Week 8 Quiz Ch. 44, 45, 47, 51, 52

The classic manifestations of Parkinson disease include: A. Skeletal muscle rigidity and intention tremor. B. Rest tremor and skeletal muscle rigidity. C. Ataxia and intention tremor. D. Intention tremor and akinesia.

B. rest tremor and skeletal muscle rigidity

Osteomalacia is

a bone disorder that comes from insufficient vitamin D in adults. Rickets is the term used for children

Parkinson disease is

a deficiency of dopamine in substantia nigra

Malunion is

a fractured bone that heals with poor alignment

Which disorder usually causes skeletal pain and involves significant bone demineralization from vitamin D deficiency? a. Osteomalacia b. Osteopenia c. Osteomyelitis d. Osteoporosis

a.

A fracture in which bone breaks into two or more fragments is referred to as a. comminuted. b. open. c. greenstick. d. stress.

a. comminuted

Following a bone fracture, the most likely event to occur is a. development of a blood clot beneath the periosteum. b. leukocyte infiltration into bone tissue. c. blood vessel growth at the fracture site. d. migration of osteoblasts to the fracture site

a. development of a blood clot beneath the periosteum

What type of fracture generally occurs in children? a. Greenstick b. Stress c. Nightstick d. Colles

a. greenstick

Muscle strains are caused by

abnormal contractions

Diabetes, smoking, and poor diet can lead to

delayed healing in fracture

Greenstick fracture

incomplete break, common in children

A patient diagnosed with diabetes, smokes a pack of cigarettes daily and eats very few green leafy vegetables. After experiencing a fractured toe, this patient is at risk for a. delayed healing. b. malunion. c. nonunion. d. dysunion.

a.

The disease that is similar to osteomalacia and occurs in growing children is a. rickets. b. osteosarcoma. c. Paget disease. d. osteopenia.

a.

The most common source of osteomyelitis is a. an infection that migrates via the bloodstream. b. direct invasion from a fracture. c. surgical contamination. d. a joint prosthesis.

a.

The most common type of osteomyelitis is a. hematogenous. b. contiguous focus. c. Brodie abscess. d. direct invasion.

a.

Systemic disorders include: A. Verrucae. B. Rheumatoid arthritis. C. Osteoarthritis. D. Adhesive capsulitis.

B. rheumatoid

Cerebral aneurysm is most frequently the result of a. embolic stroke. b. subarachnoid hemorrhage. c. subdural hemorrhage. d. meningitis.

B. subarachnoid hemorrhage

Rickets is characterized by soft, weak bones resulting from a deficiency of: A. Phosphate. B. Vitamin D. C. Estrogen. D. Calcium.

B. vitamin D

characteristics of gout

*Disturbed uric acid metabolism, crystalline deposits in bony and connective tissue, cardiac involvement, and renal involvement* can affect cartilage areas like the ear. Affects the big toe. Kidney stones form from uric acid (renal)

the chief pathologic features of osteoarthritis are ____________

-degeneration of articular cartilage -destruction of the bone under the cartilage -thickening of the synovium

Know the phases of bone healing

1) hematoma, bone is bleeding and known as necrotic area. 2) callus will build around bone and mend the two ends 3) callus is reabsorbed Cortical bone fracture results in torn blood vessels within the Haversian system. Clotting occurs at the fracture site. Avascular bone is replaced by living bone through resorption and bone deposition. Callus formation leads to new bone formation at the edges of the periosteum. Remodeling occurs with replacement of mature lamellar bone. Cancellous fracture healing occurs mainly through development of an internal callus. Rich blood supply present in cancellous bone prevents necrosis of bone at the fracture site. Osteogenic cells in the trabeculae form the primary woven bone. Woven bone eventually replaced by lamellar bone Healing time faster than cortical bone

Characteristics of gout include (select all) A. disturbed uric acid metabolism B. crystalline deposits in bony connective tissue C. onset before menopause in women D. cardiac involvement E. renal involvement

A, B, D, E

Characteristics of scoliosis include (select all) A. involvement of lateral curvature of the spine B. increase during periods of rapid growth C. more common in boys D. identifiable by uneven shoulders or scapular prominence E. possibility of leading to respiratory complications

A, B, D, E

Following a bone fracture, the most likely event to occur is a. development of a blood clot beneath the periosteum. b. leukocyte infiltration into bone tissue. c. blood vessel growth at the fracture site. d. migration of osteoblasts to the fracture site.

