Guided Lecture Notes
Chapter 42: Disorders of the Skeletal System: Trauma, Infection, and Childhood
Disorders
Learning Objective 1. Describe the physical agents responsible for soft tissue trauma.

Explain what is meant by soft tissue and identify causes of soft tissue trauma.
Learning Objective 2. Differentiate among the three types of soft tissue injuries.

Define contusion, hematoma, and laceration, and compare the signs and
symptoms.
Learning Objective 3. Compare muscle strains and ligamentous sprains (refer to
PowerPoint Slides 2–4).

Explain the difference between a strain and a sprain in terms of affected tissue,
clinical presentation, and treatment (refer to Fig. 42-1).

Differentiate between dislocations, loose bodies, rotator cuff injuries, knee
injuries, and hip injuries in terms of causes, clinical manifestations, diagnosis, and
treatment (refer to Figs. 42-2–42-4).
Learning Objective 4. Differentiate open from closed fractures (refer to PowerPoint
Slide 7 and Fig. 42-5).

Identify the three categories of fractures.

Explain the difference between an open and a closed fracture.

Describe how fractures are classified.
Learning Objective 5. List the signs and symptoms of a fracture.
Learning Objective 6. Explain the measures used in the treatment of fractures.

Discuss the diagnosis and treatment of various types of fractures.
Learning Objective 7. Describe the fracture healing process.

Describe the process by which bones heal (refer to PowerPoint Slide 8).

Identify factors that affect healing time and describe impaired bone healing (refer
to Chart 42-1).
Learning Objective 8. Differentiate the early complications of fractures from later
complications of fracture healing.

Identify the complications of fracture healing, and describe the clinical
manifestations and contributing factors associated with each complication (refer
to PowerPoint Slide 11, Table 42-1, and Fig. 42-7).
Learning Objective 9. Explain the implications of bone infections.

Identify common causes of bone infections, and discuss the clinical course and
difficulty of treating such infections.
Learning Objective 10. Differentiate among osteomyelitis due to spread from a
contaminated wound, hematogenous osteomyelitis, and osteomyelitis due to vascular
insufficiency in terms of etiologies, manifestations, and treatment.

Compare osteomyelitis due to contiguous spread, hematogenous osteomyelitis,
and osteomyelitis with vascular insufficiency in terms of etiology, pathology,
clinical manifestations, diagnosis, and treatment (refer to PowerPoint Slides 12–
14 and Fig. 42-8).
Learning Objective 11. Cite the characteristics of chronic osteomyelitis.

Define sequestrum and involucrum.
Learning Objective 12. Describe the most common sites of tuberculosis of the bone.

Describe the etiology, pathology, clinical manifestations, diagnosis, and treatment
of TB of the bone.
Learning Objective 13. Define osteonecrosis.
Learning Objective 14. Cite four major causes of osteonecrosis.

Discuss the incidence of osteonecrosis and identify the four most common causes
(refer to PowerPoint Slide 15 and Chart 42-2).
Learning Objective 15. Characterize the blood supply of bone and relate it to the
pathologic features of osteonecrosis.

Describe the pathology associated with osteonecrosis (refer to Fig. 42-9).
Learning Objective 16. Describe the methods used in the diagnosis and treatment of
osteonecrosis.
Learning Objective 17. Differentiate between the properties of benign and malignant
tumors.

Compare benign and malignant tumors in terms of characteristic pathology,
metastasis, and speed of growth (refer to PowerPoint Slides 18–20).
Learning Objective 18. Contrast osteogenic sarcoma, Ewing sarcoma, and
chrondrosarcoma in terms of the most common age groups and anatomic sites that are
affected.

Differentiate among osteogenic, Ewing, and chondrosarcomas in terms of
etiology, pathology, clinical manifestations, diagnosis, and treatment (refer to Fig.
42-10).
Learning Objective 19. List the primary sites of tumors that frequently metastasize to
the bone.

Identify tumor locations that are most likely to metastasize to bone.
Learning Objective 20. State the three primary goals of treatment of metastatic bone
disease.
Learning Objective 21. Differentiate between intoeing and outtoeing.

Describe variations in the normal growth and development of the skeletal system.

Explain the difference between intoeing and outtoeing in terms of causes and
treatment (refer to PowerPoint Slide 24 and Figs. 42-12 and 42-13).
Learning Objective 22. Describe common torsional deformities that occur in infants
and small children, proposed mechanisms of development, diagnostic methods, and
treatment.

Compare tibial and femoral torsion in terms of incidence, etiology, clinical
presentation, diagnosis, and treatment (refer to Figs. 42-11, 42-14, and 42-15).
Learning Objective 23. Define the terms genu varum and genu valgum.

Compare genu varum and genu valgum in terms of clinical presentation and
treatment (refer to PowerPoint Slide 24 and Figs. 42-16 and 42-17).
Learning Objective 24. List the problems that occur because of defective tissue
synthesis in osteogenesis imperfecta.

Identify the defective tissue and associated clinical problems that occur in
osteogenesis imperfecta (refer to PowerPoint Slide 26).
Learning Objective 25. Characterize the abnormalities associated with developmental
dysplasia of the hip and methods for diagnosis.

Describe the etiology, pathology, clinical manifestations, diagnosis, and treatment
of developmental hip dysplasia (refer to PowerPoint Slide 25 and Figs. 42-19
and 42-20).

Explain the importance of early diagnosis of developmental hip dysplasia.
Learning Objective 26. Describe the treatment for a newborn with clubfoot.

Compare developmental deformities of the foot in terms of etiology, pathology,
clinical manifestations, diagnosis, and treatment (refer to PowerPoint Slide 25
and Fig. 42-19).
Learning Objective 27. Define the term osteochondrosis.

Define juvenile osteochondrosis, and identify the two types (refer to PowerPoint
Slide 26).
Learning Objective 28. Describe the pathology and symptomatology of Legg-CalvéPerthes disease and Osgood-Schlatter disease.

Differentiate between Legg-Calvé-Perthes disease and Osgood-Schlatter disease
with regard to etiology, pathology, clinical manifestations, diagnosis, and
treatment (refer to Fig. 42-21).
Learning Objective 29. Differentiate among congenital, neuromuscular, and idiopathic
scoliosis.

Compare congenital, neuromuscular, and idiopathic scoliosis in terms of etiology,
pathology, clinical manifestations, diagnosis, and treatment (refer to PowerPoint
Slide 27 and Fig. 42-22).