broken hip with answer 4

A. long bones are the thickest midway down the diaphysis, where the stresses are the greatest.

S.P. is admitted to the orthopedic ward. She has fallen at home and she has sustained an intracapsular fracture of the hip at the femoral neck. The following history is obtained from her: She is a 75-year-old widow with three children living nearby. Her father died of cancer at age 62; mother died of heart failure at age 79. Her height is 5’3 and weighs 118 pounds. She has a 50 pack year smoking history and denies alcohol use. She has severe Rheumatoid Arthritis (RA) and had an upper GI bleed in 1993 and had Coronary Artery Disease with CABG 9 months ago. Since that time, she has engaged in “very mild exercise at home.” Vital signs are 128/60, 98, 14, 99 degree farenheight (32.7 degrees C) SAO2 94%

Patient complained she was short of breath and experiencing severe pain between her shoulder blades. She stated that she has been feeling nasuseated for the past 3 hours. She states she has a history of stable angina and is currently taking medication as needed. She states she did not take the nitroglycerin because she was not experiencing chest pain, just back pain. She states that her last check-up with the Pulmonologist showed that her EKG did not show any changes since her last visit. She denies episodes of syncope. The patient does report that she tripped over something on the floor, which resulted in her falling and hitting her back on a large table. In addition, she states that her heart rate has been ranging from 130/ 90 to 140/92. Patient states her Primary care physician placed her on blood pressure medication 2 months ago due to the increase.

“Bonnie Bowser, eighty-two years old, fell and severely injured her elbow. She was examined at the Emergency Department of the Miraculous Regional Health System and diagnosed with a fractured olecranon process, and referred to an orthopedic surgeon. The surgeon who examined Mrs. Bowser scheduled her for corrective surgery the next day. He noted in his examination that she had a past medical history of hypertension, diabetes mellitus, two myocardial infarctions with quadruple bypass surgery, and a cerebrovascular accident affecting her left side. She was taking several medications including Lasix (a diuretic), Vasotec (for treatment of hypertension and symptomatic congestive heart failure), Kylotrix (potassium supplement),

One afternoon a 67 year-old man presented to the emergency department of a small, rural hospital complaining of severe left leg and hip pain following a fall at home. The patient had no past history of falls. He had a history of impaired glucose intolerance, prostate cancer, hypercholesterolemia and hyperlipidemia. The patient’s current medications were atorvastatin and oxycodone for chronic back pain. The patient stated his pain was ten out of ten on a scale of one to ten with ten being the worst. The left leg appeared shorter than the right, edema was present in the calf, as was ecchymosis and he had limited range of motion. After an evaluation in triage by a registered nurse and a subsequent examination by the emergency department physician, a plan was established to sedate the patient using moderation sedation protocol and perform a manual reduction of the hip.

From the days of Still we are reminded that structure and function are a primary focus reciprocally interrelated-so much so that the basic structure of the skeleton and the parts that make it up are designed to operate a certain mechanical way. The physiological and deeper functional

R.P. is a 74-year-old married Caucasian female that is a homemaker that lives at home with her husband. Reason for her care is due to a recent fractured left hip and left wrist. She stated that she slipped on a rug in her home and landed on her left side. R.P. reports pain being 10/10 and sharp and radiates all over body stating, “even the slightest touch of skin hurts so much”. It all began a few minutes after the fall. Pain is alleviated with narcotics (hydromorphone and morphine) and immobilization.

At today’s visit she is found sitting in her room in her wheelchair. She is awake, alert and oriented. She reports that she has had multiple falls over the weekend. She denies pain, shortness of breath and chest pain. The facility staff reports that she has had multiple falls and seems to be falling more lately. The patient uses a wheelchair;

Christina sent to physical therapy after acute injury two weeks ago. Reportedly slipped on a wet surface went airborne and landed violently on her buttock. I do not believe this was documented but this was what described to me. She notes prior to that she had no real history of any real back issues and was working in the maintenance job. Oddly, she was in the hospital back in early fall and they did a lumbar MRI which is fairly negative. I do not have the results in the chart at this point. Apparently, it was done because she said she had some leg tingling. I am not sure what to make of that. Regardless, she does not report a lot of history and had a high level of function. Stating she would like to work and be active. She states since his acute fall she has been fairly miserable. She notes intense right buttock and right leg numbness and pain. Pain can fluctuate from a 9/10 to a 0 depending on activity and position. Notes increased pain with Valsalva, coughing, or sneezing, but particularly Valsalva maneuvers. Most relief of pain is supine with the knees

There are two types of osteoporosis that have been identified which are primary and secondary. Osteoporotic bones are thin and brittle and are prone to fracture. The bone loss involves both compact and spongy bone. In type I osteoporosis, which occurs typically in postmenopausal women, spongy bone loss predominates, occurring most prominently in the vertebrae and distal radius (Gueldner, Burke, Smiciknas-Wright, 2000). Major complications of type I osteoporosis are crush fractures of the vertebral bodies and the distal end of the radius. Type II, or old-age, osteoporosis is characterized by a proportional loss of compact and spongy bone of the long bones (Gueldner, Burke, Smiciknis-Wright). The most serious fractures of old age are those of

Describe the microscopic features of osseous tissue that normally help long bones withstand lateral stress without breaking.

Osteoporosis is a progressive silent disease that affects the quality of the bone, due to the decrease in bone mineral density , the bone becomes more porous and fragile, and the risk of fracture will increase , osteoporosis has no signs or symptoms , and people may not know that they have the disease until their bone becomes so weak that a sudden strain, fall will causes a bone to break, , the fractures that related to the osteoporosis cause pain, Disability, reduce mobility, long-term disability and reduced quality of life . The recovery from these fractures is slow, rehabilitation is often incomplete and patients nearly have to hospitalize or even have to home nursing. the most common sites of osteoporotic fracture are Hip, spine, distal forearm, and proximal humerus .

Osteoporosis affects the strength and durability of your bones. Your bones become weaker and more likely to break (fracture). If you have osteoporosis, your bones can become so weak they break from a minor accident, like a simple fall. The bones of your hip, wrist, and spine are most likely to break.

The patient is an 87-year-old female who was recently hospitalized here at St. Joseph's Medical Center and discharge to rehabilitation spent approximately 3 weeks in the rehabs setting and was home for a day before she represented to the emergency room complaining of inability to move, profound weakness, right hip pain and right thigh swelling, as well as bilateral leg edema. The patient's medical history is significant for afib, coronary disease, congestive heart for diabetes mellitus, GERD, thyroid disease, sick sinus syndrome with permanent pacemaker. She has undergone CABG, nausea, profound vascular disease, anemia, severe gastroparesis, as well as having had polio, she presents with profound weakness and she is essentially bedbound.

The patient is a 78-year-old female who had a recent fall. She fell on the left side. She has a very large left medial thigh hematoma. She continued to feel weak and unable to care for herself at home and presented to the ED. She is known to have hypertension, insulin dependent diabetes mellitus, a TIA in 1998 with some minimal left-sided weakness and she has had nephrolithiasis. In the ED she was found that her creatinine has gone from 1.2-1.82. Sodium on admission was 130 with a glucose of 360 which suggests that she has some hyponatremia not as profoundas the 130 would suggest. The patient has a complained of pain all over her body, her neck, her arms and her back. She is evaluated by physical therapy who feels that she is unsafe