Fractures and Dislocations Quiz

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Questions and Answers

What is a common manifestation of a fracture?

Unnatural alignment (correct)

Fever

Skin rash

Increased mobility

Which of the following describes a dislocation?

Complete loss of contact between articular cartilage (correct)

Partial contact of bones in a joint

Normal alignment of joint surfaces

Swelling around the joint

Which treatment method is NOT commonly used for fractures?

Open reduction

Medication for pain relief (correct)

Immobilization

Closed manipulation

What might transient numbness indicate in a fracture assessment?

Nerve trauma Signup and view all the answers

Which condition describes a partial loss of contact between articular surfaces?

Subluxation Signup and view all the answers

What is a potential consequence of improper reduction of a fracture?

Malunion Signup and view all the answers

In assessing pulses during a fracture evaluation, which aspect is NOT considered?

Weight Signup and view all the answers

Which of the following may NOT be associated with dislocation?

Proper joint alignment Signup and view all the answers

What type of fracture is characterized by a break that goes through the entire bone?

Complete fracture Signup and view all the answers

Which of the following is NOT a type of bone fracture classification?

Transmutation fracture Signup and view all the answers

Which condition is characterized by chronic widespread pain and tenderness in muscles, ligaments, and tendons?

Fibromyalgia Signup and view all the answers

Which type of fracture is typically considered a pediatric fracture that does not completely break the bone?

Torus fracture Signup and view all the answers

Which of the following is a potential secondary muscular dysfunction?

Stress-induced muscle tension Signup and view all the answers

Bone disorders are characterized by alterations in the structure of bone. Which of the following is NOT a bone disorder?

Muscle strain Signup and view all the answers

What type of injury involves a complete tear of a muscle or tendon?

Avulsion Signup and view all the answers

Which joint disorder primarily causes inflammation of the joints and can lead to joint destruction?

Rheumatoid arthritis Signup and view all the answers

What is a primary characteristic of Ankylosing Spondylitis?

Fusion of the joints Signup and view all the answers

Which antigen is strongly associated with Ankylosing Spondylitis?

HLA-B27 Signup and view all the answers

What often initiates the symptoms of Ankylosing Spondylitis?

Inflammation of fibrocartilage Signup and view all the answers

What is the typical first symptom of Ankylosing Spondylitis?

Low back pain Signup and view all the answers

What is a common long-term consequence of Ankylosing Spondylitis?

Calcification of scar tissue Signup and view all the answers

What imaging finding is often seen with Ankylosing Spondylitis?

Sacroiliitis Signup and view all the answers

Which treatment is commonly recommended for managing Ankylosing Spondylitis?

Physical therapy Signup and view all the answers

What specific effect does Ankylosing Spondylitis have on posture over time?

Loss of normal lumbar curvature Signup and view all the answers

What is the underlying cause of the inflammation in Ankylosing Spondylitis?

Unknown triggers Signup and view all the answers

Which of the following is NOT a recommended treatment for Ankylosing Spondylitis?

Rest and immobility Signup and view all the answers

What is primarily caused by excessive uric acid in the body?

Inflammatory response leading to joint damage Signup and view all the answers

Which of the following is NOT a risk factor for gout?

High intake of trans fats Signup and view all the answers

What is a common acute symptom of gouty arthritis?

Severe nighttime pain in affected joints Signup and view all the answers

What can form due to deposits of monosodium urate monohydrate?

Tophi Signup and view all the answers

Which of the following joints is most likely to be affected during an initial gout attack?

Metatarsophalangeal joint of the great toe Signup and view all the answers

What percentage more likely are individuals with gout to develop renal stones compared to the general population?

What systemic inflammation sign may accompany an acute gouty attack?

Fever Signup and view all the answers

In which of the following stages of gout would someone likely NOT experience joint pain?

Asymptomatic hyperuricemia Signup and view all the answers

Which manifestation is specifically noted during an acute gouty attack?

Hot, red, and tender joint Signup and view all the answers

What is the primary symptom of gout according to the listed aggravating factors?

Severe pain Signup and view all the answers

What is a primary characteristic of tendon and ligament injuries?

They often cause mechanical instability of a joint. Signup and view all the answers

What is tendinopathy primarily defined as?

An inflammation of a tendon. Signup and view all the answers

Which of the following describes epicondylopathy?

Inflammation of a tendon where it attaches to a bone. Signup and view all the answers

What condition is associated with 'Tennis elbow'?

Lateral epicondylopathy. Signup and view all the answers

What causes bursitis?

Overuse or excessive pressure. Signup and view all the answers

What is a common feature of muscle strain?

It involves stretching beyond normal capacity. Signup and view all the answers

What is the first phase of healing in muscle strain?

Destruction. Signup and view all the answers

Which of the following is NOT a characteristic of tendon and ligament injuries?

They are always accompanied by full tears. Signup and view all the answers

What is a common symptom associated with tendon and ligament injuries?

