Chapter 21 - Bones & Joints Flashcards
1
Q
what are the 5 functions of the skeletal system?
A
-reservoir of minerals (calcium and phosphorus)
-protection of organs
-production of blood cells
-movement
-shape
2
Q
what is bone made of?
A
connective tissue
3
Q
outer most layer of compact bone
A
cortex
4
Q
inner spongy layer of bone
A
trabeculae
5
Q
what is bone marrow
A
spaces between trabeculae that consist of fat and blood-forming tissue
6
Q
osteoblast
A
build bones
7
Q
osteoclasts
A
break down bones
8
Q
osteocytes
A
bone cells
9
Q
Wolff’s Law
A
muscle pulls on bone and strengthens it – strength of bone depends on activity level
10
Q
endochondral ossification
A
lay down cartilage
bone replaces cartilage
ossification at epiphyseal plate
females don’t grow as tall because their epiphyseal plate closes sooner
11
Q
intramembranous ossification
A
no cartilage phase occurs — usually in flat bones
12
Q
bone mineral density
A
amount of mineral per cm of bone
13
Q
what is an indicator of fracture risk?
A
bone mineral density
14
Q
what factors influence bone mineral density
A
diet
physical activity
hormones
ethnicity (caucasian and asian)
age
sex
15
Q
what is the most common affliction of bone?
A
fracture
16
Q
causes of fractures
A
trauma OR
pathologic (diseases like cancer or osteoporosis)
17
Q
what is osteopenia?
A
generalized loss of bone
18
Q
what can osteopenia be caused by?
A
osteoporosis
osteomalasia (vitamin D deficiency)
19
Q
what is the most common malignancy of bone?
A
metastatic cancer
20
Q
what are the most common cancers of bone in children and adolescents?
A
osteosarcoma and Ewing sarcomewhat
21
Q
what bone cancer is most common in adults?
A
multiple myeloma
22
Q
most common symptoms associated with bone
A
pain
decreased mobility
deformity
23
Q
symptoms associated with arthritis include
A
joint stiffness and decreased mobility
pain and inflammation
24
Q
tests for bones
A
X-rays and CT scans (tumors)
25
serum tests
-calcium, phosphorus, and alkaline phosphatase (measure BMD)
-erythrocyte sedimentation rate (how fast RBC settle to measure inflammation)
-rheumatoid factor (arthritis) and uric acid levels (gout)
26
what are used to diagnose arthritis and osteomyelitis
cultures
27
how to diagnose bone tumor or confirm infection
biopsy
28
achondroplasia
dwarfism = mutation in fibroblast growth factor 3 (Fgfr3)
-faulty bone formation in extremities and skull bones
29
what type of genetic disease is achondroplasia?
autosomal dominant (one copy from one parent)
30
what are the majority of mutations in achondroplasia?
de novo (in sperm or egg cell)
31
osteogenesis imperfecta
imperfect creation of bone because of insufficient collagen formation; they become thin and delicate and break easily "brittle bone"
32
what type of genetic disease is osteogenesis imperfecta?
autosomal dominant
33
what does osteogenesis imperfecta increase susceptibility for?
bone fractures
34
how many types of osteogenesis imperfecta are there?
8
35
symptoms/manifestations of osteogenesis imperfecta
malformation of fingers and toes
spinal curvature
brittle teeth and bones
blue sclera
36
clubfoot (talipes)
foots grow inward toward one another
37
what is the most common congenital disorder of the legs
clubfoot talipes
38
cause of clubfoot
multifactorial inheritance (many genes)
39
how do you treat clubfoot?
manipulation and casts
40
fracture definition
any disruption in continuity of bone
41
what are fractures most often caused by?
trauma or pathologic fracture (underlying disease of bone)
42
why does breaking a bone hurt?
because you tear the periosteum where pain receptors are
43
simple fracture
bone broken in only two pieces
44
comminuted fracture
bone is shattered
45
compound fracture
fracture that breaks skin - potential for infection
46
pathologic fracture
fracture through a diseased area of the bone
47
greenstick fracture
bent bone -- adolescence only because bones aren't fully matured
48
What two things must happen for a bone to heal properly?
broken fragments have to be close to each other and the fracture must be stabilized (cast or splint)
49
healing process of a fracture
proliferation of osteoblasts from site of fracture and vascular channels from periosteum; immature bone and cartilage gradually remodel into mature bone
50
how long does it take for a bone to heal?
