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CABS - MSK > pathophysiology of skeletal muscle disorders, deficiency disorders and metabolic bone disorders (wrapping up) > Flashcards

pathophysiology of skeletal muscle disorders, deficiency disorders and metabolic bone disorders (wrapping up) Flashcards

1
Q

what are contractures

A

chronic, progressive loss of joint ROM secondary to tightening of non-bony tissues
- hypertrophy or sclerosis of ligaments, musculature, tendons

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2
Q

what are contractures typically due to

A

immobilization
can be congenital disease such as (DM or CP)
Arthritis
CNS injury
ulcers, burns
surgery/trauma

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3
Q

how long does it take muscle fiber protein synthesis to decrease

A

first 6 hours of a joint being immobilized

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4
Q

when does muscle fiber shortening occur after a joint is immobilized

A

first 24 hours

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5
Q

what is the most common physical symptom associated with stress/anxiety

A

stress-induced muscle tension

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6
Q

what are tension headaches due to

A

muscle spasms in the neck

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7
Q

what is fibromyalgia

A

diffuse pain without the classic structural changes that cause discomfort (no inflammation or tissue damage) - disordered pain regulation

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8
Q

what is the cause of fibromyalgia

A

genetic predisposition, serotonin or catecholamine signaling pathway, increase substance P in CSF, decreased grey matter overall

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9
Q

what is myositis

A

disease process that result sin muscle inflammation - muscle fatigue and weakness

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10
Q

what causes myositis

A

viral: typically influenza A&B or enteroviruses
Bacterial: pyomyositis - typically hematogenous spread
Parasitic: most commonly associated with trichinosis, cysticercosis, toxoplasmosis - associated with travel

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11
Q

what can extreme viral myositis lead to

A

rhabdomyolysis or compartment syndrome

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12
Q

what is polymyositis

A

immunite-mediatedd myopathy
most commonly affects proximal muscle groups and is symmetrical muscular weakness

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13
Q

what is dermatomyositis

A

immune mediation myopathy
most commonly affects the proximal muscle groups, symmetrical muscular weakness and presents wtih skin involvement

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14
Q

what is the skin involvement in dermatomyositis

A

gottron papules
heliotrope eruption
facial erythema
holster sign

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15
Q

what is rhabdomyolysis

A

disease process in which muscle necrosis occurs leading to the release of intracelluar contents

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16
Q

what is injured during rhabdomyolysis

A

myocytes and their membranes

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17
Q

what is myoglobin

A

O2 binding protein (contains heme- why the urine will be + for blood) that stores it until needed for ATP and muscle contraction

18
Q

what are complications of rhabdomyolysis

A

acute kidney injury - secondary to renal tubular obstruction from heme casts
compartment syndrome - may be a secondary issue or cause rhabdo
disseminated intravascular coagulation- rare and may develop associated with release of thromboplastin

19
Q

what is the primary causes of phabdo

A

crush injury
alcohol
opiates
seizures
marathons/military basic training

20
Q

what is the presentation of rhabdo

A

myalgias
red/brown urine
malaise
fever
tachycardia
N/V

21
Q

what is ostomalacia

A

metabolic bone disease leading to ‘bone softening’
reduced bone mineralization that can occur at any age

22
Q

what is the presentation of osteomalacia

A

bone and muscle pain, increased frequency of fractures and fatigue

23
Q

what does osteomalacia result in

A

unmineralized osteoid

24
Q

what is ostoemalacia associated with

A

vitamin D deficiency, malabsorption, hypophophatemia, ETOH abuse, tumors and drugs

25
Q

what is Rickets

A

insufficient mineralziation of the growth plate
congenital or aquired

26
Q

what is rickets associated with

A

inadequate calcium and or phosphate

growth plate enlarges and disorganized

27
Q

what does rickets lead to

A

weakness and bowing of the bones - occurs prior to closure of the growth plates

28
Q

what is osteoporosis and osteopenia

A

low bone mass
- continuum of disease

29
Q

what does osteoporosis and osteopenia lead to

A

bone fragility because of the low bone mass and micro-architectural disruption

30
Q

what are the deficiencies in osteoporosis/osteopenia

A

both nutritional supply as well as hormonal support will cause a decrease in bone integrity

31
Q

How does thyroid disorders lead to osteoporosis/osteopenia

A

PTH produces more calcium which increases osteoclast activity

32
Q

what are the causes of osteoporosis/osteopenia

A

failure to reach peak bone mass
worsens throughout later years during times of bone mass
genetic predisposition
hormonal disorders
poor nutrition
tobacco use

33
Q

what is Paget’s disease also known as

A

osteitis deformans

34
Q

what is pagets disease

A

idiopathic dysregulation of bone remodeling results in enlarged, deformed bone - thought to be a cellular abnormality or associated with viral infection such as RSV

35
Q

what does vitamin D deficiency lead to

A

hypocalcemia and or hypophosphatemia and may result in rickets aor osteomalacia

36
Q

what is Vitamin D

A

fat soluble vitamin that assists with the absorption of calcium, magnesium and phosphate and helps with homeostasis of bone metabolism

37
Q

how much vitamin D is absorbed through the skin

A

50-90%

38
Q

what does vitamin D deficiency result from

A

decrease dietary intake/absorption
decreased sunlight absorption
decrease endogenous synthesis
increased liver breakdown

39
Q

what is neuromuscular junction channelopathies

A

disease process hallmarked by impaired neuromuscular transmission - deficiency of function between the nerve and muscle cell

40
Q

what are the causes of NMJ channelopathies

A

genetics
toxic
autoimmune disorders (myasthenia gravis, lamber-eaton syndrome)

41
Q

how do NMJ channelopathies present

A

with fatigue and weakness

CABS - MSK (12 decks)

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