Week1:BonesA&PtraumaFractureInfection

Question 0

What are the types of cartilage protein fiber?

Answer 0

elastic (nose ears), hyalin (hardest; in most jts), fibrocartilage (middle; more collagen;b/n discs, symphysis pubis)

Question 1

What is the composition of cartilage?

Answer 1

ground substance, chondrocytes (cartilage cell), protein fiber

Question 2

What are the 3 fns of cartilage?

Answer 2

bone g, shock absorption, prevent friction

Question 3

How does cartilage receive nutrition?

Answer 3

Through diffusion

Question 4

What is the fourfold composition of bone?

Answer 4

ground substance (protein)
bone cells (osteocytes)
collagen fibers
inorganic salts (Ca, Mg, manganese, fluoride etc)

Question 5

What are the two types of bone?

Answer 5

spongy bone (inner, lattice-like)
compact (outer, cortical)

Question 6

What are the 4 types of bone cells and their functions?

Answer 6

osteocytes: mature bone cells, maintain bone matrix
osteogenic cells: precursor of osteoblast, draw Ca from blood in2 bone
–Calcitonin fr thyroid drives Ca fr blood into bone
osteoblast: bone-building cells
osteoclast: reabsorb bone, draw Ca from bone in2 blood
–parathyroid hormone draws Ca from bone in2 blood

Question 7

What are the three parts of a long bone?

Answer 7

epiphysis–head
metaphysis–neck
diaphysis–body

Question 8

What are the layers of bone, from outermost to innermost?

Answer 8

periosteum--nerves and blood vessels
compact bone
spongy/porous bone
marrow
Haversian canals wherein bv are located
Blood moves w/i Volkmann's canal and supplies bone

Question 9

What forms the bone plate?

Answer 9

osteocyte

Question 10

What do tendons do?

Answer 10

Connect musc to bone

More elastin, more bv than ligaments, but still limited

Question 11

What do ligaments to?

Answer 11

Connect bone to bone (joint); more collagen fiber bc tighter than tendons; take longer to heal

Question 12

Of what are tendons and ligaments formed?

Answer 12

Collagen (stiffer) and elastin (stretchier) fibers and have a limited blood supply

Question 13

What are synarthroses?

Answer 13

Joints w/o a jt cavity having little or no movement, have no synovial cavity

Question 14

What are the three types of synarthroses?

Answer 14

Synostoses
synchondrose
syndesmoses

Question 15

Which type of joints have no movement?

Answer 15

Synostoses, e.g. fused fontanelles

Question 16

What is the nature of the synchondrone jt?

Answer 16

Connected to bone by hyalin cartilage
limited motion
e.g. where ribs connect to sternum

Question 17

What are the characteristics of a syndesmose joint?

Answer 17

separated by fibrous disk (fibrocartilage)
joined by ligament
certain amt of movement
e.g. symphysis pubis, backbone

Question 18

What is a diarthrose joint?

Answer 18

The most common type of jt and one that has both a synovial capsule and a joint capsule

Question 19

What are the 5 characteristics of diarthroses?

Answer 19

• articular cartilage
• joint cavity
• synovial capsule i.e. rich blood supply–>rapid healing
• bursae (pockets of fluid acting as cushions)
• intraarticular menisci (e.g. knee) (cartilage as well)

Question 20

What are the three types of soft tissue injury/trauma?

Answer 20

contusion
hematoma
laceration

Question 21

What is the cause and characteristics of contusion?

Answer 21

Caused by striking a body part against a hard object

Characterized by ecchymosis, SKIN INTACT

Question 22

Causes and characteristics of hematoma?

Answer 22

Caused by a contusion (striking a body part against a hard object)
Char: Swelling + pain increasing in intensity upon P

Question 23

Describe a laceration

Answer 23

Disruption of skin –>high chance of infection

Question 24

Differentiate a strain from a sprain

Answer 24

A strain involves tendons injury to musc caused by mechanical overloading recovery faster than sprain bc tendon has more bv than ligament

Question 25

Differentiate a sprain from a strain

Answer 25

A sprain involves ligaments injury (stretch, tear, or avulsion fracture) to ligamentous structures surrounding the jt due to abnormal or excessive mvmt of jt --allow sufficient healing time, otherwise re-sprain and eventually never heal

Question 26

what is the pathology of a sprain?

Answer 26

ligaments become stretched, partially or completely torn

Question 27

What are the manifestations of sprain?

Answer 27

Swelling, discoloration, disability, heat

Question 28

What are the 4 cardinal signs of acute inflammation?

Answer 28

Red, heat, pain, swelling

Question 29

Describe dislocation

Answer 29

Displacement or separation of bone end from its posn in the jt-->loss of articulation

Question 30

What are the 3 classifications of dislocation?

Answer 30

- congenital (shoulder, hip) - traumatic (most common) - pathologic (problem w joint/bone in question)

Question 31

What are the 3 manifestations of dislocation?

