Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Musculoskeletal > Ortho Introduction to Fractures > Flashcards

Ortho Introduction to Fractures Flashcards

1
Q

Osteogenesis

A

Process of bone tissue formation
Embryos leads to bony skeleton
Occurs in the form of bone remodeling and bone repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Endochondrial Ossification

A

Bone replaces a cartilage model

Long bone formation, physis, fracture callus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Intramembranous

A

Undifferentiated mesenchymal cells differentiate into osteoblasts which form bone
Flat bone formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Appositional

A

Osteoblasts deposit new bone on existing bone

Periosteal bone enlargement (adds width)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Endochondrial Ossification

A
  1. Undifferentiated cells secrete cartilagenous matrix and differentiate into chondrocytes
  2. Matrix mineralizes and is invaded by vscalar buds
  3. Osteoprogenitor cells migrate in
  4. Osteoclasts resorb calcified cartilage
  5. Osteoblasts form bone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Osteoprogenator cells

A

Form mesenchymal stem cells

Lead to formation of osteoblasts, cartilage, fibrous tissue depending on fixation and oxygen tension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Osteoblasts

A

Mesenchymal stem cells
Receptors for PTH, Active Vitamin D, Glucocorticoids, Prostaglandins, Estrogen (stimulate bone growth)
Form bone by generating organic nonmineralized matrix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Osteocytes

A

Osteoblasts that have become surrounded in newly formed matrix
Canaliculi are long cytoplasmic process that connect neighboring osteocytes
Control extracellular calcium, phosphorous concentrations
Stimulated by calcitonin, inhibits PTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Osteoclasts

A

Originate from macrophage lineage
Brush border membrane for increased surface area
Howship’s lacunae through resorption of bone surface
Inhibited by calcitonin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Zones of Physeal Growth

A
  1. Reserve zone-resting zone
  2. Proliferative zone
  3. Maturation/Hypertrophic zone
  4. Vascular invasion zone
  5. Provisional calcification
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Collagen in Physis

A

Type II Collagen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Resting Zone

A

Small scattered chondrocytes

Store lipids, glycogen, proteoglycan for later growth and matrix production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Proliferative zone

A

Chondrocytes line up in direction of growth, proliferate and divide
Longitudinal growth occurs (columns of flattened dividing cells, top cell is the dividing mother
High O2 tension, proteoglycan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Zone of Maturation/Hypertrophy

A

chrondrocytes enlarge
large increase in cell volume
Increased cell height responsible for 44-59% of long bone growth
Differential growth due to differential cell size here
This is the weakest part of the physis, fractures occur here

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Zone of Calcified Cartilage

A

Chondrocytes die and matrix starts to calcify

Calcification begins with the longitudinal septa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Apoptosis

A

Programmed cell death
Necessary for homeostasis
Terminally differentiated chondrocytes undergo apoptosis in the zone of calcification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Physeal Closure

A

Completely closed in skeletal maturity
Stops longitudinal bone growth
Decline in width of physis
Estrogen stops replicative sequence of chondrocytes (controls physis closure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Intramembranous Ossification

A
  1. Occurs without a cartilage model
  2. Undifferentiated mesenchymal cells aggregate into layers or membranes
  3. Cells differentiate into osteoblasts depositing organic matrix
  4. Matrix mineralizes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Ossification Center

A

Location in tissues where ossification begins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Bipartate patella

A

Due to formation of 2 ossification centers

Fibrous tissue links 2 pieces together

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Appositional Ossification

A

Primary bone healing

OSteoblasts align themselves on existing bone surfaces and lay down new bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Fracture

A

Break in integrity of bone
Load force applied to the bone
Results in a decrease of the functional capability of the bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Fracture Patterns

A

Determined by type and direction of force
Determined by physical characteristics of the bone
Determined by the speed of the force

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Classifications of Fractures

A

Location in a bone
Diaphyses
Metaphysics
Epiphysis end of bone adjacent to jt.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Orientation of Fractures

A 
Transverse
Oblique
Spiral
Comminuted
Segmental
Intra-articular
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Displacement of Fractures

A 
Non-displaced
Displaced
Angulated
Bayonet
Distracted
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Type I

A

Simple, transverse, short oblique with little communication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Type II

A

Moderate fracture comminution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Type III

A

Great degree of fracture comminution and instability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Type III-A

