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MSK > Intro and Fracture > Flashcards

Intro and Fracture Flashcards

1
Q

Sarcopenia

A

age related loss in muscle mass, strength, and endurance accompanied by changes in the metabolic quality of skeletal muscle

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2
Q

Changes in Joint and CT

A
  • increased stiffness and decreased flexibility
  • changed in articular cartilage
  • lower metabolic activity on tendons affects healing process
  • decrease in tensile strength and loss of integrity of some joint capsules occurs
  • decreased joint proprioception
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3
Q

3 Factors that affect bone remodeling…

A

1 mechanical stress
2 calcium and phosphate levels
3 hormone level of PTH Calcatonin, Vitamin D, cortison, GH, and sex hormones

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4
Q

bone remodeling is

A

constant

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5
Q

while ________ resorb the existing bone, new bone is being formed by ________

A

osteoclasts
osteoblasts

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6
Q

Fracture

A

any defect in the continuity of a bone

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7
Q

Traumatic Fx

A

sudden impact
- transverse
- oblique
- spiral
mostly ages 5-14

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8
Q

stress or fatigue fracture

A
  • bone stress injury
  • partial break or complete break caused b bones inability to withstand stress applied over and over
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9
Q

most stress fx occur in the ….

A

tibial shaft and metatarsal bones

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10
Q

risk factors for a stress injury

A
  • abrupt increase in intensity or duration of training
  • female recruits (pelvic and sacral b/c of wide pelvis, coxa vara, genu valgum, hormonal , and nutritional factors
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11
Q

compressive stress fracture

A

forceful heel strike during prolonged marching or running

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12
Q

distractive stress fraction

A

occur because of a muscle pull and can become more serious if displacement occurs

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13
Q

Insufficiency Fracture

A

normal stress is applied to bone that has a deficient elastic resistance or has been weakened by decreased mineralization

arise because of minor trauma

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14
Q

most common reasons of reduced bone integrity

A
  • effects of radiation
  • post pathomenopausal osteoporosis
  • corticosteroid- induced osteoporosis
    -metabolic disease
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15
Q

pathologic fracture

A

occurs in bone and rendered abnormally fragile by neoplastic or other disease conditions

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16
Q

Transverse fracture

A

The fracture line is at a right angle to the long axis of the bone; usually produced
by shearing force

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17
Q

Oblique or spiral fx

A

Occur following a twisting or torsional force fragments displace easily in the
oblique fracture, whereas nonunion rarely occurs in a spiral fracture because of
the wide area of surface contact

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18
Q

Comminuted fx

A

The bone is broken into more than two fragments and segmental if a fragment of
the free bone is present between the main fragments

Comminution describes a fracture with multiple fragments at the fracture site and
can be associated with different fracture lines

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19
Q

butterfly fx

A

The separation of a wedge-shaped piece of bone

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20
Q

3 types of incomplete fractures

A

greenstick
torus (or buckle)
crack or hairline

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21
Q

Displaced, open fractures are more likely to be
______; and more likely to require _____

A

unstable
surgery

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22
Q

epiphyseal fx

A

growth plate fracture in long bones

growth can be arrested or altered; needs immediate intervention

23
Q

What is one of the most common osteporosis related fragility fractures?

A

VCF Vertebral compression fx

24
Q

three types of VCF

A
  1. wedge
  2. biconcave fx
  3. crush
25
Q

bone mass reaches max by age

A

30

26
Q

women/men lost bone mass sooner

A

women

27
Q

men are more likely to experience bone loss in their mid to late ___

A

60s

28
Q

risk factor for fx

A

-trauma
-advanced age
-women: post menopause osteoporosis, military: stress
-men: hypogonadism, ED, prostate cancer
- insufficiency
- long term care residency
- poor health
- low PA (slow gait, can’t turn well, AD use, weak quads, sway, impaired cognition)
- etc

