Chapter 26 Flashcards
(25 cards)
connective tissue that provides a smooth articulation surface for other bones
cartilage
where bones interact
joint
congential and genetic bone diseases
a form of dwarfism caused by impaired cartilage proliferation in the growth plate; common cause of dwarfism; caused by mutation of the gene for the _____ growth factor receptor 3 (____). most mutations are ____ and related to increased ____ age.
____ function, life ___ and _____ are not affected
achondroplasia fibroblast (FGFR3) sporadic paternal mental span fertility
congenital and genetic bone diseases
___________: bones defect caused by mutations of the gene for _____
clinical features:
a) multiple _____ of bone (can mimic child abuse, but ____ is absent)
b) ______: thinning of scleral collagen reveals underlying ____, _____ loss due to ______ bone easily fractured
osteogenesis imperfecta collagen fractures bruising blue sclera veins, hearing, middle ear
thick bones resulting from a defefct in the function of ________. clinical features include bone ______, _____, _____ palsies etc
treatment: ________ transplant
osteopetrosis
osteoclasts
fractures, anemia, cranial nerve
bone marrow
infection of marrow and bone (occurs in _______)
-most commonly bacterial; arises via _______ spread. bacterial infection (____) seeds ________
open wound bactermia (___) seeds __________
-common agents: ____________: 90% of cases,
______: sexually active young adults
_______: sickle cell disease
_____: diabetics or IV drug abusers
__________: involves vertebrae (Potts disease)
-clinical features: ____ with systemic signs of infection (____ and ______), lytic focus (_____) of bone on x-ray. diagnosis is made by ________ culture or ____ aspiration
treatment: ________ therapy
osteomylitis children hematogenous children metaphysis adults epiphysis staphylococcus aureus N.gonorrhoeae salmonella Pseudomonas Mycobacterum tuberculosis bone pain fever and leukocytosis abcess blood culture bone aspiration antibiotic
reduction in bone mass. results in ______ bone with an increased risk for _____
- risk is based on _______ (in early adulthood) and afterwards
- factors may be involved: genetics (vitamin ___ receptor differences), ______, decreased _______ (menopause) and lack of ________
-subdivided into two groups: primary and secondary
clinical features: _____ and _______ in weight bearing areas such as the ________, ___, ______. bone densitiy is measured using a ____ scan
Lab tests: ____ normal (excludes osteomalacia)
treatment: _____, _____, and _______ - limit bone _____
________ - induce apoptosis of osteoclasts
____
- _________ are contraindicated (worsen osteoporosis)
osteoporosis porous freacture peak bone mass D diet estrogen exercise bone pain fractures vertebrae, hip, distal radius DEXA PTH exercise, vitamin D, calcium, loss biphosphonates SERM glucocorticoids
softening of bones as a result of inadequate ________of the organic matrix (osteoid)
due to low levels of vitamin ___, which resuts in low serum _______ and ______
-vitamin D is normally derived from the skin upon exposure to _______ and from the ____. activation requires _________ by the ____ followed by
_______ by the proximal _______ cells of the kidney
- _______ is due to low vitamin D in _____ (less than ___ years old), resulting in abnormal bone __________. _____: soft leg bones cant carry weight, delayed definition: flawed ____ mineralization, _____-____ deformity
- ________: due to low vitamin D in ____. Diffuse ____ pain, muscle ______ and increased risk of ______
- treatment: vitamin D supplement and treating the underlying cause
rickets & osteomalacia mineralization D calcium, phosphate sunlight, diet 25-hydroxylation liver 1 alpha hydroxylation tubule rickets children, 10 mineralization bow legs teeth, pigeon-breast osteomalacia, adults back, weakness, fracture
imbalance between osteoclast and osteoblast function. usually seen in late ______ (average age >__ years). _____ cause. three phases: _______, ______ and ______ phases
clinical features: bone pain due to ________,
increasing hat size - ____ is commonly affected
_____ loss, ___ like face and isolated elevated ___________ (liver enzyme)
treatment: _______ (inhibits _____ function) and _______ (includes apoptosis of _______)
paget's disease of bones adulthood 60 idiopathic destructive, mixed, osteosclerotic micro fractures skull hearing lion alkaline phosphatase calcitonin, osteoclast biphosphonates, osteoclasts
describes increased _______ within a muscle compartment of the arm or leg. it is most often due to injury that causes _____ in a muscle, which then causes increased _____ in the muscle. this pressure increase causes ____ damage due to decreased ________
pathogenesis: develops when _____ or _____ occurs within a compartment. because the ____ does not stretch, this can cause increased ____ on the ______, _____, and _____ in the compartment
- blood flow to _____ and _____ cells is disrupted. without a steady supply of ______ and ______, they can be can be damaged
compartment syndrome pressure bleeding pressure nerve damage blood supply swelling, bleeding fascia capillaries, nerves, and muscles muscle, nerve oxygen, nutrients
occurs as a complication of an injury. often it is due to a fracture of the _____ or _______ in the forearm or the ____ or _____ in the lower leg that causes significant ______ in one or more of the compartments. bleeding can also be due to a badly _____ muscle. crush injuries may cause both bleeding and swelling of a muscle.
