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UTT NURS 3303 Exam 4 Questions And Correct Answers
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UTT NURS 3303 Exam 4 Questions And CorrectAnswers
Types of Bone - ANS cortical: solid, dense
- trabecular: aka cancellous, non-solid, has an inner meshwork making the bone porous
(more susceptible to osteoporosis)
Osteoblasts - ANS BONE-FORMING CELLS that initiate bone mineralization by secreting
osteoid
Osteocytes - ANS mature osteoblasts - maintain metabolism including nutrient and
waste exchange, do not divide
Osteoclasts - ANS responsible for BONE REABSORPTION & DEGRADATION of existing
bone, opposite of osteoblasts
Osteoblasts & Osteoclasts are. - ANSWER the major bone remodeling cells - basic
multicellular unit (BMU)
New Bone Growth - ANSWER bone forms & increases in size in the process MODELING,
where osteoblastic activity is predominant
Bone Resorption - ANSWER when bone has reached full maturity, resorption and
replacement are effected through the action of osteoclasts in a process termed
REMODELING - - osteoclasts attach to bone & resorb it by acidification & proteolytic
enzymes
BONE FORMATION & RESORPTION. - ANSWER OCCUR SIMUTANEOUSLY - THE
BALNCE DETERMINES SKELETAL MASS & HEALING AFTER INJURY
,After 30. - ANSWER osteoclast activity exceeds osteoblast activity in a steady decrease
in bone mass (density)
Bone Physiology - CALCIUM - ANSWER Healthy bone production IS DIRECTLY RELATED
TO THE CALCIUM content of bone & availability
1. parathyroid hormone (PTH-posterior pituitary hormone)
2. Vitamin D (aka calcitriol)
3. Calcitonin - inhibits osteoclasts w/ high Ca+ level
Weight-bearing Stress - ANSWER influences the rate of bone remodeling and BONE
STRENGTH. The presence of androgens & estrogen also has an effect on the bones
CALCIUM - ANSWER - calcium absorption from GI tract is enhanced by Vit D
- Vit.D activation is dependent on kidney & parathyroid fxn & sunlight exposure
- w/out Vit.D, calcium cannot be absorbed causing hypocalcemia - parathyroid
stimulated - releases PTH - stimulates bone osteoclasts to break down bone releasing
calcium
- excess release of Ca+ from bone isblocked by calcitonin (thyroid hormone)
Sprain - ANSWER over-stretching of a ligament with possible tear due to twisting or
pulling of a muscle
- most common site: ankle
- S/S: swelling, bruising, pain w movement
Sprain ANSWER over-stretching of tendons and muscle
- site: often lower back & hamstring due to muscle over use
- S/S: pain, limited ROM, muscle spasms
,Fracture ANSWER any disruption complete or incomplete in the continuity of a bone
- a fx happens when a normal force of tension, compression, bending, contortion
becomes excessive OR weakened bone structure
Open/Compound Fracture ANSWER protrudes outside of body
- risk: soft tissue injury, infection
- TX: surgical repair ORIF (open reduction internal fixation)
Closed/Complete Fracture - ANSWER bone fragments separate completely, are not
displaced and remain beneath overlying tissue
- TX: casting, ORIF
Incomplete Fracture - ANSWER bone fragments remain partially joined
Compression Fracture - ANSWER crushing of cancellous bone
Stress Fracture - ANSWER bone damage from repetitive activity
Transverse Fx - ANSWER bone is separated but still close
Comminuted Fx - ANSWER more than one fracture line with shattered/crushed bone
*complex
Greenstick Fx - ANSWER incomplete break - bone is intact (children)
Avulsion Fx - ANSWER separation of a small part of bone at site of attachment of
ligament or tendon
Oblique Fx - ANSWER completely displaced, apart *complex
, Goal of Reduction (tx for fractures) - ANSWER **alignment of bone
- closed reduction = device is used outside (external fixation devices)
- open reduction (ORIF) = surgical intervention - use of pins
**EARLY stabilization of LONG bone ex's prevents fatty emboli!!
Goal of Immobilization (tx for fractures) - ANSWER prevents further tissue damage
(casts, traction, splints)
R-I-C-E Therapy - ANSWER Rest - initial 24-48 hours
Ice - 20" per hour for 48 hrs
Compression - brace, splint, ace bandage
Elevate - elevate above level of heart
+ NSAIDS & acetaminophen
Bone Healing Process - ANSWER 1. Fracture & Inflammatory Response
2. Granulation tissue forms
3. Callus formation
4. Lamellar bone deposition (lamellae=sheets of mineralized bone)
5. Remodeling occurs (adequate strength restored in 3-6 months)
Complications of Musculoskeletal Trauma - ANSWER 1. NeuroVascular Injury &
Bleeding - damage of blood vessels, edema compression nerves
2. Compartment Syndrome
3. Infection - due to open wounds & surgical intervention - local or systemic (Staph
aureus, E.coli, Pseudomonas), osteomyelitis
4. Deep Vein Thrombosis & PE - due to venous injury causing stasis of blood
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