Fractures Overview

Fractures

• Fractures are discontinuities in bones, often caused by trauma, resulting in pain and swelling due to damaged blood vessels.
• Projections for fractures are often taken at right angles (90 degrees) to each other, as in AP (anteroposterior) and lateral views.
• Colle's fracture occurs when a person falls backward, bracing themselves with an open hand, and impacting a hard surface. The distal radius, a bone in the forearm, is typically fractured.
• Smith's fracture is a reverse Colle's fracture, characterized by a forward (volar) displacement of the distal radius fracture.
• Boxer's fracture occurs at the end of the fourth or fifth metacarpal bones in the hand.
• Bennett's fracture occurs at the carpometacarpal (CMC) joint of the hand.

Open/Compound Fracture

• An open/compound fracture occurs when the bone breaks through the skin.

Monteggia Fracture

• A Monteggia fracture involves a fracture of the proximal ulna (a forearm bone) and a dislocation of the radial head (a bone in the forearm).

Depressed Fracture

• A depressed fracture involves an inward pressing of a fractured skull bone.

Ping Pong Fracture

• This is a specific type of depressed skull fracture.

Tripod Fracture

• A tripod fracture is a type of fracture involving the zygoma (cheekbone) which involves the orbital floor, zygoma, and maxilla (an upper jaw bone).

Blow-Out Fracture

• A blow-out fracture involves the orbital floor and/or the maxillary bone, typically due to blunt force trauma to the eye.

Avulsion Fracture

• An avulsion fracture occurs when a piece of bone is torn away from the main bone, commonly seen in adolescents during athletic activities, often at the base of the 5th metatarsal.

Jones Fracture

• A Jones fracture occurs on the shaft of the 5th metatarsal. It sometimes requires surgical intervention like inserting a screw or a bone graft.

Odontoid Fracture

• An odontoid fracture is an atypical fracture of the C1 and C2 vertebrae (neck).

Jefferson's Fracture

• A Jefferson's fracture affects the C1 vertebra (atlas).

Clay Shoveler's Fracture

• A Clay Shoveler's fracture affects vertebrae C6-T1 and occurs at the C7 vertebral prominence.

Hangman's Fracture

• A hangman's fracture involves the C2 and C3 vertebrae (neck). Often the dens is involved.

Imaging Considerations

• Radiography - evaluation for fractures, using radiographic examination techniques like AP, lateral views.
• CT Scan - detailed internal structure visualization for fracture and other pathology.
• PET Scan - metabolic activity of the patient for disease diagnosis.
• Nuclear Medicine - examines function using radioactive tracers via perfusion and ventilation scans.

Respiratory System

• Radiography considerations include soft tissue, bone, pleura, and mediastinum examination.
• CT Scan uses for pulmonary embolus, pulmonary adenopathy (lymph node enlargement).
• Chest Radiography requires good criteria, including trachea visualization, scapula position, ribs, and costophrenic angle assessment.
• Breathing instruction typically for radiologic examinations. A 2nd full inspiration assists accurate imagery.
• Nuclear Medicine including perfusion and ventilation scans which use radioactive substances to determine the function of the lungs or other organs.

Congenital and Hereditary

• Cystic Fibrosis is a genetic condition in which thick, sticky mucus obstructs the lungs.
• Pneumonia various types described, including lobar, segmental, bronchopneumonia, and interstitial pneumonia, depending on the affected area within the lung.
• Hyaline membrane disease occurs commonly in premature babies due to a lack of surfactant.
• Staphylococcal pneumonia involves the formation of air-filled cysts (pneumatoceles) within involved lung portions, potentially leading to abscesses.
• Pneumonia is the most prevalent lung infection, ranked 8th amongst the causes of death in the US.
• Legionnaire's pneumonia is caused by bacteria that thrive in warm, moist environments.

Inflammatory Diseases

• Pneumonia is the most frequent lung infection,
• Ranks under the top 10 causes of death in the U.S.