A.

Healing of a fractured bone with a poor alignment is called a. malunion. b. nonunion. c. disunion. d. delayed union.

A.

In the acute phase of stroke, treatment is focused on a. stabilization of respiratory and cardiovascular function. b. risk factor modification. c. prevention of bedsores and contractures. d. neurologic rehabilitation.

A.

Manifestations of osteoarthritis include (Select all that apply.)

A. Nodules on joints of the hands B. Crepitus with joint movement C. Narrowing of joint spaces

What are the criteria for diagnosing rheumatoid arthritis? (Select all that apply.)

A. Simultaneous symmetric swelling of joints B. Soft-tissue swelling of at least three joints C. Subcutaneous rheumatoid nodules D. Morning stiffness in joints

The most important determinant for prescribing therapy for acute stroke is: A. Ischemic versus hemorrhagic cause. B. Location of ischemia. c. Thrombotic versus embolic cause. D. Age of the patient.

A. ischemic versus hemorrhagic

delayed union

Anywhere from 3 to 6 months after the fracture, bone pain and tenderness are continuously increasing beyond the expected healing period.

The most important preventative measure for hemorrhagic stroke is a. anticoagulation. b. blood pressure control. c. thrombolytics. d. management of dysrhythmias.

B.

Systemic lupus erythematosus (SLE) is a rheumatic disease attributed to: A. Wear and tear on weight-bearing joints. B. Autoimmune mechanisms. C. Septic joint inflammation and necrosis. D. Unknown etiologic factors.

B. autoimmune

Paget's disease is characterized by: A. Inflammatory disorder resulting in fusion of spine joints. B. Excessive bone resorption followed by excessive formation of fragile bone. C. Failure of resorption by osteoclasts resulting in hard bones. D. Overactivity of osteoblasts leading to multiple bone tumors.

B. excessive bone resorption followed by excessive formation of fragile bone

Gouty arthritis is a complication of: A. Group A streptococcal infection. B. Inadequate renal excretion of uric acid. C. Autoimmune destruction of joint collagen. D. Excessive production of urea.

B. inadequate renal excretion of uric acid

Ankylosing spondylitis causes: A. Instability of synovial joints. B. Intervertebral joint fusion. C. Costal cartilage degeneration. D. Temporomandibular joint degeneration.

B. intervertebral joint fusion

A malignant bone-forming tumor is referred to as a(n) a. rhabdosarcoma. b. liposarcoma. c. osteosarcoma. d. chondrosarcoma.

C.

Ankylosing spondylitis is characterized by: A. Loss of articular cartilage in weight-bearing joints. B. Immune mechanisms leading to widespread joint inflammation. C. Inflammation, stiffness, and fusion of spinal joints. D. Excessive bone remodeling leading to soft bone.

C. Inflammation, stiffness, and fusion of spinal joints.

Rheumatoid arthritis involves joint inflammation caused by A. bacterial infection B. trauma C. autoimmune injury D. congenital hypermobility

C. autoimmune injury

The disorders characterized by softening and then enlargement of bones is referred to as: A. Osteomyelitis. B. Osteoporosis. C. Paget disease. D. Rickets.

C. pagets

A clinical finding consistent with a diagnosis of rheumatoid arthritis would be: A. Reduced excretion of uric acid by the kidney. B. Firm, crystallized nodules or "tophi" at the affected joints. C. Systemic manifestations of inflammation. D. Localized pain in weight-bearing joints.

