Airgas template - Morgan Community College

Transcript Airgas template - Morgan Community College

Chapter 42 Disorders of the Skeletal System: Trauma, Infection, and Childhood Disorders

Common Joint Injuries

• Injuries to muscles: strains • Injuries to ligaments: sprains, ruptures • Injuries to tendons: rotator cuff injuries • Injuries to bone surfaces – – Joint dislocations Patellar dislocation – – – Loose bodies Meniscus injuries Chondromalacia Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Common Joint Injuries (cont.)

Knee Injuries

Question

Tell whether the following statement is true or false.

Chondromalacia is the most common type of knee injury.

Answer

False Rationale: The most common knee injuries are tears of the ACL (anterior cruciate ligament), caused by hyperextension, and damage to the meniscus.

Fractures

•

Bone Healing

Hematoma forms and fibrin network fills it • Cells grow along fibrin meshwork to form new tissue • Calcium salts deposited in new tissue • New tissue remodeled into normal shape Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Question

Which of the following represents the correct sequence of bone healing?

Hematoma  cartilage  bone b.

Hematoma  elastin  fibrocartilage c.

Cartilage  spongy bone  compact bone d.

Answer

Hematoma  cartilage  bone Rationale: Following a fracture, a hematoma forms; collagen and cartilage are deposited (soft callus); bone tissue is ossified (hard callus).

Complications Resulting From Soft Tissue Injury

• Skin injury: fracture blisters • Muscle injury and swelling: compartment syndrome • Nerve injury: reflex sympathetic dystrophy • Adipose tissue or bone marrow: fat emboli Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Osteomyelitis

• Infection of bone – – Direct contamination Contamination through blood (hematogenous) º Miliary tuberculosis – Contamination from skin lesions Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Hematogenous Osteomyelitis

• In children: – Affects long bones – – – Purulent exudate inside bone Damages arteries to bone May penetrate skin or involve joints • In adults: – – In vertebrae, sternoclavicular and sacroiliac joints, or pubic symphysis Tends to affect joint space Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Chronic Osteomyelitis

Osteonecrosis

• Caused by ischemia to bone due to: – – – – – Bone injury Thrombosis or embolism Vessel injury Compartment syndrome inside bone (increased intraosseous pressure) Corticosteroid-associated Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Question

Which type of bone disorder is associated with thrombus formation or embolus?

Hematogenous osteomyelitis b.

Chronic osteomyelitis c.

Osteonecrosis d.

Answer

Osteonecrosis Rationale: Bone has an extensive blood supply (remember, it cannot rely on diffusion of nutrients and gases like cartilage can). When blood flow to an area of osseous tissue is disrupted because of a clot/thrombus or an embolus (a clot that has broken off and traveled), the tissue dies (necrosis).

Benign Bone Tumors

• Osteoma: small bony tumor on bone surface • Chondroma: tumor made of cartilage • Osteochondroma: cartilage-capped tumor with bony stalk • Osteoclastoma: giant cell tumor – May invade bone and cause bone destruction Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Malignant Bone Tumors

• Osteosarcoma – – Most common primary malignant bone tumor Tends to appear in areas with the fastest bone growth • Ewing sarcoma • Chondrosarcoma – Malignant tumor of cartilage • Metastases – Most common malignancies found in bone Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Manifestations of Cancer

• Changes in organ function (organ damage, inflammation, and failure): pathologic fracture • Local effects of tumors (e.g., compression of nerves or veins, stretching of periosteum):

pain and weakness

• Nonspecific signs of tissue breakdown (e.g., protein wasting, bone breakdown): calcium

release, hypercalcemia

Question

Tell whether the following statement is true or false.

Bone cancer is more likely to result in the release of PTH than the release of calcitonin.

Answer

False Rationale: As bone tissue deteriorates/breaks down, calcium is released into the blood (hypercalcemia). The hormone released in response to hypercalcemia is calcitonin (it inhibits osteoclasts). PTH is released in response to hypocalcemia.

Scenario

• Mr. K had lung cancer and received chemotherapy • He is suffering from chronic back pain and weakness, and he has trouble moving his hands and grasping heavy objects • His blood calcium is elevated, and CT scans show lesions in his thoracic spine Question: • What are two possible explanations for his weakness?

Variations in Normal Growth and Development

• Torsional deformities – – Intoeing and outtoeing Internal and external tibial torsion – Internal and external femoral torsion • Genu varum and genu valgum Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Hereditary and Congenital Deformities

• Congenital dysplasia of the hip • Foot deformities (clubfoot) – Talipes varus: foot inverted at heel – – – Talipes valgus: foot everted at heel Talipes equinus: plantarflexion, toes lower than heel Talipes calcaneus: dorsiflexion, heel below toes Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Abnormal Bone Formation

• Osteogenesis imperfecta – Mutations in genes for collagen • Juvenile osteochondrosis – – Osteonecrotic º Local degeneration of ossification centers followed by disordered regeneration Abnormal ossification of cartilaginous tissue Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Airgas template - Morgan Community College

Transcript Airgas template - Morgan Community College

Chapter 42 Disorders of the Skeletal System: Trauma, Infection, and Childhood Disorders

Common Joint Injuries

Common Joint Injuries (cont.)

Knee Injuries

Question

Answer

Fractures

Bone Healing

Question

Answer

Complications Resulting From Soft Tissue Injury

Osteomyelitis

Hematogenous Osteomyelitis

Chronic Osteomyelitis

Osteonecrosis

Question

Answer

Benign Bone Tumors

Malignant Bone Tumors

Manifestations of Cancer

Question

Answer

Scenario

Variations in Normal Growth and Development

Hereditary and Congenital Deformities

Abnormal Bone Formation

Scoliosis

Directory