Bone and Joint Disease Spondos in here

Question 1

Objectives:

Answer 1

• List and describe major skeletal disorders

- Explain the healing process of bones following common types of fractures.

Question 2

What system

• Provides body framework, support and movement
• Protects internal organs
• Stores calcium
• Produces blood cells

Answer 2

Functions of the 
Musculoskeletal System:

Question 3

What makes up the Musculoskeletal System?

Answer 3

Muscles Tendons
Bones Ligaments
Cartilage Bursae

Question 4

What are the function of Bones

Answer 4

• Provide structure for body
• Bear weight
• Protect organs
• Store Calcium

Question 5

Classification of Bones:

Answer 5

Long bones
Short bones
Flat bones
Irregular bones

Question 6

Where can you find Long bones

Answer 6

humerus and femur

Question 7

Where can you find Short bone

Answer 7

wrist and ankle

Question 8

Where can you find Flat bone

Answer 8

skull

Question 9

vary in shape and have projections

Answer 9

skull- (Vertebrae and mandible)

Question 10

what bone composition is composed of collagen fibers and calcium phosphate salts

Answer 10

Matrix

Question 11

what bone composition lie between rings of matrix

Answer 11

Bone cells (osteocytes)

Question 12

what are Two types of bone tissue:

Answer 12

Compact, Cancellous (spongey)

Question 13

What bones are strong, rigid structure

Answer 13

Compact

Question 14

What bones are less dense, forms internal portion of bone

Answer 14

Cancellous (spongey)

Question 15

where is Bone Marrow found

Answer 15

Medullary cavity

Question 16

What takes place in the Bone Marrow

Answer 16

Hematopoiesis

Question 17

What are the function of Joints

Answer 17

• Form the union between bones

- Often allow for movement

Question 18

What do most joints have?

Answer 18

ligaments, cartilage, bursae

Question 19

• Absorbs shock
• Chondrocytes: produce collagen and -proteogylcans
• 80% water

Answer 19

Synovial joint

Articular or hyaline cartilage

Question 20

May allow mobility or increased stability

Answer 20

Synovial joint-Ligaments

Question 21

Help increase stability

Answer 21

Synovial joint-Menisci or labrum

Question 22

Sacs filled with fluid

Answer 22

Synovial joint- Bursae

Question 23

What type of DJD
Not a true inflammatory disease
May become inflamed at times
Age group: most typically 45 and older
21 million people in US
Primary: unknown
Secondary: previous injury, repetitive stress, obesity, hemophilia, infection, hypermobility, repetitive stress

Answer 23

Osteoarthritis

Question 24

Osteoarthritis (OA) - pathophysiology:

Answer 24

Surface of cartilage becomes rough, interfering with joint movement.
Tissue damage causes release of enzymes that accelerate disintegration of cartilage.
Bone underneath cartilage becomes exposed and damaged. Cysts and bone spurs (osteophytes) develop.
Pieces of bone spurs break off and cause irritation in the synovial cavity (can produce locking.)

Question 25

Osteoarthritis (OA) – signs and symptoms:

Answer 25

Initially – mild, insidious pain that occurs with weight bearing and movement Pain becomes more severe as degeneration process progresses Limited joint movement Enlarged, hard joint Crepitus NO SYSTEMIC SIGNS

Question 26

Osteoarthritis (OA)-evaluation of Xray

Answer 26

``` Loss of jt space Sclerosis of bone ends Flattened shape of articular bone ends Osteophytes Usually affects hip, knee, shoulder, hands ```

Question 27

What happens when Osteoarthritis affects the hip

Answer 27

Pain in groin to hip Muscles: hip flexors, adductors and lat rotators Mm weakness Trendelenburg gait

Question 28

What happens when Osteoarthritis affects the Knee

Answer 28

Quads atrophy Genu varus gait Ant jt pain with enlargement of jt Ant knee pain

Question 29

Osteoarthritis (OA) – treatment:

Answer 29

Minimize undue stress on joint Assistive devices to minimize stress on joint (SPC, FWW) Intraarticular injection of synthetic synovial fluid Glucocorticoids NSAIDS Joint replacement + rehab

Question 30

PT for OA

Answer 30

Increase function Strengthen weak mm, increase endurance, home ex Weight reduction Regular exercise Modalities: heat, ice, US, e-stim, massage, parrafin List pg 177

Question 31

Degeneration of vertebral discs Affects apophyseal jts Facet jts of spine

Answer 31

Spondylosis

Question 32

This disease may be caused by Poor posture Heavy lifting Prior injury

Answer 32

Spondylosis

Question 33

What are these signs and symptoms deterioration of disc Lipping Compression fractures, ligamentous thickening, inflammation

Answer 33

Spondylosis

Question 34

This is the prognosis for what:(prognosis does vary w/ each pt) MI: reduce pain, relieve neurological symptoms Analgesics, anti-inflammatories Decompressive surgery (radiculopathy or myelopathy) Cortisone inj

Answer 34

Prognosis: Spondylosis

Question 35

physical therapy for What? Restore function Postural re-ed, mm strengthening, flexibility, jt mobilization, pain relief

Answer 35

Spondylosis

Question 36

Defect of pars interarticularis in lumbar spine 3-7% of population Contact sports and gymnastics

Answer 36

Spondylolysis (2y's)

Question 37

Etiology for Spondylolysis

Answer 37

Microtrauma or genetic defect Spina bifida occulta S/S: usually L4/5 or L5/S1 Pain or find on xray

Question 38

Medical intervention for Spondylolysis

Answer 38

diagnose with CT or MRY, x-ray, bone density Treat with period of inactivity Analgesics

Question 39

PT for Spondylolysis

Answer 39

Abdominal and extensor strengthening | Postural re-ed

Question 40

- Slippage of one vertebral body anteriorly on another - Narrows spinal canal - Usually L4/5 L5/S1 - Onset over 40 or in children

Answer 40

Spondylolisthesis

Question 41

Etiology for Spondylolisthesis

Answer 41

trauma with fracture of pars interarticularis

Question 42

S/S: of Spondylolisthesis

Answer 42

LBP better supine, mm spasm, Increased lordosis, referred pain Prognosis: PT, analgesics, exercise, spinal fusion

Question 43

medical intervention for Spondylolisthesis

Answer 43

fusion if severe

Question 44

PT for Spondylolisthesis

Answer 44

strengthening, postural re-ed, avoid extension, support

Question 45

See in young, old or immunosuppressed, drug abuse Increased incidence with RA STD: 80% of incidence in young

Answer 45

Infective Arthritis

Question 46

Etiology of Infective Arthritis

Answer 46

bacteria; viral or metabolic disorders | Puncture, decubitus, strep, staph, pseudo, syphilis, gonorrhea, TB, Lyme

Question 47

S/S of Infective Arthritis

Answer 47

if prolonged: jt damage. Usually 1 jt with severe pain, acute tenderness, inflammation

Question 48

Prognosis of Infective Arthritis

Answer 48

life threatening or may resolve

Question 49

Medical intervention Infective Arthritis

Answer 49

CT, x-ray, MRI, lab tests, Abx, drains

Question 50

PT for Infective Arthritis

Answer 50

after infx is treated: progressive strenthening, stretching, endurance