NUR 3032 EXAM #4
Study online at https://quizlet.com/_d49f66
1. Types of Os- Hematogenous Osteomyelitis :
teomyelitis - Infectious organisms reach bone through blood stream
- Seen in kids/post-op pts
Contiguous Spread Osteomyelitis :
- 2nd to contiguous infection
- Direct inoculation from exogenous source OR adjacent extraskeletal site
- Any bone that experienced trauma spreads through direct penetration/up bone
Chronic Osteomyelitis :
- Occur 2nd to open wound
2. Chronic Os- - Hallmark feature = infected dead bone (sequestrum) separated from living bone
teomyelitis - Includes ALL inflammatory processes; excluding the ones in Rheumatoid dis-
eases
- Usually occurs in ADULTS, most often to bone/surrounding tissue
***Best way to diagnose --> bone scan w/ biopsy
3. Joint Injuries Strain :
- Stretching injure to muscle caused by mechanical overload
- DON'T see external evidence from pt
- Common in lower back, elbows, shoulders (high risk = athletes)
Sprain :
- Involves ligaments surrounding joint pain & swelling more slowly than strain
- Caused by abnormal/excessive movement to joint
Dislocation :
- Displacement/separation of bone of joint w/ loss of articulation
- Severe trauma that disrupts ligaments holding it in place --> can be congenital,
traumatic, OR pathologic
Loose Bodies :
- Small pieces of bone/cartilage in joint
- Can be trauma to joint, cartilage wears away bone separates
- Occurs in weight-bearing joints (ankle, knee, hip)
- PT has "locking" of joint, restricted ROM, Cracking w/ movement
, NUR 3032 EXAM #4
Study online at https://quizlet.com/_d49f66
4. Healing Process - Accomplished by fibroblasts from inner tendon sheath
in Soft Tissue - Capillaries infiltrate injured area during initial healing process
- Formation of long collagen bundles !
5. Classifications of By Cause :
Fractures - Sudden injury
- Stress fractures (2 weeks after symptoms)
- Pathologic fractures
Location :
- Proximal, mid shaft, distal
Types :
- Open (also considered a compound fracture)
- Closed
Pattern of Fracture :
- Comminuted (broken bone in 2+ spots)
- Compression (narrowing of vertebrae in older pts; also known as spinal arthri-
tis/spinal stenosis)
- Greenstick (in kids w/ partial break vertically as bones still grow)
- Spiral (occurs w/ twisting motion, wraps around bone like "corkscrew")
- Transverse (straight break opposite of direction of bone)
- Oblique (bone broken @ angle)
6. Symptoms of - Pain
Fracture - Tenderness @ site
- Swelling
- Loss of function
- Deformity of affected part
- Abnormal mobility
7. 3 Main Objec- 1. Reduction of fracture
tives Post-Frac- 2. Immobilization
ture Care 3. Preserving/restoring function
, NUR 3032 EXAM #4
Study online at https://quizlet.com/_d49f66
**Splinting, elevation, immobilization CAN be done immediately!!!!
8. 5 Stages of Bone 1. Hematoma Formation --> 1-2 days after fracture, torn blood vessels around
Healing bone/tissue develop hematoma, 2-5 days after hemorrhage develops clot
2. Cellular Proliferation --> new vessels start to develop by end of 1st week
3. Callus Formation --> new capillaries infiltrate hematoma @ site, form granu-
lation tissue, fibroblasts bridge bone fragments, BUT still not strong enough for
weight-bearing
4. Ossification --> converted to boney callus ... 1st deposited bone on outside then
formation of new bone progresses to fracture site, over time replaced by dense
bone, 3-4 weeks
5. Remodeling --> dead portions removed by osteoclasts, compact bone replaces
spongey boney, area looks different compared to unbroken bone
9. Factors Delaying - Age
Bone Healing - Current meds (corticosteroids slow process)
- Debilitating diseases (arthritis/diabetes)
- Local stress around site
- Circulatory problems
- Coagulation disorders
- Poor nutrition
10. Complications of - Loss of skeletal continuity
Fractures - Injury from bone fragments
- Pressure from swelling/hemorrhage --> fracture blisters (necrosis of epidermis in
ankle/elbow form twisting movement) & compartment syndrome (swelling/bleed-
ing occurs, if NOT treated can lead to amputation)
- Involvement of nerve fibers --> Reflex sympathetic dystrophy & causalgia (burning
pain caused from damage of peripheral nerve)
- Development of fat emboli --> like a PE, fat droplets come out of bone marrow @
site, go into venous system, lodge into lungs
