patho

• Bones:


  • Shape: Bones give the body its structure.

  • Support: The bones of the legs, pelvis, and spinal column support the body and hold it upright.

  • Protection: Bones protect delicate internal organs.

  • Movement: Movement of the arms and legs, as well as the ability to breathe, results from the interaction between muscles and bones.

  • Electrolyte balance: Bones store and release minerals such as calcium and phosphorus.

  • Blood production: Bones encase bone marrow, a major site of blood cell formation.

  • Acid-base balance: Bone absorbs and releases alkaline salts to help maintain a stable pH.
• Osteoblasts


  form bone (bone makers!)
• Osteoclasts


  dissolve unwanted bone and release calcium into the blood stream (bone breakers!)
• Osteocytes


  • mature osteoblasts embedded in hardened bone matrix
• What is the role of skeletal muscle in the body?

  • Facilitate movement

  • Maintain body position

  • Stabilize joints

  • Produce heat
• For bone disorders:


  Radiography or nuclear imagining
• For joint disorders:


  Radiography

  Arthroscopy

  MRI

  Radiography - x-ray (bone fracture)

  Nuclear imagining -

  bone scan (cancer)
• Electromyography


  Measures the electrical charge associated with muscle contraction and are helpful in differentiating muscle disorders from neurologic disease
• Arthroscopy


  Insertion of a lens directly into joint
• Transverse Fracture


  across bone
• Linear Fracture


  along axis of bone
• Oblique Fracture


  break at an angle to the diaphysis
• Spiral Fracture


  angles around the bone, usually from twisting injury
• Greenstick Frature


  think of bending a "green stick"
• Comminuted Fracture


  multiple fractures
• Hematoma


  When a bone breaks, bleeding occurs and blood collects in the space between the bone edges
• Granulation Tissue Formation


  Fibrin is laid-down at the site of injury and collagen fibres and new cartilage is formed
• Pro-callus


  The two ends are held together by cartilage and collagen
• Bony Callus


  New bone tissue forms
• Remodelling


  Excessive bone tissue is removed by osteoclasts
• a. compartment syndrome


  Edema within the fascia (nonelastic covering of the muscle)

  Ischemia and infarction of tissue may occur because of compression of arterial blood supply

  A tight cast can cause compartment syndrome!

  CWMS (colour warmth movement senstaoin) important nursing assessment!

  If not resolved, muscle dies and amputation may result
• a. dislocations


  A dislocation is the separation of two bones at a joint with loss of contact between the articulating bone surfaces
• Sprain


  a tear in a ligament
• Strain


  a tear in a tendon
• Avulsion


  ligaments or tendons completely separated from bony attachments

  Immobilization often used to prevent tissue damage and promote healing`
• Treatment for sprains & Strains

  RICE

  Rest

  ICE/Immobilization

  Compression

  Elevation
• muscle tears


  Result of trauma or overextension or overstressing

  Repeated injuries result in fibrous scar tissue
• First Degree Muscle Tear


  usually involves only a small percentage of the muscle. Pain is usually mild and does not result in any appreciable loss in strength or range of motion.
• Second Degree Muscle Tear


  a larger tear that involves much of the muscle but stops short of being a complete tear. Pain is usually severe and the muscle can be partially contracted with a substantial loss of strength and range of motion.
• Third Degree Muscle Tear


  a complete tear across the width of the muscle. The muscle will be unable to contract, there will be a great deal of internal bleeding, and surgery may be required for proper healing.
• Treatment for Muscle Tear

  PRICE

  • Protection: Apply soft padding to minimize impact with objects.

  • Rest: Rest is necessary to accelerate healing and reduce the potential for re-injury.

  • Ice: Apply ice to induce vasoconstriction, which will reduce blood flow to the site of injury. Never ice for more than 20 minutes at a time.

  • Compression: Wrap the strained area with a soft-wrapped bandage to reduce further diapedesis and promote lymphatic drainage.

  • Elevation: Keep the strained area as close to the level of the heart as is possible in order to promote venous blood return to the systemic circulation.
• repetitive strain injuries


  Affects muscles, tendons, and nerves

  Develop over a period of time in which the same movement is repeated
• a. osteomyelitis


  is a bone infection usually caused by bacteria and sometimes fungi. The microorganisms can enter the blood from an infection anywhere in the body and spread to the bones. An infection can also occur as a result of surgery, particularly when a pin or structural insert is involved.
• Osteosarcoma


  (osteogenic sarcoma) is a primary malignant neoplasm that usually develops in the metaphysis of the femur, tibia, or fibula in children or young adults, particularly males
• Ewing sarcoma


  is another malignant neoplasm common in adolescents that occurs in the diaphysis of long bones.
• Nephron


  removes remaining wastes that remain in the blood moving materials from the peritubular capillaries to the tubules
• Elevated serum urea (blood urea nitrogen [BUN])


  indicate failure to excrete nitrogen wastes (resulting from protein metabolism) due to decreased GFR
• Metabolic acidosis (decreased serum pH and decreased serum bicarbonate


  indicates decreased GFR and failure of the tubules to control the acid-base balance
• Anemia (low hemoglobin level)—


  indicates decreased erythropoietin secretion and/or bone marrow depression due to accumulated wastes
• Electrolytes


  depend on the related fluid balance; that is, retention of fluid if GFR is decreased may result in a dilution effect, and laboratory values are therefore not a true reflection of renal status; however, abnormal levels may still cause clinical effects and require monitoring and treatment