Answer 31

- pain - deformity - limited mvmt

Question 32

What joint is most commonly dislocated?

Answer 32

Shoulder

Question 33

Define chondromalacia

Answer 33

Softening of the articular cartilage as the result of recurrent subluxation

Question 34

What is a loose body?

Answer 34

Fragment of bone, cartilage or sthg else (dirt, bullet frag) inside the jt

Question 35

what are the manifestations of a loose body?

Answer 35

pain | locking jt

Question 36

Define bone fracture

Answer 36

Any discontinuity of bone

Question 37

What are the 3 causes of bone fracture?

Answer 37

injury stress (over-use, overweight etc) pathologic (bone problem e.g. osteoporosis, bone infection)

Question 38

What are the 2 types of bone fracture with regard to communication with the exterior?

Answer 38

compound (open)--prone to infection | closed

Question 39

What are 8 types of bone fracture?

Answer 39

``` transverse oblique spiral comminuted compression/impacted (stress fracture) butterfly segmental green stick ```

Question 40

what are the 5 manifestations of bone fracture?

Answer 40

ECCHYMOSE, regardless of size of fracture pain at site of disruption swelling deformity (angulation, shortening, rotation) local shock (good time for bone reduction)

Question 41

What are the 5 sequential stages of the bone fracture healing process?

Answer 41

1 formation of hematoma-->initiate the formation of framweok for the ingrowth of fibroblast and capillaries (build up collagen for healing) 2 formation of fibrocartilaginous callus (scar tissue that's not yet bone) 3 callus formation 4 ossification--mature bone replaces callus, fracture bridged and firm CAST OFF 5 remodeling and consolidation--over years, OSTEOCLAST

Question 42

What is the 3-step treatment for bone fracture

Answer 42

reduction (realign displacement) immobilization (splint, cast) preservation and restoration of fn (PT, OT)

Question 43

What are 3 possible complications of bone fracture?

Answer 43

- compartment syndrome - fat emboli (rare, large bones only) - impaired healing (medical prob, insufficient immob or nutrition, TCM oversex)

Question 44

Define compartment syndrome

Answer 44

increased pressure within limited anatomic space that compromises circulation

Question 45

Name 2 types of bone infection

Answer 45

Osteomyelitis | osteonecrosis

Question 46

What are 2 causes of osteomyelitis?

Answer 46

trauma | surgery

Question 47

What are 2 modes of contamination leading to osteomyelitis?

Answer 47

indirect--homatogenous seeding (pt disease, e.g. TB, travels in blood to bone direct--through an open wound cf. compound fracture

Question 48

What are 2 pathologies of osteomyelitis?

Answer 48

- purulent exudate--subperiostal abscess | - formation of sequestrum (necrotic bone tissue)

Question 49

What is necrotic bone tissue called?

Answer 49

Sequestrum

Question 50

What are 3 signs and symptoms of osteomyelitis?

Answer 50

1 high fever 2 pain upon movement of affected part 3 local swelling, redness, tenderness, warmth (ie acute inflammation)

Question 51

What is death of a segment of bone called

Answer 51

osteonecrosis

Question 52

What is the cause of osteonecrosis?

Answer 52

Any situation that causes interruption of blood supply to the bone

Question 53

What are 2 pathologies of osteonecrosis?

Answer 53

necrosis of spongy bone--release Ca (goes to blood, Ca levels rise) necrosis of marrow--release fatty acids

Question 54

What is the sign of osteonecrosis?

Answer 54

Pain upon movement progressing to pain at rest

Question 55

What type of injury has a risk of developing an infection?

Answer 55

laceration

Question 56

What cell is regulated by PTH

Answer 56

osteoclast

Question 57

What type of joint includes jt cavity and synovial capsule

Answer 57

diarthrose

Question 58

What type of fracture is most difficult to heal

Answer 58

comminuted

Question 59

Where is fibrocartilage found?

Answer 59

intervertebral joint

Question 60

What type of joint does not provide any motion?

Answer 60

synostose

Question 61

What condition is it when there is numbness, tingling and paresthesia after casting?

Answer 61

compartment syndrome

Question 62

Pt has pain upon moving ankle, which is swollen, tender, warm, and red. Pt has a fever. What's the condition?

Answer 62

bone infection

Question 63

Correct sequence of bone healing

Answer 63

callus formation calcification remodeling

Question 64

Collagen fiber is or is not tighter than elastic fiber

Answer 64

Is

Question 65

Describe the pathology of sprain

Answer 65

ligaments become stretched and/or partially or completely torn

Question 66

Describe the pathology of osteomyelitis

Answer 66

formation of pus, sequestrum

Question 67

chondromalacia is the result of

Answer 67

softening of articular cartilage resulting from recurrent subluxation

Question 68

cause of osteonecrosis

Answer 68

any situation disrupting blood supply to the bone