Pathophysiology
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| Kyphosis | increase in the curvature of the thoracic spine outward; hunchback
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| when does kyphosis appear | during adolescent growth spurts; can appear as poor posture
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| what does kyphosis develop secondary to? | osteoporosis, degenerative spine disesase, or injury
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| kyphosis manifestations | fatigue, back pain, and spine stiffness
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| complications of kyphosis | impaired lung expansion and ventilation; increased risk for injury as their center of gravity is altered
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| treatment for kyphosis | exervises, proper posture, bracing, surgery
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| Lordosis | exaggerated concave of the lumbar spine; swayback
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| when does lordosis develop? | during adolescent growth spurts or because of poor posture
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| risk factors for lordosis | obesity and dwarfism
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| treatment for lordosis | exercise, proper posture, bracing, and surgery
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| scoliosis | lateral deviation of the spine, affecting either the thoracic or lumbar area, or both; may also include a rotation of the vertebrae on their axis
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| risk factor for scoliosis | females. maybe genetic (autosomal dominant), embryonic developmental deformities, degenerative diseases, unequal leg lengths, spinal nerve compression, and asymmetrical muscle support
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| complications of scoliosis | pulmonary compromise, chronic pain, degenerative arthritis of the spine, intervertebral disk disease, and sciatica
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| clinical manifestations of scoliosis | asymmetrical gait, hip, shoulders, thoracic cage
back pain or discomfort, fatigue,, respiratory compromise
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| scoliosis treatment | exercise, bracing, surgery
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| fracture | break in the rigid structure of the bone
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| simple fracture | fracture with a single break in the bone, and in which bone ends maintain their alignment and position
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| transverse fracture | fracture straight across bone shaft
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| oblique fracture | a fracture at an angle to the bone shaft
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| spiral fracture | a fracture that twists around the bone shaft
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| comminuted fracture | a fracture characterized by multiple fracture lines and bone pieces
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| greenstick fracture | an incomplete fracture in which the bone is bent and only the outer curve of the bend is broken; commonly occurs in children because of minimal calcification and often heals quickly
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| compression fracture | a fracture in which the bone is crushed or collapses into small pieces
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| complete fracture | occur when the bone is broken into two or more separate pieces
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| incomplete fractures | bone is partially broken
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| open fractures | compound fractures. the skin is broken. the bone fragments or edges may be angled and protrude out of the skin. characterized by more damage to soft tissue and are at risk for infection
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| closed fractures | the skin is intact
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| impacted fractures | occur when one end of the bone is forced into the adjacent bone
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| pathologic fractures | result form a weakness in the bone structure secondary to conditions such as bone tumors or osetoporsis
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| stress fractures | fatigue fractures; occur from repeated excessive stress
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| depressed fractures | occur in the skull when the broken piece is forced inward on the brain
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| callus | bridges the broken bone ends together inside and outside; takes 2 to 6 weeks to form. collagen fibers
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| complications of fractures | delayed union, malunion, or nonunion
compartment syndrome, fat embolism, osteomyelitis, and osteonecrosis
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| compartment syndrome | serious condition that results from pressure increases in a compartment.Can cause permanent tissue damage. identify from pain higher than expected. diagnose by measuring pressures inside muscle fascia. treat by removing cast and immediate fasciotomy
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| fat emoblism | occurs when fat enters bloodstream. emboli can then travel to vital organs and be fatal. prevent with early immobilization of the fracture
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| osteomyelitis | infection of bone tissue. serious complication because often undetected and takes months to resolve. results in bone or tissue necrosis. treated with antibiotic therapy and surgery
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| osteonecrosis | death of bone tissue due to loss of blood supply; often requires surgical replacement of the necrotic bone and/or joint
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| crepitus | grating sound or sensation, occurring with movement
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| clinical manifestation so fracture | deformity, swelling at site, inability to move affected limb, crepitus, pain, paresthesia, muscle flaccidity progressing to spasms
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| reduced | fracture is reduced to restore the bone to its normal position; accomplished with closed manipulation by applying pressure or traction or with open manipulation via surgery.
