Fractures, Osteonecrosis, Osteomyelitis Flashcards Preview

MS/Rheum > Fractures, Osteonecrosis, Osteomyelitis > Flashcards

Flashcards in Fractures, Osteonecrosis, Osteomyelitis Deck (42):
1

The bone fractures after repeated extra stress, i.e., there were some tiny microfractures (as in osteoporosis)

stress fracture

2

The bone is cracked, but not broken into two pieces

incomplete fracture

3

What is a greenstick fracture?

incomplete fracture in kids that results from impact to thier "supple" long bones

4

closed fracture

overlying tissue is in fact

5

The bacteria have a route from the surface to the bone; perhaps the bone is even sticking out the wound.

compound, open fracture

6

The bone is broken into several pieces.

multifragmented (comminuted) fracture

7

A curious term for a fracture in which the ends of the bone fragments have done serious damage to the surrounding tissue.

complex fracture

8

Due to intrinsic disease of the bone; the force would not have broken a normal bone. Seen in osteoporosis, cancer, osteogenesis imperfecta.

pathologic fracture

9

Describe the process of callus formation after a bone fracture

1. bleeding and formation of clot
- devascualrization of edges of fractured/dead bone
2. recruitment and ingrowth of neovascualization
3. fibroblasts organize clot
4. removal of dead cortex
5. ingrowth of osteocytes
6. new/woven bone formation
7. cartilage produced at surface of callus
8. continued remodeling (over months)
9. complete bone healing (loss of cartilage cap)

10

T or F: the fractured ends of bone must be perfectly aligned to begin the process of healing/callus formation

F: but they must be in close proximity

11

What happens if the fractured ends of a bone are not in close enough proximity for healiing?

the callus cannot form an there is a "fibrous nonunion" of the ends
= fibrous replacement of tissue between the ends

**pathologic

12

Microscopically, during bone healing, fractured bony spicules are being joined together by...

new osteiod

13

Why are metal pins surgically inserted after some fractures?

to produce the conditions necessary for appropriate callus formation and bone healing.

= align the ends

14

Where on the bone does osteonecrosis most likely occur?

convex surface of joints
*usually spares the synovium/joint space

15

What is the feared result of osteonecrosis

detachment of the articular cartilage

16

osteonecrosis can be a complication of what 3 conditions?

1. femoral neck fracture or disslocation
2. sickle cell
3. decompression sickness

17

Osteonecrosis has a mysterious link to..

alcohol abuse and glucocorticoid use

18

How can sickle cell disease lead to osteonecrosis?

sickled RBCs occlude vessel

hypercellularity of the marrow can interfere with normal blood flow in the marrow

19

soft tissue swelling with periosteal new-bone formation and a moth-eaten lytic process

hand foot syndrome
*seen in sickle cell dz

20

XR manifestation of bone with chronic infarcts and secondary osteoarthritis (seen in sickle cell)

irregular sclerosis and lucency (infarcts)
bone-in-bone appearance (infarcts)

narrowed cartilage and irregular joint surfaces (OA)

21

Bone within bone appearance on XR can indicate

***sclerosis, resulting from multiple infarctions
*think sickle cell dz

22

osteomyelitis is caused by ___ organisms that spread

pyogenic
*most commonly staphylcoccus (80-90%)

that spread hematogenously, contiguously, or in pts with vascualr insufficiency

*hematogenous is most common in kids

23

What are risk factors for developing osteomyelitis

DM
periph vascualr dxz
sickle cell
congenital phagocyte function defect
presence of foreign materials
ortho surgery
adjacent infections

24

TB osteomyelitis

Name of dz?
what bones are affected?

Pott Dz
vertebrae (causes collapse --> kypohosis)

25

What organism is assc with osteomyelitis in sickle cell pts

salmonella

26

Mixed bacterial osteomyelitis is assc with

trauma or surgery

27

congenital syphilitic osteomyelitis is assc with

saber shins and saddle nose

mom passes syphillis to fetus

28

chronic osteomyelitis can give rise to

squamous cell carcinoma

29

On what part of the bone does osteomyelitis typically begin

metaphysis

(spreads internally and externally from here +/- sinsus tracts)

30

sinus tracts in bone

osteomyelitis

31

In chronic osteomyelitis what is happening outside the bone and inside the bone at the site of infection?

outside = bone growth = reactive = involucrum

inside = bone necrosis = partial reabs = sequestration

32

subperiosteal shell of viable new bone

involucrum

*chronic osteomyelitis

33

inner necrotic cortex

sequestrum

*chronic osteomyelitis, necrosis is purulent

34

empty lacunae in spicules implies

dead bone

35

T or F: poly predominant in CHRONIC osteomyelitis

T
NO LYMPHOCYTES present

36

What immune cells are present in acute osteomyelitis? Chronic?

neutrophils! NO lymphocytes

prob some fibroblasts and maybe macrophages too

37

marked ulceration and necrosis of calcaneus

osteo in DM

38

spinal tuberculosis is a combined infectious of

vertebral bodies (spondylitis) and joint spaces (spondylarthritis)

39

gibbus deformity

severe kyphosis from vertebral collapse

* can be seen with Pott Dz

40

manifestation of primary syphillis

chancre = skin lesion at point of contact (usually genitals or anus)
*can last 4 to 6 weeks and heals spontaneously

41

manifestation of secondary syphillis

-1-6 mos after primary

- Chondylomata lata: symmetrical reddish-pink non-itchy rash on the trunk and extremities (can be on palms and soles) that contain ACTIVE treponeme = CONTAGIOUS

42

manifestations of tertiary syphillis

-1-10 years after primary

-gummas = chronic soft, tumor like granulomas due to the immune sys inability to clear the org
--> chronic infalm state

-neuropathic joint dz = degeneration of joint surfaces --> loss of sensation and fine position sense (proprioception)

-neuro syphillis

-CV syphillis

Nolan Never Gets Cold bc he has the syph