Clinical Case Study: Look Out Below (Bones)

Look Out Below: A Case Study on Bone Tissue Structure and Repair

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

1. Define the following terms, used in the case and also in associated questions:

a. hemorrhage

“a profuse discharge of blood as from a ruptured vessel; bleeding.” (Dictionary.com) 1

b. fracture

A complete, or partial break in the bone.

c. Proximal

“Nearest to a point of reference, as to a center or median line or to the point of attachment or origin.” (medical-dictionary.thefreedictionary.com)2

d. diaphysis

“The portion of a long bone between the ends or extremities, which is usually articular, and wider than the shaft; it consists of a tube of compact bone, enclosing the medullary cavity.”(medical-dictionary.thefreedictionary.com)3

2. One...