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| if a fracture is suspected, patient is NPO | because they might need surgery
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| what is crucial to prevent complications of fracture? | immobilization
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| dislocation | separation of two bones where they meet at a joint; complete or partial loss of contact
usually result from sudden impact to the joint, but may be congenital
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| clinical manifestations of dislocation | visibly out of place, discolored, or deformed joint, limited movement, swelling or bruising, intense pain, paresthesia near the injury
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| treatment for dislocation | immobilize area with splint or sling. do not straighten or move. assess for tissue perfusion. apply ice. do not move person unless injury is immobilized. do not move person with an injury to any weight bearing joint unless necessary. patient NPO
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| dislocation: after injury is stable | immobilized for several weeks, remove splint or sling then gradual rehab program (primarily PT). avoid strenuous acitivyt iwht injured joint. may need several months to heal.
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| sprain | injury to a ligament that often involves stretching or tearing of the LIGAMENT
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| what causes sprains? | caused when a joint is forced to move into an unnatural position. severity is on a grading scale. most often ankles and knee occur
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| sprain injury triggers what? | inflammatory response, causing edema and pain at site. blood vessels may be damaged and result in bleeding and bruising
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| treatment for sprain | at home. apply ice. immobilize joint wiht a splint or elastic wrap or bandage. elevate swollen joint above heart lvl. rest joint and gradually increase activity. NSAIDS. keep pressure off injury. crutches. physical therapy. surgery for torn ligaments
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| PRICE | treatment for sprains. Protect. Rest. Ice. Compress. Elevate.
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| strain | injury to a muscle or tendon that often involves stretching or tearing of MUSCLE OR TENDON. also called a pulled muscle
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| what causes muscle strain? | awkward muscle movement, excess force, improper use, or overuse of muscle.
excessive physical activity, improper stretching poor flexibility
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| what is the most common site for strains? | lower back
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| what are clinical manifestations for strain? | pain, stiffness, difficulty moving the affected muscle, skin discoloration, and edema
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| treatment for strains | PRICE. NSAIDS. muscle relaxants, surgically repair severe tendon tears, physical therapy
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| herniated intervertebral disk | state in which the nucleus pulposus protrudes through the annulus fibrosus. also called slipped disk or ruptured disk.
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| where is the most frequently invovled vertebrae of slipped disc? | lumbrosacral region but can occur in cervical
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| what is cause of herniated disk | improper body mechanics, lifting heavy objects, trauma, degenerative changes secondary to aging, demineralization secondary to metabolic conditions (eg osteoporosis)
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| manifestations of herniated intervertebral disks | sciatica; pain, paresthia, or weakness in lower back and one leg, or in neck, shoulder, chest, or arm. lower back pain or leg pain worsened by sitting, coughing, sneezing, laughing, bending, or walking. limited mobility
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| treatment of herniated disks | rest, analgesics, NSAIDS, muscle relaxants, physical therapy, heat/cold, traction. injections, surgical repair, weight loss
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| osteoporosis | condition characterized by a progressive loss of bone calcium that leaves the bones brittle
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| what causes osteoporosis | can occur due to either a decrease in osteoblast actiivty or an increase in osteoclast activity. can be primary or secondary
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| what increases risk factors of osteoporosis | calcium defiiciency, deficient intake of protein, vitamin C, and vit D, and excessive intake of phosphorus. caucasians, asians, women, smoking, alcohol or caffiene, certain medicines and health conditions. bone tumors, malabsorption, underweight
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| what complications result from osteoporosis | increased risk of bone fractures
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| osteopenia | bone mass that is less than expected for age, ethnicity, or gender
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| clinical manifestations of osteoporosis | osteopenia, bone pain, fractures with little or no trauma, low back and neck pain, kyphosis, height reduction over time
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| treatment for osteoporosis | proper nutrition. exercise, stop smoking, limit alcohol and caffiene. pharmacologic therapy like biphosphonates, estrogen receptor modulators, and calcitonin. safety measures. pain management. surgery for fractures or weakened bones
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| Rickets | softening and weakening of bones in children, suually because of an extreme and prolonged vitamin D, calcium, or phosphate deficiency
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| Osteomalacia | rickets in adults
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| what plays an essential role in promoting absorption of calcium and phosphorus from the gastrointestinal tract? | vitamin D
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| what does hereditary rickets occur from | kidneys are unable to reabsorb phosphate. may also occur in renal disease
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| clinical manifestations of rickets | skeletal deformities, fractures, delayed growth, dental problems, bone pain, muscle cramps
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| treatment for rickets | provide calcium, phosphorus, or vitamin D that is lacking. epxosure to moderate amounts of sunlight. vit D supplements. change diet. positioning or bracing to reduce or prevent deformities. surgery
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| Paget's disease | progressive condition characterized by abnormal bone destruction and remodeling, which results in bone deformities.
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