Mycoplasma Pneumonia

• Reticular pattern and patchy air space in distribution, may mimic TB.

Bronchiectasis

• Abnormal dilation of bronchi, often due to destruction of elastic and muscular components of the walls. Different types of bronchiectasis discussed: cylindrical, saccular, and varicose.

Aspiration Pneumonia

• Pneumonia resulting from aspiration of stomach contents, potentially triggered by anesthesia, alcohol intoxication, or stroke.

Viral/Interstitial Pneumonia

• Pneumonia caused by various viruses, especially influenza A & B.

Pulmonary Tuberculosis (PTB)

• Infection caused by Mycobacterium tuberculosis (aerobic). Diagnostic tools such as apicolordotic views and Lindblom/Fleischner method approaches are mentioned.

Chronic Obstructive Pulmonary Disease (COPD)

• Group of disorders causing chronic airway obstruction, including chronic bronchitis and emphysema.

Lung Abscess

• A localized area of dead (necrotic) lung tissue surrounded by inflammatory debris.

Pneumoconioses

• Lung diseases caused by inhaling dusts including silica from silicosis, coal from anthracosis, and asbestos. This includes dusts which cause injury, inflammation within lung tissues, or fibrosis.

Pleural Effusion

• Blunting of costophrenic angles is evidence of pleural effusion.

Neoplastic Diseases

• Describes diseases that involve uncontrolled cell growth such as pulmonary metastases, cotton ball appearances.

Endocrine System

• Posterior pituitary gland – regulates uterine contractions and water retention in kidneys.
• Anterior pituitary gland – controls other glands for hormonal regulation (prolactin for lactation, growth hormone for growth, follicle stimulating hormone for reproductive health, luteinizing hormone for reproductive health, and adrenocorticotropic hormone for adrenal cortex health).
• Pineal gland - regulates the sleep/wake cycle.
• Thyroid gland - regulates metabolism (T3 and T4 hormones).
• Parathyroid – regulates calcium levels.
• Pancreas – regulates blood sugar, secreting insulin and glucagon hormones.
• Adrenal glands - regulate stress response (epinephrine and norepinephrine hormones).
• Ovaries – produce estrogen and progesterone for reproduction.
• Testes – produce testosterone for reproduction.
• Imaging considerations: radiography, and specific techniques to aid in analysis.
• Cushing syndrome involves dysfunctions within the adrenal cortex leading to increased glucocorticoid production and resulting health conditions.
• Addison's disease is a rare disorder involving adrenal insufficiency regarding cortisol and aldosterone lack.
• Gigantism and Dwarfism - result from over- and under-secretions of growth hormone, respectively.

Acromegaly

• Increased extremity size due to increased growth hormone production dysfunction.

MRI

• Evaluates the hypothalamus and pituitary gland structure.

CT Scan

• Diagnostic tool for organs like the pineal gland, parathyroid, and thyroid.

Nuclear Medicine

• Diagnostic tool for conditions such as thyroid disorders, by use of Iodine 123 and 131.

Ultrasound

• Evaluates the thyroid muscle and gland.

Diabetes Insipidus

• Posterior pituitary dysfunction leading to inadequate antidiuretic hormone (ADH) secretion.

Diabetes Mellitus

• Syndrome relating to chronic hyperglycemia. It also relates to defects of pancreatic beta cell secretion issues resulting in various forms like Type 1, Type 2.

Hyperthyroidism and Hypothyroidism

• Conditions affecting thyroid hormone balance. Hyperthyroidism (overactive) causes bulging eyes (exophthalmos); hypothyroidism (underactive) causes goiter.
• Hashimoto's disease is a form of hypothyroidism.

Adrenal Carcinoma

• Cancer of the adrenal gland often detected through CT or MRI.

Explore the various types of fractures including Colle's, Smith's, and Boxer's fractures in this informative quiz. Understand the mechanisms of injuries and their respective classifications. Test your knowledge on both open and compound fractures as well as specific fracture patterns.