A

Extensive soft tissue laceration, adequate bone coverage after debridement
Free flaps are not necessary to cover bone
Segmental fractures, such as gunshot injuries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Type III-B

A

Extensive soft tissue injury with periosteal stripping and exposed bone after debridement
Requires local or free flap to cover bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Type III-C

A

Same as B
Extensive soft tissue injury with periosteal stripping and exposed bone after debridement
Require local or free flap to cover bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Pediatric

A

Bone is more porous
High proportion of articular cartilage
Opens epiphyseal plates
Periosteam much thicker (great blood supply)
Higher osteoblastic activity
Fractures can remodel
Joint injuries and dislocations much less common (ligaments stronger than bone)
Cartilagenous epiphyseal plate is weaker than joint capsulre or ligaments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Why are hip fractures bad in kids?

A

Devastating due to AVN of femoral head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Tillaux Fracture

A

Occurs because of asymmetrical closure of distal tibia growth plate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Triplane Fracture

A

Sagittal fracture line through epiphysis, transverse fracture line through physis, coronal fracture through metaphysis

37
Q

Types of Pediatric fractures

A 
Plastic deformations
Buckle 
Greenstick
Complete
Epiphyseal plate
Apophyseal plate
38
Q

Salter Harris I

A

Widening of epiphyseal plate

39
Q

Salter Harris II

A

Fracture through plate and metaphysis

40
Q

Salter Harris III

A

Fracture through plate and epihysis

41
Q

Salter Harris IV

A

through plate, metaphysis and epiphysis

42
Q

Salter Harris V

A

Crushed epiphysis (compression fracture of growth plate leads to disturbances in growth)

43
Q

What are the orthopedic aspects of child abuse

A

Fractures in various stages of healing

Corner fractures can be noted at the corner of the metaphysis (jerked leg/arm)

44
Q

Apophyseal Fractures

A

Fracture of a diaphysis that does not add length

45
Q

Modifying Factors of Fracture Healing

A
  1. Bleeding
  2. Resorption
  3. Mesenchymal differentiation into osteo and fibro-progenitor cells
  4. Callous formation
46
Q

Stages of Fracture Healing

A
  1. Bleeding–>devascularizes and forms hematoma
  2. Resorption–>osteoclasts and inflammatory response
  3. Mesenchymal differentiation into osteo and fibro-progenitor cells
  4. Callous formation
47
Q

Bone Circulation

A
  1. Nutrient artery system
  2. Metaphyseal-epiphyseal system
  3. Periosteal system
48
Q

Stages of Fracture Healing

A
  1. Hematoma and inflammatory response
  2. Fracture hematoma maturation
  3. Conversion of hypertrophic cartilage to bone
  4. Bone remodeling
49
Q

Cells of early postfracture

A

Primaritive mesenchymal and osteoprogenitor cells facilitate production of the BMPs

50
Q

Bone Growth Factors

A

BMP
TGF-B
IFG-II
PDGF

51
Q

Bone Morphogenic Protein

A

Stimulates growth
Induces metaplasia of mesenchymal cells into osteoblasts
Target for BMP is undifferentiated perivascular mesenchymal cell

52
Q

TGF-B

A

Induces mesenchymal cells to produce type II collagen and proteoglycans
Induce osteoblasts to synthesize collagen
Regulate cartilage and bone formation in fracture callus

53
Q

Conversion of hypertrophic cartilage to bone

A

Undergo terminal differentiation, cartilage calcifies and new woven bone is formed
Hard callus
Woven bone is remodeled
Mature bone eventually established and is not distinguishable from surrounding bone (week 17+)

54
Q

Cortical Bone Remodeling

A

Remodels by osteoclastic tunneling

55
Q

Cancellous bone Remodeling

A

Remodels by classic resorption followed by blasts laying down new bone

56
Q

Wolff’s Law

A

Bone remodels in response to mechanical stress

57
Q

Piezoelectric Charge

A 
Compression side (negative charge) activates blasts
Tension side (positive charge) activates clasts
58
Q

Delayed Union

A

Fracture that has not healed in twice the normal healing time

59
Q

Nonunion

A

Fracture that has not healed in three times the normal healing time (6 months)

60
Q

Hypertrophic Nonunion

A

bone at fracture site form enormous amounts of bone with no healing (elephants foot)

