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Pathophysiology

Denver School of Nursing – BSN Program Lecture: Monday & Thursday 8:00 am – 10:45 am No Laboratory component for this class. Pathophysiology. BIO 308 – CH 37 Alterations of Musculoskeletal Function. Traumatic Fracture. Cannonball. General Sickles. Musculoskeletal Injuries.

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Pathophysiology

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  1. Denver School of Nursing – BSN Program Lecture: Monday & Thursday 8:00 am – 10:45 am No Laboratory component for this class Pathophysiology BIO 308 – CH 37 Alterations of Musculoskeletal Function

  2. Traumatic Fracture

  3. Cannonball

  4. General Sickles

  5. Musculoskeletal Injuries • Fractures • A fracture is a break in the continuity of a bone • Classifications • Complete or incomplete • Closed or open • Comminuted • Linear • Oblique • Spiral • Transverse

  6. Fracture Classifications • Greenstick • Torus • Bowing • Pathologic • Stress • Fatigue and insufficiency • Transchondral

  7. Fractures

  8. Total Hip Replacement

  9. Bone Fractures • A broken bone can cause damage to the surrounding tissue, the periosteum, and the blood vessels in the cortex and marrow • Hematoma formation • Bone tissue destruction triggers an inflammatory response • Procallusformation

  10. Callus Formation

  11. Callus Formation

  12. Bone Fractures • Manifestations • Unnatural alignment, swelling, muscle spasm, tenderness, pain, impaired sensation, and possible muscle spasms • Treatment • Closed manipulation, traction, and open reduction • Internal and external fixation

  13. Bone Fractures • Improper reduction or immobilization • Nonunion, delayed union, and malunion

  14. Bone Fractures • Dislocation • Temporary displacement of two bones • Loss of contact between articular cartilage • Subluxation • Contact between articular surfaces is only partially lost

  15. Bone Fractures • Dislocation and subluxation are associated with fractures, muscle imbalance, rheumatoid arthritis, or other forms of joint instability

  16. Support Structure Injuries • Strain • Tear or injury to a tendon or muscle • Sprain • Tear or injury to a ligament • Avulsion • Complete separation of a tendon or ligament from its bony attachment site

  17. Tendinopathy and Bursitis • Tendinitis • Inflammation of a tendon • Tendinosis • Painful degradation of collagen fibers

  18. Tendinopathy and Bursitis • Bursitis • Inflammation of a bursa • Skin over bone, skin over muscle, and muscle and tendon over bone • Caused by repeated trauma • Septic bursitis is caused by a wound infection

  19. Tendinopathy and Bursitis • Epicondylitis • Inflammation of a tendon where it attaches to a bone • Tennis elbow (lateral epicondylitis) • Golfer’s elbow (medial epicondylitis)

  20. Tendinopathy and Bursitis

  21. Muscle Strain • Sudden, forced motion causing the muscle to become stretched beyond its normal capacity • Local muscle damage • Muscle strains can also involve the tendons

  22. Rhabdomyolysis • Rhabdomyolysis (myoglobinuria) is a life-threatening complication of severe muscle trauma with muscle cell loss • Crush syndrome • Compartment syndromes • Volkmann ischemic contracture

  23. Compartment & Crush Syndrome

  24. Osteoporosis • Porous bone • Poorly mineralized bone • Bone density • Normal bone • 833 mg/cm2 • Osteopenic bone • 833 to 648 mg/cm2 • Osteoporosis • <648 mg/cm2

  25. Osteoporosis • Potential causes • Decreased levels of estrogen and testosterone • Decreased activity level • Inadequate levels of vitamins D and C, or Mg++

  26. Osteoporosis • Demonstrated by reduced bone mass/density and an imbalance of bone resorption and formation • Bone histology is usually normal but it lacks structural integrity

  27. Osteoporosis

  28. Osteoporosis

  29. Osteoporosis • Iatrogenic osteoporosis • Regional osteoporosis • Postmenopausal osteoporosis • Glucocorticoid-induced osteoporosis • Age-related bone loss

  30. Osteoporosis

  31. Osteoporosis

  32. Osteoporosis

  33. Osteomalacia • Deficiency of vitamin D lowers the absorption of calcium from the intestines • Inadequate or delayed mineralization • Bone formation progresses to osteoid formation but calcification does not occur; the result is soft bones • Pain, bone fractures, vertebral collapse, bone malformation

  34. Paget Disease • Also called osteitis deformans • Excessive resorption of spongy bone and accelerated formation of softened bone • Disorganized, thickened, but soft bones • Most often affects the axial skeleton

  35. Paget Disease • Thickened bonescan cause abnormal bone curvatures, brain compression, impaired motor function, deafness, atrophy of the optic nerve, etc.

  36. Osteomyelitis • Osteomyelitis is most often caused by a staphylococcal infection • Most common cause is open wound (exogenous); also can be from a blood-borne (endogenous) infection

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