29
Q

5 phases of fx healing

A
  1. Hematoma formation
  2. Cellular proliferation
  3. Callous formation
  4. Ossification
  5. Consolidation and remodeling
30
Q

how much time for a fx to stop bleeding and form a clot

A

6-12 hours

31
Q

how much time before an acute inflammatory response and granulation tissue is formed in a fx

A

1-2 days

32
Q

what happens in weeks 1-3 of a Fx

A

Osteogenesis, fibrous union, and callus formation occur

33
Q

what happens at week 6 of a Fx

A

There is continuity of the external callus

34
Q

what happens at 4 months to a year after a Fx

A

There is remodeling of the medullary canal and organized
lamellar bone

35
Q

clinical manifestations of Fx

A

pain and tenderness
- over site of fx
- weight bearing
- resistive motions
- depression and anxiety
- increased dependence on others
- loss of mobility and function

36
Q

nonspecific pain of what area occurs if there is a spine, pelvis, or sacrum insufficiency fx

A

low back
groin
pelvic pain

37
Q

clinical manifestations of VCFs

A
  • often painless
  • initial pain sharp… dulls after few days to an ache
  • reproducible pain with pressure over SP involved
  • postural pain
  • associated with height loss
38
Q

Fx complications

A
  • deformity
  • malunion
  • delayed union
  • nonunion
  • fat embolism
39
Q

fat embolism

A

The fat globules from the bone marrow (or from the
subcutaneous tissue at the fracture site) migrate to the lung
parenchyma and can block pulmonary vessels, decreasing
alveolar diffusion of oxygen

40
Q

treatment for Fx (goal)

A

To promote hemostasis, hemodynamic stability, comfort, and early mobilization to prevent potential
complications from immobility (e.g., constipation, deep vein thrombosis, pulmonary embolism,
pneumonia)

41
Q

treatment for Fx (medical approach)

A

Medical approach to mgmt is based on the location of the fracture, assessment of fracture
type, need for reduction, presence of instability after reduction, and functional requirements
of the affected individual
* Stress fxs are usually uncomplicated and can be managed by rest and restriction from activity
* Unstable fx of any bone may require immediate surgical intervention

42
Q

treatment for VCF (nonoperative)

A

Activity modification, bracing, assistive devices, pharmacology (e.g., narcotic analgesics,
calcitonin), and PT

43
Q

treatment for VCF (surgical )

A

Bone grafts or bone graft substitutes, internal fixation (e.g., metal plating, wiring, screws),
traction, or reduction and casting or immobilization

44
Q

treatment for VCFs (minimally invasive procedures)

A
  • vertebroplasty - inject medical cement into fx
  • kyphoplasty - insert a balloon to expand the collapsed vertebra followed by bone cement to stabilize
45
Q

the _________ period after a fracture allows for phagocytic removal of neurotic bone tissue and the initial deposition of the fibrocartilaginous

A

stabilization

46
Q

tissue engineering

A
  • Porous scaffolds and biodegradable plastics
  • The use of osteoconductive scaffolds, growth factors, and osteoprogenitor cells
  • Commercially available demineralized bone matrix can function as a scaffold for osteoconduction
47
Q

Allogeneic bone grafting

A

material from a donor (bone mark)

48
Q

Autogenous bone grafting

A
  • Most often taken from the iliac crest or fibula
  • Donor site pain is a common complaint
49
Q

fractures in children heal in __________; in adolescence _________; in adults ______

A

4-6 weeks
6-8 weeks
10-18 weeks

50
Q

less than 50% of older adults with a hip fracture will regain their prior level of function; with at least half experiencing

A

at least 1 fall in the year after

51
Q

Post Op Rehab can start (fracture)

A

within one week

52
Q

fracture will be immobilized until

A

evidence of callous

53
Q

reasons to call Physician when you have a a Fx

A

1- compartment syndrome
2- Fat embolism
3- breakage of wires

54
Q

Fat embolism Syndrome (symptoms)

A
  • subtle changes in behavior and orientation
  • dyspnea and chest pain, diaphoresis, pallor, or cyanosis
  • rash on the anterior chest wall, neck, axillae, and shoulders

MSK (19 decks)

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