61
Q

Malunion

A

Fracture that is united with unacceptable angulation, rotation or shortening

62
Q

Fracture Blisters

A

Occur in response to increased compartmental pressure

Caused by uneven extrinsic pressure

63
Q

Jones Fracture

A

Proximal fracture through 5th metatarsal

Rarely heals due to poor blood supply

64
Q

DVT and PE Increasing Risks

A 
Locations of fracture
Age of patient
Body type
Degree of Immobilization
Compliance
65
Q

Signs and Symptoms of DVT and PE

A 
Calf and thigh pain
Edema distal to obstruction
Homans sign
Shortless of breath 
Decreased PO2 
Chest pain
Tachycardia
Hypotension
66
Q

Fat Embolism

A

Fact without circulation
Produce embolic phenomena
With or without clinical sequelae

67
Q

Fat Embolism Syndrome

A

Fat in circulation associated with identifiable clinical pattern of symptoms and signs
Risk high with femoral shaft fracture and concomitant head injury
Multiple trauma with major visceral injuries and blood loss
Hip/knee with intramedullary instrumentation

68
Q

Mechanical FES

A
  1. Injury to adipose tissue
  2. Rupture of veins within zone of injury
  3. Mechanism that will cause passage of free fat into open end of vessels
  4. Disrupted venules in marrow remain tethered open by osseous attachments
69
Q

Lehman Biochemical Theory

A

Plasma mediators mobilize fat from body stores into large droplets
Degradation of embolized fat into free fatty acids

70
Q

FES Triad

A

Neurological abnormalities in 80% of FES pts
Hypoxemia
Petechia rash

71
Q

ARDS

A

Release of sytokines secondary to inflammation causes increase permeability of alveoli and capillary membranes causing pulmonary edema

72
Q

Compartment Syndrome

A

Circulation and function of tissue in fibro-osseous space is compromised secondary to increased pressure in the space
Increased pressure can result from bleeding, increase capillary permeability, decreased size of space (tight dressing)

73
Q

Signs and Symptoms of Compartment Syndrome

A

Pain, palor, parethesias and pulselessness

74
Q

Implants

A 
Contractures
Skin Coverage
Loosening
Infection
Failure of implant
75
Q

Post-Traumatic Arthritis

A 
Chronic pain
Deformity
Loss of motion
Crepitance
RSD (complex regional pain syndrome)
76
Q

Reflex Sympathetic Dystropy

A

RSD burning pain, increased skin sensitivity, changes in skin color/tecture/hair growth patterns, swelling and stiffness of affected joints, motor disability

77
Q

Type I RSD

A

Triggered by tissue injury

78
Q

Type II RSD

A

Triggered by nerve injury

79
Q

What are the causes of CRPS

A

Catecholamines released from sympathetic nerves acquire the capactiy to activate pain pathways frollowing a nerve or tissue injury

80
Q

Stages of CRPS

A
  1. Acute-burning, swelling, pain
  2. Dystrophic-thin shiny skin, loss of hair, contractures
  3. Atrophic-loss of motion, loss of subcutaneous fat, osteoporosis, pathological fractures
81
Q

Avascular Necrosis

A

Disruption of blood supply to poorly vascularized bone leads to degeneration of the bone that is no longer vascularized
Sites: femoral head, carpal navicular, talus, humeral head, metacarpal head

82
Q

Causes of AVN

A

Site, displacement, delay in immobilization, surgical approach, drug therapy, systemic disease, alcohol

83
Q

PAthological Fractures

A

Bone breaks in area weakened by another disease process
Usually occurs with normal activity
Treatment must address underlying disease process

84
Q

Bone Insufficiency Fractures

A

Fracture due to weakening of the bone from inadequate density (such as loss from osteoporosis)

85
Q

Causes of pathological fractures

A

Weakness of bones (altered metabolism of calcium, vitamin D, parathyroid hormones)
Destruction of bone (infection, tumors, fibrous dysplasias)

86
Q

Subcapital Fracture of Hip

A

Fracture of the femoral neck
This disrupts the blood supply to the head of the femur
Disruption of calcium metabolism can cause bone to weaken, or an infection can cause bone resorption

87
Q

Stress Fracture

A 
Fracture of bone that occurs secondary to repeated microtrauma
Usually occur in weight bearing bones
Seen in athletes
See in atheletic wanabees
Seen as an occupational disease
Seen in military (march fracture)
88
Q

Pars Fracture

A

Weightlifting can cause it

Musculoskeletal (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions