Term
| Typical Parts of Long Bone |
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Definition
Epiphysis (ends)
Diaphysis (shaft) |
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Term
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Definition
Osteoblasts
Osteocytes
Octeoclasts |
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Term
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Definition
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Term
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Definition
| Mature bone cells in matrix |
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Term
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Definition
| Remove old bone cells for repair, remodeliing or absorption. |
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Term
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Definition
| Disruption or break in the continuity of the structure of the bone usually resulting from trauma. |
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Term
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Definition
| Chunk(s) chipped out of the side of a bone. |
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Term
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Definition
| Bone broken in multiple large pieces usually from blunt force trauma. |
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Term
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Definition
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Term
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Definition
| Break across the shaft of a bone at an angle. |
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Term
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Definition
| Break that is completely across the shaft at 90 degrees. |
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Term
| Clinical Manifestations of Fractures |
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Definition
Pain, swelling, tenderness
Loss of function
Numbness
Deformity
Discoloration/ecchymosis
Crepitation
Muscle spasms |
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Term
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Definition
1. Hematoma formation
2. Cellular proliferation
3. Callus formation
4. Ossification
5. Remodeling |
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Term
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Definition
| First stage of bone healing. Begins in the first 48-72 hours after fracture. Clotting factors initiate formation of fibrin meshwork. Granulation tissue replaces clot. |
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Term
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Definition
| 2nd stage of bone healing. Osteoblasts connect to lay down matrix by forming a firbrocartilaginous callus, which is softer and flexible. Begins distal to the fracture to access blood supply. Forms a "collar" around the fracture site. |
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Term
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Definition
| 3rd stage of bone healing. Fibrocartilaginous callus calcifies as mineral salts are deposited, forming a bridge that connects bone fragments. 3rd -4th week after injury. Formed by osteoblasts, Ca+, P and cartilage. |
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Term
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Definition
| Involves the final laying down of bone. Fracture fragments are firmly united and mature bone replaces the callus. Excess callus is gradually resorbed by osteoclasts. Cast can be removed. |
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Term
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Definition
| Resorption of excess bony callus in the marrow space and encircles external part of fracture site. Site gains strength as it is put more into use. |
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Term
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Definition
| Bruising from soft tissue damage. |
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Term
| Factors that affect bone healing |
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Definition
Age
Blood Supply
Degree of Immobilization
Presence of Infection
Amount of bone loss
Poor Nutrition |
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Term
| How to diagnose fractures |
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Definition
History & physical exam
X-rays
CT |
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Term
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Definition
Anatomic Realignment of bone fragments
Immobilization to maintain realignment
Restoration of normal or near normal function. |
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Term
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Definition
| Realignment of bone fragments using either closed or open (surgical) fixation. |
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Term
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Definition
Type of reduction for fractures. Weight used as counter to body's pull in opposite direction of injury.
Used to reduce muscle spasms
Forces on distal portion or joint.
Max of 9lbs used.
Goal: Immobilization or Realignment |
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Term
| Goals of Fracture Treatment |
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Definition
Anatomic Realignment of bone fragments
Immobilization to maintain realignment
Restoration of normal or near normal function. |
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Term
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Definition
Casting or splinting: plaster or fiberglass which follows closed reduction.
Traction
External or Internal Fixation.
Body jacket for spinal injuries.
Single hip - lumbar or femoral fractures. |
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Term
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Definition
Condition of compromised circulation related to progressively increased pressure in confined space, usually the fascia. Will compress muscles, vessels, tissue and/or nerves d/t swelling.
Two causes:
1. Decreased compartment size (ie. dressings, casts, etc. too tight.)
2. Increased compartment content d/t bleeding or edema. |
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Term
| Clinical Manifestations of Compartment Syndrome |
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Definition
Pain
Pallor
Pulselessness
Pressure
Paralysis
Parasthesia |
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Term
| Nursing Management of Compartment Syndrome |
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Definition
Notify MD immediately
Assess for myoglobinuria - released from muscles to kidney and leads to ARF
Prepare for Fasciotomy - surgical opening to relieve pressure
No cold compresses - d/t vasoconstriction
Do not elevate above the heart.
Look for dark, reddish-brown urine - sign of ARF. |
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Term
| Fat Embolism Syndrome Clinical Manifestations |
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Definition
CP
Signs of Resp Failure
Elevated Temperature
Change in Mental Status (from drop in PaO2)
Petechia - rash >50% will get on chest
"Snowstorm" or whiteout on CXR.
Happens 12-72 hours after injury. |
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Term
| Management of Fat Embolism Syndrome |
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Definition
Directed at prevention
Immobilization of fracture (long bones) ***
Corticosteroids to reduce inflammation
Monitor fluid status
Monitor chest pain and respiratory |
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Term
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Definition
| Improper alignment or healing of bone and results in deformity. |
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Term
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Definition
| Failure of bone to unite w/in expected timeframe. Can be caused by infection. |
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Term
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Definition
| Failure to heal completely before process stops. Pt will continue to have pain. |
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Term
| Factors for Venous Thrombosis (r/t fractures) |
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Definition
Incorrectly applied casts or traction
Local pressure on a vein
immobility
Can be an issue in heart of lungs (emboli) |
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Term
| Nursing Management of Fractures |
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Definition
Neurovascular assessement
Pt. education re: cast care, preop teaching, post-op teaching
Prevention of complications assoc w/immobility
Pain management
Mobility training w/assistive aids
Prevention of muscle atrophy |
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Term
| Intracapsular Hip Fracture |
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Definition
| Femoral head is broken within the joint capsule (at the neck). More sever d/t lack of blood supply. |
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Term
| Extracapsular hip fracture |
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Definition
| Fracture that is outside the joint capsule. Trochanter fracture has beeter blood suppy. |
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Term
| Manifestations of hip fracture |
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Definition
Severe pain and tenderness
Difficulty bearing weight
External rotation
Muscle Spasms
Groin pain with intracapsular
Shortening of the affected extremity (disformity) |
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Term
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Definition
Buck's traction
Casting
Surgical Management - #1 choice for both
Traction for 8-12 wks. |
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Term
| Education for hip fracture |
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Definition
No tub bath
No driving
Limit movement - ADLs
Rick of infection
Signs and Symptoms of dislocation
Pain management |
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Term
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Definition
Severe infection of the bone, bone marrow and surround soft tissue.
Most commonly caused by Staph aureus.
More common in men.
Can be caused by fixation or implants. |
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Term
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Definition
| Infected dead bone where new forms around it and becomes separated. Can be caused by cancer. |
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Term
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Definition
Pain (not always)
Low fever
Slow wound healing |
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Term
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Definition
Altered bone development.
Lateral deviation of the spinal column that may or may not include rotation or deformity of the vertebrae.
Can be idiopathic (70-80%) of nonidiopathic
Most common deformity in adolescent
girls.
May be r/t cerebral palsy or genetics.
Right thoracic curve is most common. |
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Term
| Metabolic Bone Disruptions |
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Definition
Osteoporosis
Osteomalacia
Paget's Disease |
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Term
| Definition of Metabolic Bone Disruptions |
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Definition
Characterized by abnormal bone structure caused by altered or inadequate biochemical reactions - r/t hormones, nutrition or hereditary factors.
Changes chemical or physical structure of bones. |
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Term
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Definition
Disease where bone tissue is normally mineralized but mass is decreased.
Bone resorption (by osteoclasts) exceeds bone formation.
Females are 8x more likely to develop.
Progressive disease that drops density of bone. |
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Term
| Risk factors of Osteoporosis |
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Definition
Gender (Females 1:2 will fx d/t low Ca+ and smaller frame)
Increasing age.
Genetics
White or Asian ethnicity
Cigarettes and ETYOH - 2x the risk
inactivity
certain medications and steroid use
Low testosterone levels
Anorexia or bulemia. |
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Term
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Definition
Rare bone disease in adults where bone becomes abnormally soft d/t disturbed C+ and phosphorus balance r/t Vit D deficiency.
Softening of spine, pelvis and LE.
Similar to Ricketts in children. |
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Term
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Definition
Poor diet
Intestinal malabsorption of Vit. D
Renal Tubular diseases
lack of exposure to UV rays.
Results in low Ca+ and phosphorus |
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Term
| Manifestations of Osteomalacia |
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Definition
Back Pain
LE Pain
Muscle Pain |
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Term
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Definition
Idiopathic chronic bone disease in adults - mostly men where there is an abnormal and accelerated bone resorption and formation in one or more bones.
Chronic will eventually enlarge and soften affected bones. |
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Term
| Bones affected by Paget's Disease |
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Definition
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Term
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Definition
Osteosarcoma
Ewing's sarcoma
Chondrosarcoma |
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Term
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Definition
Usually secondary to breast, lung, prostate, kidney or lymph cancer.
Most common bone tumor
Occurs 10-25yo, mostly males.
Most common sites: distal femur, proximal tibia, proximal humerus (all around the knee) - 50%
Surgery is tx of choice w/amputation and chemo w/60% survival rate. |
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Term
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Definition
Primary bone tumor in children (5-15 yo)
Found iin diaphysis of the femur and pelvis in the medullary cavity.
Fractures r/t bone destruction.
Poor prognosis.
Need biopsy to confirm dx.
50% spread to lungs, bones, and marrow. |
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Term
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Definition
Maglinant bone tumor that affects middle-aged and elders adults.
Slow growing, late metastisis so does not respond well to Chemo.
Common: Legs, arms and pelvis.
Surgery is most common tx. |
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Term
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Definition
Resutls from excessive stretching of muscle and fascial sheath (tendons).
Pain in lower back and spine. |
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Term
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Definition
Injury to ligaments (bone to bone) - mild to severely torn.
Joint injury. - most common is ankle |
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Term
| Tx for Sprains and Strains |
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Definition
RICE
R - Rest
I - Ice - help w/pain and spasms
C - Compression
E - Elevate - 24-48 hrs to reduce swelling. |
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Term
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Definition
| Partial or incomplete displacement of the join surface |
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