Bone breaks part 1

Question 1

For children why are growth plates vulnerable to injury?

Answer 1

-because child bones are still growing it makes the growth plates weak

Question 2

function in bone formation

Answer 2

osteoblasts

Question 3

mature bone cells that function in bone maintenance

Answer 3

osteocytes

Question 4

multinuclear cells function in destroying, reabsorbing, and remodeling bone

Answer 4

osteoclasts

Question 5

process of bone formation

Answer 5

osteogenesis

Question 6

the process of formation of the bone matrix and deposition of minerals

Answer 6

ossification

Question 7

How does PTH regulate the concentration of calcium in the blood?

Answer 7

• if blood Ca levels are low increased PTH causes mobilization of calcium and demineralization from bone
• If calcium levels in blood are high calcitonin which is released by thyroid causes bone resorption and deposits calcium in bone

Question 8

What are the primary and secondary causes of fractures?

Answer 8

• primary: due to trauma

- secondary: due to disease process (cancer, osteoporosis)

Question 9

What subjective data should the nurse assess when a pt has a break?

Answer 9

Past medical history
Trauma
Bone or systemic diseases
Immobility
Osteopenia / Osteoporosis
Medications
Smoking history
Surgery or other treatments

Question 10

What objective data should the nurse assess when a pt has a break?

Answer 10

Apprehension
Guarding
Skin lacerations, color changes
Hematoma, edema
↓ or absent pulse, ↓ skin temperature
Delayed capillary refill

Question 11

What is the difference between an open and closed fracture?

Answer 11

• Open: (formerly compound), has communication with the outside environment
• Closed: (formerly simple), no communication with the external environment

Question 12

• skin is broken, exposing the bone and causing soft tissue injury.
• higher risk of osteomyelitis, tetanus, gas gangrene Wound may be left open, wound vac

Answer 12

open fracture

Question 13

the skin has not been ruptured and remains intact

Answer 13

closed fracture

Question 14

two ends separated from one another

Answer 14

displaced

Question 15

periosteum is intact and bone is aligned.

Answer 15

non displaced

Question 16

What are the 6 stages of fracture healing?

Answer 16

1. fracture hematoma
2. granulation tissue
3. callus formation
4. ossification
5. consolidation
6. remodeling

Question 17

When a fracture occurs, bleeding creates a hematoma, which surrounds the ends of the fragments. The hematoma is extravasated blood that changes from a liquid to a semisolid clot. This occurs in the initial 72 hours after injury.

Answer 17

1. fracture hematoma

Question 18

During this stage, active phagocytosis absorbs the products of local necrosis. The hematoma converts to granulation tissue. Granulation tissue (consisting of new blood vessels, fibroblasts, and osteoblasts) produces the basis for new bone substance called osteoid during days 3 to 14 postinjury.

Answer 18

2. granulation tissue

Question 19

As minerals (calcium, phosphorus, and magnesium) and new bone matrix are deposited in the osteoid, an unorganized network of bone is formed that is woven about the fracture parts. Callus is primarily composed of cartilage, osteoblasts, calcium, and phosphorus. It usually appears by the end of the second week after injury. Evidence of callus formation can be verified by x-ray.

Answer 19

3. callus formation

Question 20

occurs from 3 weeks to 6 months after the fracture and continues until the fracture has healed. Callus ossification is sufficient to prevent movement at the fracture site when the bones are gently stressed. However, the fracture is still evident on x-ray. During this stage of clinical union, the patient may be allowed limited mobility or the cast may be removed.

Answer 20

4. ossification

Question 21

As callus continues to develop, the distance between bone fragments diminishes and eventually closes. During this stage ossification continues. It can be equated with radiologic union. Radiologic union occurs when there is x-ray evidence of complete bony union. This phase can occur up to a year following injury.

Answer 21

5. consolidation

Question 22

Excess bone tissue is reabsorbed in the final stage of bone healing, and union is completed. Gradual return of the injured bone to its preinjury structural strength and shape occurs. Bone remodels in response to physical loading stress or Wolf’s law. Initially, stress is provided through exercise. Weight bearing is gradually introduced. New bone is deposited in sites subjected to stress and resorbed at areas where there is little stress.

Answer 22

6. remodeling