HUMB2009 Lecture Notes - Lecture 2: Osteoarthritis, Collagen, Tuberosity Of The Tibia

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5 Aug 2018

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Fractures can be classified according to: cause, soft tissue lesion promoted by the fracture, type of fracture line ligament rupture on ankle fall could lead to injury on the junction between the lumbar and thoracic spine. Pott"s fracture: medial malleolus with loss of ankle mortise. Jones fracture: fracture on the proximal 5th metatarsal. Lis franc fracture/dislocation: dislocation involving the articulation of tarsus with the metatarsal bases. Osgood-schlatter disease: chronic fatigue injury at the patellar ligament insertion onto tibial tuberosity. Or apophysitis of the tibial tubercle, is an inflammation of the patellar ligament at is inserted on tibial tuberosity due to the repetitive quadriceps contraction. Can be studied using xr, us and mri. Commonly affecting boys between age of 10-15. Us: can detect if there is any swelling within the tissue as well as cartilage swelling at a early stage. Xr: lateral view shows changes in tibial tuberosity (irregular) Mri: shows the bone and tendon changes, associated swelling.

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Chief Complaint: 72-year-old woman who fell on her right hip.

History: Margaret Donovan, a 72-year-old white female, was brought to the emergency room by her son-in-law after falling in her bathtub. She was previously in good health, despite leading a relatively sedentary lifestyle and having a 30-year history of cigarette smoking. The only medication she currently takes is Inderal (propranolol) for mild hypertension (high blood pressure). She fell upon entering the bathtub when her right leg slipped out from under her; she landed on her right hip. There was no trauma to her head, nor does she complain of right or left wrist pain. However, she reports severe pain in the right hip and upper thigh, and was unable to get up after her fall. An injection of oxymorphone hydrochloride (Numorphan) helped relieve her pain and she was taken to the radiology department for an X-ray of her right leg and hip.

Physical examination: The patient was alert, oriented to time, place and date, and was responding appropriately to questions despite being in considerable pain. There were no signs of trauma to the head, neck, torso, arms or left leg. The right thigh and hip were extremely tender and were immobilized by a leg splint. Heart and lung sounds were normal and abdominal sounds were reduced.

Radiology report: The X-ray of the right hip revealed a complete, comminuted, intertrochanteric fracture of the right hip. No other fractures were noted in the right leg. There were also long-term osteoporotic changes in the femur, tibia and fibula.

Surgeons performed an open reduction of Margaretâs fracture, immobilizing the bones with internal pins. ORIF is a procedure in which the broken bones are re-aligned and long, thick pins are inserted lengthwise into the bone tissue. The pins are held in place by screws drilled in from the outside of the bone.

Please Answer the Following Questions

Please answer the following questions regarding this case study.

1. Pick out at least 5 med term words from the case study and dissect them into their prefixes, suffixes and word roots â defining each.

2. What is meant by a âcomplete, comminuted, intertrochanteric fracture of the right hip?â

Use as many medical term words as possible to answer this question:

Read the medical report, and answer the following questions: Mr. Feingold had epigastric pain, nausea and diarrhea. Explain the meaning of each of these terms. Mr. Feingold took Mylanta and Pepcid for his discomfort. Identify the category of each drug and describe each. Mr. Feingold had an "occult blood test" that showed blood in the feces. Explain how this test is done. Mr. Feingold had a colonoscopy. Describe the test, the preparation that is needed, and what parts of the gastrointestinal system the physician can visualize. Mr. Feingold had a biopsy. Explain what this is and how it is done. Medical Report: Consultation: Evaluation of recurrent epigastric pain, nausea and diarrhea. History of Present Illness: Mr. Feingold is a 60-year-old white male who has had severe and recurrent epigastric pain, nausea, and occasional diarrhea for the past 2 years. His symptoms have become more severe in the past six months, resulting in 2 visits to the emergency room. A 20-pound weight loss has occurred over the past six months. He has treated his symptoms with Mylanta and Pepcid, but has not sought medical intervention until the past six months. He has had no reported illnesses throughout his life, with the exception of a left leg fracture at age 20 due to a skiing accident. Results of Physical Examination Abdomen soft and distended. Patient complains of mild pain and tenderness in lower abdomen. An occult blood test is positive for blood in the feces. Colonoscopy reveals growths in the colon. Biopsies reveal Stage III colon cancer. Recommendations: Surgery to remove the tumors, resection of affected colon, and colonoscopy to be followed by chemotherapy for 6 to 8 months.

A 2-year-old male child was brought to the emergency room to determine why he was suddenly refusing to walk and complaining of pain in his right leg. There was no history of trauma. He had been seen by his pediatrician earlier in the day due to the presence of fever and with an upper respiratory infection; he was diagnosed with otitis media, prescribed an antibiotic, and sent home.

Physical tests in the emergency room revealed pain and tenderness of the right ankle. There was also some edema and erythema. X-ray tests of the lower extremities did not reveal any fractures or displacements. Laboratory tests were ordered on his peripheral blood and a fluid aspirate was taken from the ankle. Lab results on these samples are listed on the table below:

Peripheral Blood WBC Count	26,000/Î¼L
Peripheral Blood Differential	Neutrophils 77% Lymphocytes 19% Monocytes 4%
Erythrocyte Sedimentation Rate	Elevated
Plasma Glucose	96 mg/dL
Ankle Fluid Physical Appearance	Yellow, purulent
Ankle Fluid WBC Count	22,000/Î¼L
Ankle Fluid RBC Count	375,000/Î¼L
Ankle Fluid Differential	Neutrophils 95% Macrophages 5%
Ankle Fluid Glucose	39 mg/dL

What is the name for the fluid collected from the patientâs ankle, and what is the procedure used to collect that fluid called?

What collection tubes should the fluid be placed into, and to which laboratory department does each tube go?

Which lab results are abnormal?

What type of disorder do you suspect causing the illness in this patient? (More than one answer may be correct)

What additional testing could be performed to prove your suspected diagnosis?

HUMB2009 Lecture Notes - Lecture 2: Osteoarthritis, Collagen, Tuberosity Of The Tibia

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