Study online at https://quizlet.com/_d49f66
1. Types of Os- Hematogenous Osteomyelitis :
teomyelitis - Infectious organisms reach bone through blood stream
- Seen in kids/post-op pts
Contiguous Spread Osteomyelitis :
- 2nd to contiguous infection
- Direct inoculation from exogenous source OR adjacent extraskeletal site
- Any bone that experienced trauma spreads through direct penetration/up bone
Chronic Osteomyelitis :
- Occur 2nd to open wound
2. Chronic Os- - Hallmark feature = infected dead bone (sequestrum) separated from living bone
teomyelitis - Includes ALL inflammatory processes; excluding the ones in Rheumatoid dis-
eases
- Usually occurs in ADULTS, most often to bone/surrounding tissue
***Best way to diagnose --> bone scan w/ biopsy
3. Joint Injuries Strain :
- Stretching injure to muscle caused by mechanical overload
- DON'T see external evidence from pt
- Common in lower back, elbows, shoulders (high risk = athletes)
Sprain :
- Involves ligaments surrounding joint pain & swelling more slowly than strain
- Caused by abnormal/excessive movement to joint
Dislocation :
- Displacement/separation of bone of joint w/ loss of articulation
- Severe trauma that disrupts ligaments holding it in place --> can be congenital,
traumatic, OR pathologic
Loose Bodies :
- Small pieces of bone/cartilage in joint
- Can be trauma to joint, cartilage wears away bone separates
- Occurs in weight-bearing joints (ankle, knee, hip)
- PT has "locking" of joint, restricted ROM, Cracking w/ movement
, NUR 3032 EXAM #4
Study online at https://quizlet.com/_d49f66
4. Healing Process - Accomplished by fibroblasts from inner tendon sheath
in Soft Tissue - Capillaries infiltrate injured area during initial healing process
- Formation of long collagen bundles !
5. Classifications of By Cause :
Fractures - Sudden injury
- Stress fractures (2 weeks after symptoms)
- Pathologic fractures
Location :
- Proximal, mid shaft, distal
Types :
- Open (also considered a compound fracture)
- Closed
Pattern of Fracture :
- Comminuted (broken bone in 2+ spots)
- Compression (narrowing of vertebrae in older pts; also known as spinal arthri-
tis/spinal stenosis)
- Greenstick (in kids w/ partial break vertically as bones still grow)
- Spiral (occurs w/ twisting motion, wraps around bone like "corkscrew")
- Transverse (straight break opposite of direction of bone)
- Oblique (bone broken @ angle)
6. Symptoms of - Pain
Fracture - Tenderness @ site
- Swelling
- Loss of function
- Deformity of affected part
- Abnormal mobility
7. 3 Main Objec- 1. Reduction of fracture
tives Post-Frac- 2. Immobilization
ture Care 3. Preserving/restoring function
, NUR 3032 EXAM #4
Study online at https://quizlet.com/_d49f66
**Splinting, elevation, immobilization CAN be done immediately!!!!
8. 5 Stages of Bone 1. Hematoma Formation --> 1-2 days after fracture, torn blood vessels around
Healing bone/tissue develop hematoma, 2-5 days after hemorrhage develops clot
2. Cellular Proliferation --> new vessels start to develop by end of 1st week
3. Callus Formation --> new capillaries infiltrate hematoma @ site, form granu-
lation tissue, fibroblasts bridge bone fragments, BUT still not strong enough for
weight-bearing
4. Ossification --> converted to boney callus ... 1st deposited bone on outside then
formation of new bone progresses to fracture site, over time replaced by dense
bone, 3-4 weeks
5. Remodeling --> dead portions removed by osteoclasts, compact bone replaces
spongey boney, area looks different compared to unbroken bone
9. Factors Delaying - Age
Bone Healing - Current meds (corticosteroids slow process)
- Debilitating diseases (arthritis/diabetes)
- Local stress around site
- Circulatory problems
- Coagulation disorders
- Poor nutrition
10. Complications of - Loss of skeletal continuity
Fractures - Injury from bone fragments
- Pressure from swelling/hemorrhage --> fracture blisters (necrosis of epidermis in
ankle/elbow form twisting movement) & compartment syndrome (swelling/bleed-
ing occurs, if NOT treated can lead to amputation)
- Involvement of nerve fibers --> Reflex sympathetic dystrophy & causalgia (burning
pain caused from damage of peripheral nerve)
- Development of fat emboli --> like a PE, fat droplets come out of bone marrow @
site, go into venous system, lodge into lungs
