PAT 202 : FRACTURES AND OSTEOPOROSIS EXAM
QUESTIONS WITH VERIFIED ANSWERS
What is a fracture? - Answers - - Break in continuity of a bone
- Occurs when force applied exceeding tensile or compressive strength of bone
What is the incidence of fractures? - Answers - - Fracture incidence varies depending
on bone involved, age, gender
- highest incidence of fractures occurs in young males ages 15 to 24 and in adults 65
years and older
- rates of hip and wrist fractures tend to be higher in women
an estimated 158 million hip fractures occurred worldwide in 2015
- this number is expected to increase to 316 million by 2040
What are the classifications of fractures? - Answers - •Complete
•bone broken all way through
•Incomplete
•bone damaged but still in one piece
•Closed or simple (complete or incomplete)
•skin intact
•Open or compound (complete or incomplete)
•skin broken
•Comminuted
•bone breaks into more than two fragments
•Linear
•fracture runs parallel to long axis of bone
•Oblique
•fracture of shaft of bone is slanted
What are the risk factors for fractures in pediatric populations? - Answers - •bone
mineral content, bone size, bone accrual all lower = low bone mineral density (BMD)
•genetic factors
•poor nutrition
•inadequate intake of dietary calcium, milk avoidance, excessive consumption of
carbonated beverages
•lack of weight-bearing physical activity
•obesity
•play and sport (exposure to trauma)
What are the risk factors for fractures in older adults? - Answers - •age
•gender
•osteoporosis (fragility fracture)
•smoking
, •alcohol
•steroids
•diabetes
•previous fracture
What are fractures most commonly caused by? - Answers - Fractures are most
commonly caused by falls, car accidents, and athletic injuries
What happens physiologically when a bone is broken? - Answers - •When bone broken
•disrupts periosteum and blood vessels in cortex, marrow, surrounding soft tissues
•Bleeding occurs from damaged ends of bone and from neighboring soft tissue
•Hematoma forms within medullary canal, between fractured ends of bone, and beneath
periosteum
•Bone tissue immediately adjacent to fracture dies
•Necrotic tissue and any debris in fracture area stimulate intense inflammatory response
•characterized by vasodilation, exudation of plasma and leukocytes, and infiltration by
inflammatory leukocytes and mast cells
•Cytokines, including transforming growth factor-beta (TGF-β), platelet-derived growth
factor (PDGF), prostaglandins, and other factors are released
•promote healing
•Within 48 hours after injury
•vascular tissue invades fracture area from surrounding soft tissue and marrow cavity
•blood flow to entire bone is increased
•Osteoblasts and osteoclasts in periosteum, endosteum, and marrow are activated
•produce subperiosteal procallus along outer surface of shaft and over broken ends of
bone
What are the three healing phases of a fracture? - Answers - Inflammatory, Repair,
Remodelling
What is involved in the inflammatory phase? - Answers - •Lasts 3-4 days
•Bone tissue destruction triggers inflammatory response
•Hematoma formation
What is involved in the repair phase? - Answers - •Lasts several days
•Capillary ingrowth, mononuclear cells, and fibroblasts transform hematoma into
granulation tissue
•Osteoblasts within procallus synthesize collagen and matrix to form callus
What is involved in the remodelling phase? - Answers - •Lasts months to years
•Unnecessary callus
•is resorbed, and trabeculae formed
•At the end, bone can withstand normal stresses
T/F: Bone will heal with scar tissue after a fracture. - Answers - False! Bone heals with
normal tissue.
QUESTIONS WITH VERIFIED ANSWERS
What is a fracture? - Answers - - Break in continuity of a bone
- Occurs when force applied exceeding tensile or compressive strength of bone
What is the incidence of fractures? - Answers - - Fracture incidence varies depending
on bone involved, age, gender
- highest incidence of fractures occurs in young males ages 15 to 24 and in adults 65
years and older
- rates of hip and wrist fractures tend to be higher in women
an estimated 158 million hip fractures occurred worldwide in 2015
- this number is expected to increase to 316 million by 2040
What are the classifications of fractures? - Answers - •Complete
•bone broken all way through
•Incomplete
•bone damaged but still in one piece
•Closed or simple (complete or incomplete)
•skin intact
•Open or compound (complete or incomplete)
•skin broken
•Comminuted
•bone breaks into more than two fragments
•Linear
•fracture runs parallel to long axis of bone
•Oblique
•fracture of shaft of bone is slanted
What are the risk factors for fractures in pediatric populations? - Answers - •bone
mineral content, bone size, bone accrual all lower = low bone mineral density (BMD)
•genetic factors
•poor nutrition
•inadequate intake of dietary calcium, milk avoidance, excessive consumption of
carbonated beverages
•lack of weight-bearing physical activity
•obesity
•play and sport (exposure to trauma)
What are the risk factors for fractures in older adults? - Answers - •age
•gender
•osteoporosis (fragility fracture)
•smoking
, •alcohol
•steroids
•diabetes
•previous fracture
What are fractures most commonly caused by? - Answers - Fractures are most
commonly caused by falls, car accidents, and athletic injuries
What happens physiologically when a bone is broken? - Answers - •When bone broken
•disrupts periosteum and blood vessels in cortex, marrow, surrounding soft tissues
•Bleeding occurs from damaged ends of bone and from neighboring soft tissue
•Hematoma forms within medullary canal, between fractured ends of bone, and beneath
periosteum
•Bone tissue immediately adjacent to fracture dies
•Necrotic tissue and any debris in fracture area stimulate intense inflammatory response
•characterized by vasodilation, exudation of plasma and leukocytes, and infiltration by
inflammatory leukocytes and mast cells
•Cytokines, including transforming growth factor-beta (TGF-β), platelet-derived growth
factor (PDGF), prostaglandins, and other factors are released
•promote healing
•Within 48 hours after injury
•vascular tissue invades fracture area from surrounding soft tissue and marrow cavity
•blood flow to entire bone is increased
•Osteoblasts and osteoclasts in periosteum, endosteum, and marrow are activated
•produce subperiosteal procallus along outer surface of shaft and over broken ends of
bone
What are the three healing phases of a fracture? - Answers - Inflammatory, Repair,
Remodelling
What is involved in the inflammatory phase? - Answers - •Lasts 3-4 days
•Bone tissue destruction triggers inflammatory response
•Hematoma formation
What is involved in the repair phase? - Answers - •Lasts several days
•Capillary ingrowth, mononuclear cells, and fibroblasts transform hematoma into
granulation tissue
•Osteoblasts within procallus synthesize collagen and matrix to form callus
What is involved in the remodelling phase? - Answers - •Lasts months to years
•Unnecessary callus
•is resorbed, and trabeculae formed
•At the end, bone can withstand normal stresses
T/F: Bone will heal with scar tissue after a fracture. - Answers - False! Bone heals with
normal tissue.