Soft tissue swelling. Signup and view all the answers

Which condition could result from excessive pressure on the bursa?

Bursitis. Signup and view all the answers

What characterizes osteoporosis?

Gold standard detection through DXA Signup and view all the answers

Which condition results from vitamin D deficiency?

Osteomalacia Signup and view all the answers

What is a common cause of osteomyelitis?

Bacterial infection typically caused by Staphylococcus aureus Signup and view all the answers

What does Paget disease primarily cause?

Accelerated remodeling and disorganized bone deposition Signup and view all the answers

Which is NOT a typical manifestation of osteoarthritis?

Severe systemic inflammatory response Signup and view all the answers

Rheumatoid arthritis symptoms are primarily due to:

Autoimmune response damaging connective tissue in joints Signup and view all the answers

A Brodie abscess is indicative of which type of osteomyelitis?

Chronic osteomyelitis Signup and view all the answers

Which of the following is a treatment option for osteomyelitis?

Hyperbaric oxygen therapy Signup and view all the answers

What is a significant risk factor for the development of osteoarthritis?

Joint trauma and mechanical stress Signup and view all the answers

Which changes occur in osteoarthritis?

Inflammation and new bone formation at joint margins Signup and view all the answers

Which of the following conditions involves systemic signs of inflammation?

Rheumatoid arthritis Signup and view all the answers

What is the primary treatment focus for osteomalacia?

Nutritional supplements, especially vitamin D Signup and view all the answers

The thickening of synovial fibroblasts in rheumatoid arthritis leads to the formation of what?

Pannus Signup and view all the answers

Study Notes

Alterations of Musculoskeletal Function

Disorders discussed include bone fractures, support structure disorders, bone disorders, joint disorders, secondary muscular dysfunctions, fibromyalgia, chronic fatigue syndrome, bone tumors, and muscle tumors.

Fractures

A fracture is a break in the continuity of a bone.
Fractures can be classified as complete or incomplete, closed or open, comminuted, linear, oblique, spiral, transverse, greenstick, torus, or bowing. They can also be pathologic, stress, fatigue, or transchondral.
Healing can be direct (primary) or indirect (secondary).
- Direct healing happens when surgical fixation is used and involves intramembranous bone formation.
- Indirect healing happens when a cast is used and involves both intramembranous and endochondral bone formation, as well as callus formation and remodeling.

Healing

Direct (primary) healing often follows surgical fixation
Indirect (secondary) healing typically occurs with casting and involves a cascade of bone formation steps.

Manifestations (Symptoms)

Symptoms of fractures include unnatural alignment, swelling, muscle spasm, tenderness, pain, impaired sensation, decreased mobility, and often transient numbness due to nerve trauma.

Treatment (of fractures)

Treatment options include immobilization, closed manipulation with traction, open reduction, internal or external fixation.
Improper reduction or immobilization can lead to nonunion, delayed union, or malunion.

Dislocations and Subluxations

Dislocation involves the complete displacement of bones in a joint, with loss of contact between articular cartilage.
Subluxation involves partial loss of contact between articular surfaces.

Question 1 - Bone fracture splinter

The correct answer is D – Greenstick fracture.

Support Structures

Strain: Tearing or stretching of a tendon or muscle.
Sprain: Tearing or injury to a ligament.
Avulsion: Complete separation of a tendon or ligament from its bony attachment site.
Tendinopathy: Inflammation of a tendon.
Epicondylopathy: Inflammation of a tendon where it attaches to a bone (Commonly called tennis or golfer's elbow).
Bursitis: Inflammation of a bursa. (A fluid-filled sac that reduces friction in joints).

Rhabdomyolysis

Rapid breakdown of muscle.
Release of intracellular contents, including myoglobin, into the extracellular space.
Can lead to acute renal failure and electrolyte imbalances.
Characterized by muscle pain, weakness, and dark urine.

Compartment Syndrome

Increased pressure within a muscle compartment.
Caused by conditions disrupting vascular supply.
Leads to muscle ischemia, edema, rising compartment pressure, and tamponade.
Typically involves muscle infarction and nerve injury.
"6 Ps" are used for diagnosis.

Disorders of Bones

Metabolic bone diseases: Osteoporosis, osteomalacia, and Paget disease of bone.
Infectious bone diseases: Osteomyelitis.

Bone Remodeling Cycle

Osteoclasts resorb bone (break down).
Osteoblasts form new bone (build up).

Osteoporosis

Characteristics: Poorly mineralized bone, increased risk of fractures (due to alterations in bone microarchitecture). Old bone is resorbed faster than new bone is made, leading to loss of bone mass.
Potential Causes: Endocrine dysfunction (parathyroid, cortisol, thyroid, GH), medications, vitamin D deficiency, underlying diseases, low physical activity, and abnormal BMI.
Manifestations: Often pain, bone deformity, lower back pain, and/or hunchback (kyphosis).

