Question

Mrs. Debbie Morgan is a 45-year-old female who works as a stocking clerk for a local home improvement store. While she was at work today a large box of metal rivets fell from a 20-ft.-high overhead shelf, striking her outstretched arm and knocking her to the ground. The ambulance personnel reported that she had lost quite a bit of blood at the accident scene and was “knocked out” when they arrived. To minimize further hemorrhage, the paramedics applied a pressure bandage to her arm.

You meet the paramedics as they bring Mrs. Morgan into the emergency room and begin to assess her for injuries. She is awake and alert, but complaining of severe left arm and back pain, plus she has a “killer headache.” To fully examine her injuries you remove four blood-soaked bandages from her arm. You notice a large open wound on her arm with what appears to be bone tissue sticking out of the skin. She also has bruises covering her left shoulder, left wrist, and lower back. To determine the extent of her injuries Mrs. Morgan undergoes several x-rays, which reveal the following:

1) fracture of the left humerus at the proximal diaphysis,

2) depressed fracture of the occipital bone,

3) fracture of the 3rd lumbar vertebral body.

Short Answer Questions

Define the following terms, used in the case and also in associated questions (1 point each):

1. hemorrhage
2. fracture
3. proximal
4. diaphysis

Answer 1

Hemorrhage

Hemorrhage is defined as escape of blood out of the blood vessels due to injury or illness which results into rupture of the blood vessels, it can involve any vessel such as veins, capillaries or arteries.

It has two types - external and internal.

External hemorrhage is one in which blood can be seen such as epistaxis.

Internal hemorrhage is one which is not seen outside such as hematoma.

Fracture

Fracture is defined as a break in continuity of the bone. It is caused due to trauma, road traffic accidents, or crushing injuries.

Signs and symptoms of fracture include - pain, swelling, deformity, loss of transmitted movements, tenderness, crepitus, abnormal mobility and bruising etc.

Fracture can be either open or close.

In open fracture, there is break or breach in the skin whereas in close fracture the skin is intact.

Proximal

Proximal is a relative position in human body. Proximal means near to the site of origin or attachment whereas distal means away from the site of the attachment or origin of the body part.

Example - head of the humerus is proximal whereas trochlea and capitulum are distal

Diaphysis

Bone has three parts - epiphysis, diaphysis and metaphysis.

Epiphysis is the initial part of the bone which has role in bone growth.

Metaphysis is the part of bone found in between epiphysis and diaphysis.

Diaphysis is the long part of the bone which is made up of cortical bone mainly. It is the site for bone ossification.