Pathophysiology - Final - B

Front 1

Fracture

Back 1

Bone is cracked, splintered or bisected

Front 2

Most common location of fractures in young

Back 2

Tibia, clavicle and low humerus

Front 3

Most common location of fractures in elderly

Back 3

Upper femur (hip), upper humerus, vertebrae and pelvis

Front 4

Most common location of fracture in pt with osteoporosis

Back 4

Hip

Front 5

Classes of fx

Back 5

Complete
Incomplete
Open
Closed

Front 6

Complete fracture

Back 6

All the way through the bone

Front 7

Incomplete fracture

Back 7

Damage done, but still in one piece

Front 8

Open fracture aka -

Back 8

compound fracture
Skin and bone broken

Front 9

Closed fracture

Back 9

Broken bone, skin intact

Front 10

Comminuted fx =

Back 10

two or more pieces

Front 11

Oblique fx

Back 11

fracture is diagonal to axis

Front 12

Spiral fx

Back 12

fracture goes around bone

Front 13

Transverse fx

Back 13

fracture goes straight across

Front 14

Greenstick fx

Back 14

splintering of outside of bone leaving shreds sticking out

Front 15

Pathologic fx

Back 15

Due to pre-exisiting abnormality such as tumor or osteoporosis

Front 16

Stress fx

Back 16

Due to repetitive use of muscle and lack of bone strength

Front 17

Fatigue fx

Back 17

Abnormal stress applied to bone

Front 18

Manifestations of fx

Back 18

Misalignment
Swelling
Pain
Impaired sensation
Decreased mobility

Front 19

CSM

Back 19

Circulation
Sensation
Motor
-Assesments for pt with fx

Front 20

Reduction

Back 20

Realignment

Front 21

ORIF

Back 21

Open reduction Internal fixation
- a short incision is made, the bones are realigned and screws are placed to keep the bones together

Front 22

Closed reduction

Back 22

Conscious sedation
Bone aligned externally

Front 23

External fixation

Back 23

Pins and screws which are external

Front 24

Causes of Rhabdomyolysis

Back 24

burn injuries,
“found down”,
anesthesia,
very strenuous excercise

Front 25

Treatment of Rhabdomylosis

Back 25

IV fluids and dialysis if necessary

Front 26

Rhabdomylosis manifestations

Back 26

Reddish brown urine
High CK 2000x normal
Renal failure

Front 27

Most significant risk of Rhabdo

Back 27

Renal Failure (intra-renal failure)

Front 28

CK

Back 28

creatine kinase-
-enzyme which results from the break down of muscle

Front 29

Osteoporosis

Back 29

- Porous bone decreased bone mass leading to bone weakness and fracture
-BMD – 2.5 below peak bone mass
-Old bone is reabsorbed faster than new bone is formed

Front 30

BMD

Back 30

Bone mineral density

Front 31

Osteoporosis risk factors

Back 31

Genetic
Size
Hormonal
Dietary
Lifestyle
Hyperparathyroidism
Use of glucosteroids
Trauma
Diabetes
Liver disease
Drugs
SMOKING
Pt. with kidney failure

Front 32

Osteoporosis and Parathyroid

Back 32

Parathyroid regulates ca+ uptake from bones and puts it in blood stream.

Too much PTH, too much Ca+ taken from bone , which leads to osteoporosis

Front 33

Osteoporosis manifestations

Back 33

Pain
Bone deformity
Vertebral collapse and kyphosis

Front 34

Hip fractures in pt with osteoporosis By age 90,

Back 34

32% of all women will have a hip fracture

Front 35

Bone density scan

Back 35

Dx-dual energy x ray absorptiometry

Front 36

Rx Osteroporosis

Back 36

- Drugs to slow down the rate of bone loss
- alendronate (Fosamax) or vista
- Weight-bearing exercise, calcium and Vitamin D helpful
-after fosamax pt must sit upright for at least 30 minutes

Front 37

Osteomyelitis

Back 37

Bone infection that is usually caused by bacteria, but can be viral, fungal or parasite

Front 38

Typical osteomyelitis bacterial culprits

Back 38

Staph aureus
Group B strep
Salmonella

Front 39

Endogeneous/hematogenous osteo causes

Back 39

Sinus, ear or dental infection

Front 40

Exogeneous causes osteomyletis

Back 40

Surgical procedures, bites, open fractures and drug use

Front 41

Pts susceptible to osteomyelitis

Back 41

Diabetics and those taking glucosteroids

Front 42

Osteomyelitis what happens -

Back 42

Invading organism initiates inflammatory response
- Blood supply to area is blocked
- New bone forms around site of infection
- Bone cortex is weakened and is more prone to fx

Front 43

Osteomyelitis – manifestations -

Back 43

vague sx of fever, malaise or anorexia
- abscesses
- joint pain

Front 44

Diagnosis osteomylitis

Back 44

Lab tests - looking for WBC > 10,000
Bone Scans

Front 45

Rx osteomyelitis

Back 45

- Long term antibiotics (6 mo. +)
- Removal of infected implants
(replace with antibiotic spacer put in place for several months)

Front 46

Osteoarthritis

Back 46

-caused by loss of articular cartilage
- degenerative “wear and tear” non-inflammatory joint disease

Front 47

Articular cartilage

Back 47

Smooth hyaline substance at the ends of bones that articulate with other bones

Front 48

Osteophytes

Back 48

Bone spurs

Front 49

Osteoarthirtis

Back 49

– what happens Irritated tissue release enzymes
Enzymes cause further distruction
Secondary inflammation

Front 50

Osteoarthritis– manifestations

Back 50

Joint stiffening
Pain
Parestesia
Limited ROM
Muscle wasting
Crepitus

Front 51

Crepitus

Back 51

The sound of creeping joints

Front 52

OA evaluation

Back 52

x-ray, CT
Range of motion

Front 53

OA treatment

Back 53

PT
Anti-inflammatory drugs
Joint replacements

Front 54

THR

Back 54

Total hip replacement
One of the most common procedures performed in US

Front 55

Rheumatoid arthritis

Back 55

- Systemic autoimmune disease
- Characterized by remissions and exacerbations
of synovial tissue breakdowns
- Most likely to affect middle aged women

Front 56

Rheumatoid arthritis manifestations

Back 56

Systemic sx (rash, malaise, enlarged lymph nodes)
Bilateral joint pain
Typically in smaller joints (i.e. hands)

Front 57

Diagnostic criteria for RA -

Back 57

Morning stiffness lasting more than one hour
-three or more affected joints
-bilateral pain
-serum rheumatoid factor

Front 58

RA – treatment

Back 58

immunosuppressants
Anti-inflammatory agents
Possible joint replacements

Front 59

Gout

Back 59

- Inflammatory response to hyperuricemia
- usually affects men over 40

Front 60

hyperuricemia

Back 60

Long lasting abnormally high concentration of uric acid in blood.

Front 61

Gout – what happens

Back 61

Crystals of uric acid lodge in joints and kidney tubules

Front 62

Gout - manifestations -

Back 62

Inflammation of a single joint
- Tophi
- Renal problems

Front 63

Tophi

Back 63

Uric acid deposits found just under the skin

Front 64

Gout – Rx

Back 64

- Colchicine – breaks down and allow the secretion of uric acid
- NSAIDs

Front 65

Fibromyalgia

Back 65

Chronic musculoskeletal disorder with vague symptoms

Front 66

Fibromyalgia s/sx

Back 66

Diffuse pain
Fatigue
Tender points (11 of 18 needed for diagnosis)
Depression
Low pain tolerance