiographically
What is an Insufficiency Fx?
Normal stress on diseased bone (form of Pathological Fx)
