Musculoskeletal System Disorders

Question 1

low back pain

Answer 1

• pain in low lumbar,lumbosacral, region of back and typically scatia
• often a Sx underlying condition
• cause is often uncertain
• x-ray, radioisotope bone scan, electromyography
• Tx: depends on course
• prognosis: depends on acute
• recovery from acute attack is common

Question 2

Gout / Gouty arthritis

Answer 2

• results from
• usually affects a single joint (big toe)
• Tx: reducing serum uric acid levels by drugs and dietary changes, increasing fluid intake
• NASIDs for acute inflammation and pain

Question 3

osteoarthritis

Answer 3

• degenerative or wear & tear joint disease
• men more affected than women
• major care of disibility absence from work place
• associated with obesity + aging (primary)
• ingjury / abuse (secondary)
• S&S aching that occurs with weight bearing + use
• as it advances, pain beoming more severe
• cepitus, limited joint movement
• x-ray
• Tx: reduce stress on joint, massage, steroids, surgerys, NSAID

Question 4

Infectious (septic) Arthritis

Answer 4

• usually develops in a single joint
• S&S: joint is usually red, swollen + painful with decrease range of movement
• synovium s swollen and a purulent exudate forms
• Dx: aspiration of synovial fluid followed by CTs confirms dx
• bacteria such as gonococcos or staphyococcos are source of infection
• lyme disease could be vaccine
• Tx: antimicrobial

Question 5

pathophysiology of bone healing

Answer 5

• when a bone breaks, bleeding occurs from blood vessels in bone + periosteum
  1. hematoma / clot forms in medullary canal
  2. inflammatory process occurs as a reaction to the trauma
  3. hematoma turns into fibrin network turns into granulation tissues. chondroblasts begin to form cartilage
  4. procallus, preliminary bridge repair in bone, Not strong enough to bear weight
  5. osteoblasts begin to generate new bone

Question 6

causes of fractures

Answer 6

1. sudden ingury
   (direct - fall, blow)
   (indirect - transmission of force along bone, muscle contraction)
2. fatigue, stress
   (repeated wear on a bone)
   (tibia, femur, metatarsals)
   (typically in runners, dancers, etc.)
3. disease (pathologic)
   (bone has been weakend by tumor or other disease)
   (fracture occurs spontaneously)
   (or result of force that would not normally affect a normal bone)

Question 7

fractire complications

Answer 7

1. ischemia - not enough blood supply circulation must be observed carefully until danger has passed.
   - look @ applying pressure to a finger / toenail + rate of blood return
2. compartment syndrome
   - very common
   - if cast / dressing has been applied may have to be loosened
   - fasciotomy may be required
   - delay in Tx can result in nerve + muscle dmg
3. delayed union
   - takes a long time to heal

Question 8

strain

Answer 8

tendon = connects muscle to bone
- tear in a tendon
Dx: x-ray
- approx. 6 wks of healing required

Question 9

sprain

Answer 9

ligament = connects bone to bone
- a tear in the ligament
Dx: x-ray
- approx. 6 wks of healing required

Question 10

avulsion

Answer 10

when ligaments + tendons are completely separed from their bony attachments

Question 11

jovenile rheumatoid arthritis

text p.591

Answer 11

• large joints frequently affected
• onset usually more acute than adult form
• abnormal antibodies may be present

Question 12

rheumatoid arthritis

Answer 12

• autoimmune disorder causing chronic inflammatory disease
• increase risk in elders
• can be mild - severe
• Dx: blood tests, deformity appears, synovial fluid analysis
• cause: genetic, familial predisposition
• S&S: inflammation, joints red + painful, sensiive to touch
• Tx: rest + mild activity, NSAID, steroids

Question 13

PFS

primary fibromyalgia syndrome

Answer 13

• group of disorders characterized by pain
• stiffness (muscles, tendons)
• 18 specific trigger points where pains + tenderness may be stimulated
• cause: not known - altered central neurotransmission
• high incidence in women 20-50 y.o.
• S&S: sleep deprivation, stress, fatigue, sleep disturbance, depression
• IBS/UTI
• TX: stress reduction, exercise, NSAID, massage, antidepressants, occupational therapy

Question 14

osteosarcoma

manual p. 24

Answer 14

• usually develops in metaphysis of femur, tibia, o fibula in children + yung adults (usually males)
• S&S: grows quickly and spread to lungs in early stages
• can sometimes be revealed by pathologic fracture
• bone pain is common + steady pain @ rest
• Tx: surgical amputation / excision of tumor + chemo, adjuvant therapy

Question 15

chondrosarcoma

Answer 15

• arise from cartilage cells + common in adults 30+ y.o.
• S&S: develop gradually in pelvis / shoulder
• eventually spread to lung
• pain doesnt develop until late
• tumors remain silent until advanced
• Tx: surgery

Question 16

osteoporosis

Answer 16

• metabolic bone disorder
• decrease in bone mass /density conbined with loss of bone matrix and mineralization
• women have a higher risk
• S&S: some ppl can be asumptomatic
• aching pain in bones - esp. backl
• loss of height due to weight + fractures wrist, femur, hip fractures
• Dx: bone densitometry, serial heigh measurements, blood tests, MRI, x-ray
• Tx: exercise, physio, medication

Question 17

loose bodies

Answer 17

• small pieces of bone or cartilage found within joint space. typically elbow, knee + ankle
• result from trauma to joint when cartilage has worn away and an underlying piece of bone separates + joins joint fluid
• S&S: loose bodies gets caught in joint causing locking and painful catching
• Tx: arthroscopic removal
• complications: OA may occur if loose body is nt removed

Question 18

osteomyelitis

Answer 18

• causitive organism is staphylococcus aureus