Osteomalacia

Inadequate or delayed mineralization of osteoid.
Remodeling cycles occur but calcification does not, leading to soft bones, resulting from vitamin D deficiency.
Symptoms might include pain, bone fractures, vertebral collapse, and bone malformation.
Treatment varies by etiology.

Paget's Disease of Bone

Chronic, accelerated bone remodeling.
Disorganized bone deposition.
Often enlarges and softens bones.
Frequently affects vertebrae, skull, sacrum, sternum, pelvis, and femur.
May be asymptomatic (without symptoms).
Often diagnosed through radiographic findings.

Osteomyelitis

Bone infection, often caused by bacteria such as Staphylococcus aureus.
Hematogenous: Pathogens carried through bloodstream.
Can be either contiguous (infections spread to adjacent bones) or via direct inoculation (open fractures, surgical procedures).
Treated with antibiotics, débridement (cleaning), surgery, and hyperbaric oxygen therapy.

Disorders of Joints

Osteoarthritis: Characterized by loss and damage of cartilage, inflammation, new bone formation, subchondral bone changes, variable degrees of synovitis, and thickening of the joint capsule. Prevalence increases with age.
Risk factors: Age, joint trauma/mechanical stress, and obesity.
Characteristics: Local areas of cartilage damage, new bone formation (bone spurs), subchondral bone changes, and variable degrees of mild synovitis and thickening of the joint capsule.
Manifestations: pain, stiffness (which diminishes with activity), swelling, and joint enlargement (e.g., Heberden and Bouchard nodes).

Rheumatoid Arthritis

Inflammatory, autoimmune disease.
Systemic damage to connective tissue, primarily synovial membrane in joints.
Symptoms often include pain, tenderness, stiffness (especially in the morning), and joint deformities.
The onset is insidious, and other symptoms can include fatigue, malaise, fever, and weight loss.
Often involves significant joint deformities (boutonniere, swan-neck, ulnar deviation) and sometimes rheumatoid nodules, and related syndrome "Caplan syndrome."

Ankylosing Spondylitis

Inflammatory arthropathy.
Affects spine and sacroiliac joints.
Characteristically leads to stiffening and fusion of the joints.
Is a systemic disease, commonly associated with HLA-B27 antigen and inflammatory process at the entheses (where ligaments and tendons attach to bones).
Diagnosed principally by imaging (identifying sacroiliitis, the presence of inflammation on the sacroiliac joints).

Gout

Inflammatory response from excessive uric acid levels.
Characterized by elevated levels in blood and synovial fluid, resulting in the formation of monosodium urate crystals in joints causing acute, painful inflammation (gouty arthritis).
Risk factors include male sex, increasing age, high intake of alcohol, red meat, and fructose.
Diagnostic criteria include acute attacks of pain, especially at night, tenderness and redness of a single joint (usually the base of the big toe), signs of systemic inflammation (elevated ESR or CRP), and tophi (uric acid crystal deposits in and around joints).
Symptoms include severe pain at night, and swelling; redness and warmth in affected joint.

Secondary Muscular Dysfunction

Contractures: Lack of full passive range of motion due to muscle and soft tissue limitations.
Can be physiologic (muscle fiber shortening), or pathologic (caused by muscle spasm or weakness).

Chronic Fatigue Syndrome

Also called myalgic encephalomyelitis.
Characterized by profound fatigue, musculoskeletal pain, cognitive impairment, and unrefreshing sleep, often worsened by activities.
Related to central sensitization within the CNS, potentially related to dysfunction in the reticular activating system and autonomic nervous system.

Fibromyalgia

Chronic widespread diffuse pain and muscle pain/tender points causing fatigue; potentially marked by increased sensitivity to touch and other sensory abnormalities.
Symptoms include fatigue, tender points, nonrestorative sleep, and possible anxiety/depression.
Potentially influenced by underlying genetic alterations in serotonin, catecholamines, and dopamine.

Bone Tumors

May originate from bone cells (e.g., osteogenic, osteosarcoma), cartilage (e.g., chondrogenic, chondrosarcoma), fibrous tissue (e.g., collagenic, fibrosarcoma), or marrow/blood cell precursors.
Can be classified based on originating cell type.
Criteria including nuclear/cytoplasmic ratio, borders, chromatin density, prominently displayed nucleolus, and mitotic rate (growth rate) are evaluated to distinguish benign from malignant tumors.
May appear as geographic, moth-eaten, or permeative patterns of bone destruction on X-rays.

Muscle Tumors

Two major types of muscle tumors: benign rhabdomyoma, and malignant rhabdomyosarcoma, both affecting striated muscle (generally voluntary muscle) but with different qualities.
Rhabdomyosarcoma is generally highly malignant with rapid metastasis, and typically originates from head, neck, and genitourinary tracts.

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Description

Test your knowledge on fractures and dislocations with this informative quiz. Explore various types of fractures, treatment methods, and common symptoms related to these conditions. Understand the significance of proper assessments and the potential complications that can arise from injuries.