C. systemic manifestations

Know the different types of fractures

Comminuted fracture: more than one fracture line and more than two bone fragments Impacted fracture: telescopes or drives one fragment into another Greenstick fracture: incomplete break (common in children) Nondisplaced fracture: fragments remain in alignment and position; displaced: ends of fracture fragments are separated Depressed fracture: fragment displaced below the level of the bone surface Complete: break through entire bone; incomplete: break only buckles or cracks Classified as open or compound when skin is penetrated; closed or simple when skin is not broken

Parkinson disease is associated with A. demyelination of CNS neurons B. a pyramidal nerve tract lesion C. insufficient production of acetylcholine in the basal ganglia D. a deficiency of dopamine in the substantia nigra

D. a deficiency of dopamine in the substantia nigra

Although skin manifestations may occur in numerous locations, the classic presentation of systemic lupus erythematosus (SLE) includes: A. Cracked, scaly areas in the webs of fingers. B. Lesions affecting the palms of hands and the soles of feet. C. Dry, scaly patches in the antecubital area and behind the knees. D. A butterfly pattern rash on the face across the bridge of the nose.

D. butterfly pattern rash

Bone healing may be impaired by: A. Excessive vitamin C. B. A high-protein diet. C. Immobilization. D. Nicotine use.

D. nicotine use

Rupture of a cerebral aneurysm should be suspected if the patient reports a. ringing in the ears. b. transient episodes of numbness. c. transient episodes of vertigo. d. sudden, severe headache.

D. sudden, severe, headache

In contrast to osteoarthritis, rheumatoid arthritis may be associated with A. debilitating joint pain and stiffness B. improvement in symptoms with asprin therapy C. changes in activities of daily living D. systemic aching in the musculoskeletal system

D. systemic aching in the musculoskeletal system

Know the difference between osteoarthritis and rheumatoid arthritis

Osteoarthritis: Unilateral, NOT autoimmune, NOT inflammatory. *-degeneration of articular cartilage -destruction of bone under the cartilage -thickening of the synovium* From wear and tear on the body from older people or athletes Rheumatoid: systemic autoimmune inflammatory condition

what can lead to delayed healing in fracture?

Diabetes, smoking, and poor diet

Viral infection can cause

Encephalitis

characteristics of scoliosis

Lateral curvature, increase in periods of rapid growth, uneven shoulders, scapular prominence, and respiratory complications

Osteoarthritis

Local degenerative joint disorder associated with aging and wear and tear from repetitive stress. UNILATERAL, NOT AUTOIMMINE, NOT INFLAMMATORY. -degeneration of articular cartilage -destruction of the bone under the cartilage -thickening of the synovium Most common in the world Characterized by loss of articular cartilage, cartilage calcifies, wear of underlying bone, and the formation of bone spurs; noninflammatory; weight-bearing joints are often affected

headache is

One common cause of acute pain

risk factors and symptoms for meningitis

Risk factors: being in close contact with someone who has meningitis Signs and symptoms: fever, headache, stiff neck

Gouty arthritis is

an inadequate renal excretion of uric acid

SLE (systemic lupus erythematosus)

autoimmune and butterfly rash

A risk factor for osteoporosis is a. endometriosis. b. early menopause. c. late menopause. d. ovarian cysts.

b.

Complete healing of a bone fracture occurs when a. no movement of the break is detectable. b. the callus has been completely replaced with mature bone. c. the fracture site and surrounding soft tissue are pain free. d. a cast is no longer required to stabilize the break.

b.

Most muscle strains are caused by a. a tear in an adjoining tendon. b. abnormal muscle contraction. c. muscle asymmetry. d. bleeding into the muscle.

b. abnormal muscle contraction

A college student living in a dormitory, reports a stiff neck and headache and is found to have a fever of 102° F. This information is most consistent with a. encephalitis. b. meningitis. c. skull fracture. d. cerebral ischemia.

b. meningitis

Osteoporosis can lead to

bone fractures early menopause is a risk factor for osteoporosis

Multiple myeloma has a common symptom of

bone pain

Risk factors for hemorrhagic stroke include a. atherosclerosis. b. dysrhythmias. c. acute hypertension. d. sedentary lifestyle.