6-8 weeks
51
osteomyelitis
bacterial infection of bone and marrow
52
etiology of osteomyelitis
organisms gain access to bone via:
-spread of infection from somewhere else in the body
-following trauma or surgery to bone itself
53
manifestations of osteomyelitis
-fever
-local pain and tenderness
54
how to diagnose osteomyelitis
X-ray
55
how to treat osteomyelitis
antibiotics
surgery if needed
56
complications of osteomyelitis
spread of infection (endocarditis or sepsis)
amputation of limb
57
osteoporosis
absolute reduction of total bone mass -- histology is normal but lacks structural integrity
58
is osteoporosis age related?
yes; one third of the population over 85 have it
59
who is more at risk for osteoporosis?
women; especially after menopause due to decreased estrogen levels
60
symptoms of osteoporosis
none
61
what can result from osteoporosis
increased mortality
loss of independent living
decreased mobility
62
causes of osteoporosis
primary: age, declining estrogen
secondary: excess cortisol, increased PTH
63
at what age does your bone mass peak?
25-30
64
risk factors of osteoporosis
age
ethnicity (caucasian and asian)
genetics
skeletal frame size (smaller)
decreased estrogen/testosterone
decreased physical activity
excess intake of phosphorus, alcohol, nicotine
inadequate vitamin D, calcium, potassium, magnesium
65
manifestations of osteoporosis
vertebral fractures
lumbar lordosis and kyphoscoliosis (hunchback)
pulmonary embolism (fractures of the neck, pelvis, spine)
66
how to diagnose osteoporosis
DEXA (dual-energy x-ray absorptiometry)
67
can osteoporosis be reversed?
no - once the bone is gone, it's gone (osteocytes cannot regenerate themselves)
68
treatment for osteoporosis
medication:
-osteoclast inhibitory
-estrogen mimetic
-synthetic PTH
69
osteopenia
lower than normal bone mineral density (precursor to osteoporosis)
70
osteomalacia
softening of bone from poor mineralization
71
cause of osteomalacia?
vitamin D deficiency
72
what is osteomalacia called in children?
rickets
73
complications of osteomalacia
deformity, increased fracture risk
74
scoliosis
abnormal S-shaped curvature of sping
75
kyphosis
abnormal forward bending of upper spine (hunchback)
76
potential causes of spine deformities
arthritis
congenital
osteoporosis
idiopathic
77
complications of spine deformities
impairment of activity
breathing problems
back pain
78
hematopoeitic cancer is what percentage of bone cancers?
40% - most common
79
what are benign cysts and tumors of the bone called?
osteomas
80
what are primary malignant bone tumors called?
osteosarcomas
81
what is the most common malignant tumor of the bone in children?
osteosarcoma
82
symptoms of osteosarcoma
bone pain
progressive enlargement of mass
pathologic fracture
83
is osteosarcoma more common in males or females?
males
84
where do osteosarcomas usually occur
the ends of long bones
85
is metastases common in osteosarcomas
yes
86
arthritis
degeneration of synovial joints
87
arthroscopy
tool with a lighted camera to visualize joint space
88
osteoarthritis
degenerative joint disease -- "wear and tear" of joints from old age
89
what joints does osteoarthritis affect?
weight-bearing big joints, small joints of hands and feet
90
primary classification of osteoarthritis
unknown or multifactorial
91
secondary classification of osteoarthritis
related to another disease
92
etiology of osteoarthritis
cartilage becomes thin and the bone surfaces rub together producing bone cysts
93
treatment of osteoarthritis
replace the joint
94
risk factors for osteoarthritis
increased age
joint trauma; long-term stress
endocrine disorders
drugs
obesity
95
rheumatoid arthritis
systemic autoimmune disease affecting the joints; produces chronic inflammation and thickening synovial membrane
96
what is often associated with rheumatoid arthritis
rheumatoid factor; an autoantibody in blood and synovial tissues (attacks immune system)
97
is rheumatoid arthritis age associated?
no
98
clinical course of rheumatoid arthritis
malaise, fatigue, and generalized joint pain
-joints then become swollen, warm, painful and stiff
99
treatment for RA
immunosuppressants or NSAIDs
100
Gout/gouty arthritis
too much uric acid in the blood and other body fluids; crystals made of uric acid deposit in tissues throughout the body
101
where does gouty arthritis usually occur
big toe (50%), heel, ankle, inside of foot, knee, wrist, elbow
102
contributing factors of gout
age
male
obesity
high intake of alcohol and red meat
genetic predisposition
