Name 2 biological, 3 extrinsic, and 1 behavioral factor that can predispose a
patient to a fracture. Answer - Biological:
1) Age: bone structure becomes less dense/more susceptible to injury
2) Type of bone involved: some are better equipped to handle difference
stresses and forces without injury
Extrinsic:
1) Amount of force applied
2) Angle of force applied
3) Duration of force
Behavioral:
1) Participating in adrenalin-seeking activities such as skydiving, rock-climbing,
motor cross
Describe nursing instructions that may be given to a patient in a cast. Answer -
1) Cast should be kept dry.
2) Monitor the skin areas at the end of the cast.
3) Never stick anything into or under the cast to scratch or itch.
4) Alert medical care in case of tightness or increasing pain, numbness, color
change, or temperature change in areas of distal ends of cast.
5) Follow up if cast gets loose or cracks.
,What is the basic anatomy of a long bone? Answer - Typically has two main
components:
1) Diaphysis - makes up long shaft of bone. Outer portion is made of compact
bone. Inner layer is made of marrow.
2) Epiphyses - set at either end of long bone. Outer layer is compact bone and
inner core is spongy bone.
Periosteum - membrane that lines both externally. - contains supply of nerve
fibers, lymph, blood vessels
Give examples of tapping fracture and penetrating fracture. Answer - 1)
Tapping - sustained from a small force to a concentrated area. Bone will absorb
this force - may or may not be mild soft tissue display of injury.
EX: fracture of forearm when blocking a hit with a fist or bat; being kicked in
lower leg
2) Penetrating - caused by large amount of force on small area. Object of force
is usually small and soft tissue involvement is minimal.
EX: stab wound, gunshot wound
Different from crush wound because object of force is much larger.
List several factor that determine fracture-healing outcome. Answer - 1)
Skeletal maturity decreases healing.
- Immature skeleton increases rate and success of healing.
2) Single bone fracture has better prognosis than multi-bone fracture.
3) Big displacement that affect surrounding tissues requires more healing time.
, 4) Thoracic spine injury heals better than unstable lumbar/cervical spine
injuries.
5) Fracture of joint surfaces are more unstable/difficult to treat.
6) Fracture with nearby unaffected support bone has good prognosis - acts as
natural splint.
Differentiate between linear, oblique, and transverse fractures. Answer -
LINEAR: the fracture forms a straight line through the bone; doesn't tell if
fracture line is angled or horizontal; a linear can be oblique or transverse
OBLIQUE: fracture line that travels at an angle through the bone
TRANSVERSE: break that travels in a horizontal line through the bone.
Don't ever just say a fracture line is linear - differentiate with oblique or
transverse.
Describe/give examples of following bony injuries. Answer - 1) CRUSH - caused
by large stress on a small area; results in multiple break lines and severe soft
tissue damage; EX: sledgehammer coming down on a finger or heavy
suspended mass falling on foot or leg
2) COMPRESSION - happens with large axial loading force; most often in
vertebrae; EX: landing on feet or butt, fall from a moderate height
3) STRESS - not sustained by one-time incident but instead with repetitive
activity that stresses a normal bone over time
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