c. acute hypertension

It is true that encephalitis is usually a. due to a bacterial infection in the CNS. b. fatal. c. due to a viral infection in brain cells. d. asymptomatic.

c. it is a viral infection

SLE has a

classic presentation of butterfly rash and is autoimmune

Complete and incomplete fracture

complete: break through entire bone incomplete: break only buckles or cracks

Stroke of one side of the cerebral hemisphere will affect the

contralateral side

People who have osteoporosis are at risk for a. rhabdomyolysis. b. osteomyelitis. c. osteomalacia. d. bone fractures.

d. bone fractures

Paget's disease

excessive bone resorption followed by excessive formation of fragile bone

Depressed fracture

fragment displaced below the level of the bone surface

One common cause of acute pain is

headache

Osteomyelitis is

hematogenous

Acute hypertension is a risk factor for

hemorrhagic stroke

Blood pressure is a risk factor for

hemorrhagic stroke

During acute stroke is important to distinguish between

ischemic: decreased blood flow to the area. That area of the brain will be ischemic and the tissue can die (necrotic). Will be treated with tPA, clot buster. hemorrhagic: too much blood. High blood pressure (hypertension) is a great risk factor. Will be treated with a suppressor.

Healing process Callus formation

leads to new bone formation at the edges of the periosteum. Remodeling occurs with replacement of mature lamellar bone (complete replacement of mature bone)

Comminuted fracture

more than one fracture line and more than two bone fragments

Parkinson disease will give

rest tremor and skeletal muscle rigidity

Healing process Cortical bone fracture

results in torn blood vessels within the Haversian system. Clotting occurs at the fracture site. Avascular bone is replaced by living bone through resorption and bone deposition.

Migraine will present as

severe, pounding headache with nausea and photophobia

In acute stroke, what do you want to stabalize?

stabilize cardiovascular system and respiratory system

Cerebral aneurysm results in

subarachnoid hemorrhage

Impacted fracture

telescopes or drives one fragment into another

The most common site for Paget's disease is

the lower spine

Nonunion

total failure of healing of a fracture Not healed by >6 months after a fracture Osteonecrosis (avascular necrosis), osteomyelitis, and neurovascular injury may also occur.

tell me again the name of that chemical that makes crystals when my gout flares up" the nurses best response is _______

uric acid

Encephalitis is caused by

viral infection

The pathophysiology of rheumatoid arthritis involves: A. Free radicals attaching to the synovial membrane and tunneling into articular cartilage. B. Excessive wear and tear and microtrauma that damage articular cartilage. C. Immune cells accumulating in pannus and destroying articular cartilage. D. Cysts developing in subchondral bone and creating fissures in articular cartilage.

C.

A bone disorder that results from insufficient vitamin D is referred to as a. rickets. b. osteoporosis. c. osteomalacia. d. subluxation.

c.

Clinical manifestations of a stroke within the right cerebral hemisphere include a. cortical blindness. b. right visual field blind ness. c. expressive and receptive aphasia. d. left - sided muscle weakness and neglect.

D.

Osteosarcoma is

a malignant bone forming tumor

Early menopause is

a risk factor for osteoporosis

Cerebral aneurysms present with

a severe, sudden headache

Pain is

a subjective experience difficult to measure objectively

Rheumatoid arthritis is

a systemic inflammatory autoimmune condition

A compound, transverse fracture is best described as a bone that is a. broken in two or more pieces. b. cracked but not completely separated. c. broken along the long axis. d. broken and protruding through the skin

d.

Healing process of Cancellous fracture

healing occurs mainly through development of an internal callus. Rich blood supply present in cancellous bone prevents necrosis of bone at the fracture site. Osteogenic cells in the trabeculae form the primary woven bone. Woven bone eventually replaced by lamellar bone Healing time faster than cortical bone

hemorrhagic stroke risk factor

high blood pressure, acute hypertension

Ankylosing spondylitis has

inflammation, stiffness, and fusion of spinal joints

Nondisplaced and displaced fracture

nondisplaced: fragments remain in alignment and position displaced: ends of fracture fragments are separated