Pathophysiology Chapter 48 HW #10 Musculoskeletal week 14.docx

Marvin is a healthy, active 36-year-old who belongs to a martial arts club. Once a week, he takes lessons in Judo, and on the weekends, he participates in local competitions. At his last competition, Marvin was paired with a skilled participant from another club. His rival threw him to the mats, and as Marvin struggled, came down hard to pin him down. Marvin heard a snap, followed by instant pain in his left forearm. Radiographs at the local hospital confirmed that he suffered a transverse fracture of the distal aspect of his left ulna (Learning Objectives 1, 2, and 8). 1. What are the typical signs and symptoms of a fracture? Why shortly after the injury does the pain temporarily subside? Signs and symptoms of a fracture include pain, tenderness at the site of bone disruption, swelling, loss of function, deformity of the affected part, and abnormal mobility. Shortly after a fracture has occurred, nerve function at the fracture site may be temporarily lost. The pain temporarily subsides shortly after an injury because, the area may become numb, and the surrounding muscle flaccid. This condition has been called local shock and during this time, which could last a few minutes, fractured bone pain may be reduced to little or no pain. This study source was downloaded by from CourseH on :52:15 GMT -05:00 Your text here 1 2. How does a hematoma form, and what function does it serve in the process of healing a fracture? A hematoma is the result of a traumatic injury to your skin or the tissues underneath your skin. When blood vessels under your skin are damaged and leak, the blood pools and results in a bruise. A hematoma forms as your blood clots, resulting in swelling and pain. The process involves internal and external Calli formation where chondrocyte create internal callus and osteoclasts create external callus. The cartilage of callus is replaced by trabecular bone and then remodelling occurs. When a fracture occurs, bleeding creates hematoma, which surrounds the ends of the fragments. The hematoma is the extravasated blood that changes from liquid into semi-solid clot. This occurs within initial 72 hours after injury. Then organization of hematoma into a fibrous network occurs. During this stage active phagocytosis absorbs the product of local necrosis. The hematoma is converted into granulation tissue which form the basis for new bone substance called osteoid from 3 to 14 days post-injury. 3. Marvin was told he would be seeing a physiotherapist as his healing progressed. What are the muscular and joint changes that occur during immobilization and the ways Marvin and his physiotherapist can work to address these changes? The pathological changes of muscle tissue caused by immobilization-induced joint contracture include disuse skeletal muscle atrophy, loss of strength and endurance, contractures and soft tissue changes, disuse osteoporosis and degenerative bone disease. Physiotherapist would help Marvin by conducting a neurovascular assessment of the extremities: includes peripheral vascular assessment (color, temperature, capillary refill, peripheral pulses and edema) and a peripheral neurological assessment (sensation, motor function and pain). Throughout the neurovascular assessment compare both extremities, using range of motion exercises for instance, abduction and adduction of fingers, opposition of fingers, supination and pronation of hands to mobilize his bones since in fracture there are no range of motion. These exercises will assist him to return his forearm back to normal