NUR 327 Micro Assessment #3: Musculoskeletal

Causes of osteoporosis - Genetics, age, estrogen levels (low levels/ menopause is a risk factor), anorexia nervosa, prolonged bed rest, stress of weight, vitamin C, D, calcium, and protein deficiency. What is osteoporosis? - decrease in bone density Types of Fractures – -Transverse -Spiral -Longitudinal -Oblique -Comminuted -Impacted -Greenstick -Stress -Avulsion spiral fracture is most common in - children complete fracture - a break that extends through the entire thickness of the bone incomplete fracture - bone is not broken all the way through open (compound) fracture - the broken bone has pierced through the skin. closed (simple) fracture - break that does not penetrate the skin compressed fracture - when there is a blunt force being put on the bone causing it to shatter on itself. transverse fracture - bone break with fracture line straight across shaft of bone spiral fracture - a fracture in which the brake in the bone is twisted apart longitudinal fracture - a fracture that runs parallel to the long axis of the bone oblique fracture - bone break in which fracture line runs along an angle to shaft of the bone comminuted fracture - fracture in which the bone is splintered or crushed impacted fracture - fracture in which one bone fragment is pushed into another greenstick fracture - bending and incomplete break of a bone; most often seen in children stress fracture - a small crack in the bone that often develops from chronic, excessive impact avulsion fracture - Bones pulling away from each other (usually seen in the patella) healing of bones with complications - 3 different types: delayed union, malunion, and nonunion delayed union - usually recognized 3-6 months after healing due to the bone pain lasting long than expected, usually caused by distraction of fx fragments or the consequence of systemic causes such as infection. malunion - occurs when a fractured bone heals in an abnormal position causes of malunion - - Inability to secure reduction - Inability to maintain effective immobilization - smoking - use of corticosteroids - poor vascular circulation to the affected area nonunion - occurs when the fx has no healed after 6 months due to poor blood supply and repetitive stress on the fx site. other comorbidities for complications of bone healing - diabetes, coronary artery disease, peripheral vascular disease, or osteoporosis. strains - is an overstretching or tearing of a muscle or tendon sprains - is an overstretching or tear of ligaments Rickets - deficits in mineralization of newly formed bone matrix in the growing skeleton, it can be caused by vitamin D resistance rickets symptoms - Can cause kyphosis, genu valgum (knock knee) and genu varum (bowleg), delayed eruption of teeth, enlargement of costochondral junctions, and decreased muscle tone is also common. rickets treatment - Treatment includes the correction of the vitamin D deficient, increase in calcium and phosphate is also a dietary adjustments/ supplements rickets effects on the body - cartilage in the growing epiphyses fails to calcify and continues to grow leading to widening of epiphyseal plates or irregularity of the junction with the metaphysis. osteomyelitis - a severe pyogenic infection of bone and local tissue that requires urgent treatment. Osteomyelitis organisms - The most common causative organism is Staphylococcus aureus followed by Streptococcus pneumoniae, with gramnegative bacterial infections increasing in frequency. osteomyelitis routes of infection - (1) via the bloodstream (hematogenous osteomyelitis), (2) from adjacent soft tissue (contiguous focus), and (3) by direct introduction of the organism into the bone. Brodie Abscesses (Osteomyelitis) - when the infection will remain localized if it becomes enclosed by fibrotic tissue reaction. Direct invasion of the organism into the bone (osteomyelitis) - can occur as a result of open fractures; penetrating wounds; surgical contamination; or insertion of surgical instrumentation such as prostheses, metal plates, or screws. Infections caused by surgical instrumentation can act as a focus for bacterial reproduction. Osteomyelitis treatment - 4-6 weeks of antibiotics therapy, debridement, surgery, and hyperbaric oxygen therapy Paget's disease (osteitis deformans) - is a slowly progressive metabolic bone disease characterized by an initial phase of excessive bone resorption, mediated by osteoclasts, followed by excessive bone formation.