common causes include
- a person is in an auto accident where their legs are trapped and compressed with heavy debris, which are subsequently freed from the debris after a period of time
- when a blood _____ is damaged and subsequently repaired through surgery. the above conditions are due to the ______ swelling and may occur after the _____ is re established (reperfusion swelling) to an area that has lost it for a period of time
- may be complication of ______ or ____ that are applied too tightly
symptoms:
pain which is more intense that would be expected from the injury itself. using or stretching the involved ____ increases the pain. there may also be burning or tingling sensations in the ______. _______ or ______ are late signs of compartment syndrome. they usually indicate _______ tissue injury.
- this syndrome is a _________. there is no effective nonsurgical treatment. stabilization of the patient prior to surgery is via two large _____ with ________. your doctor will make an incision and cut open the skin and fascia covering the affected compartment. this procedure is called a _____
- sometimes the swelling can be severe enough that the skin incision cannot be _____ immediately. the incision is surgically repaired when swelling subsides. sometimes a ____ is used.
acute compartment syndrome radius, ulna tibia, fibula bleeding bruised vessel compartment blood supply bandages, casts skin numbness, paralysis permanent surgical emergency bore IVs, pain meds fasciotomy skin graft
causes pain or cramping during ________. this pain subsides when activity stops. it is most often occured in the ___. symptoms may include: ______, difficulty moving the ____ and visible muscle ______.
treatment: treated by _______, _____ (inserts for shoes), and ______ medicines are sometimes suggested. some athletes have symptoms have symptoms that are worse on certain _____ (concrete vs running track, or artificial turf vs grass)
- if conservative measures fail, _____ may be an option. similar to surgery in acute, the operation is designed to opent he ____ so that there is more room for the muscles to swell. also, this surgery is typically an _____ procedure - not an emergency.
chronic compartment syndrome exercise leg numbness, foot, bulging physical therapy, orthotics anti-inflammatory surfaces surgery fascia elective
benign bone tumors
- _______ (associated with Gardner’s syndrome)
- ______
- ________ (benign in most cases but may recur
osteoma
chondroma
giant cell tumor
malignant bone tumors
- ________
- ________
- _________
osteosarcoma
chondrosarcoma
ewing’s sarcoma
tumors of the bone
- ______ malignant bone tumors are unusual
- metastatic tumors from _____, _____ and other organs
primary
prostate, breasts
malignant tumor of cartilage. commonly found in ____. treatment: ___ years survival with surgery. _____.
chondrosarcoma
pelvis
5
chemotherapy
malignant tumor from bone-forming cells (______). frequent occurence in age ___ to ___ year old men. older person with ____ disease may have an increase risk. 60% of the tumors in the ____ area. x-ray often shows an elevation of the _______ known as _________ or _____ growth pattern
treatment: _____ or ______
osteosarcoma osteoblasts 10,20 paget's knee periosteum codman's triangle, suburst surgery, chemo
childhood tumor. ___ in color due to sheets of primitive cells which store large amount of _________. ages of patients less than ____ years
tumors often invade the _____ bones and may mimic _______,. imaging results show ____ tumor with ___ skin appearance
treatment:
ewing sarcoma blue glycogen 20 long osteomyelitis lytic, onion radiation, chemo, and surgery
most common joint disease (____) and known as wear and tear disease, disease of ___ age (__+) may increase with _____ and _______
- affects weight bearing big joints but also small joints of hands and feet. classic presentation is joint _____ in the morning that worsens during the day. imaging results show joint space _______ with _____ and _____ cartilage known as “______”
classified as primary and secondary
treatment:
osteoarthritis-Degenerative Joint Disease (DJD)
old
60
trauma, obesity
stiffness
narrowing, ostophytes, floating, joint mice
NSAIDS, COX-2 inhibitors, and surgery
chronic systemic disease of unknown etiology characterized by the _______ inflammation of joints.
pathogenesis: with 1. _____ inflammation and _____ of synovial membrane (______) which leads to ______(inflamed granulation tissue) formation
2. increasing degrees of ______ destroys the ______ and _____(fusion) of the joint
3. ________ disease due to presence of ____ (rheumatoid factor) in the blood. mainly affects ______. associated with ______ gene.
clinical symptoms: arthritis with morning ____ that improves with activity. involvement of ____ joints of the fingers (_____ deformity), wrists (____ deviation), elbows, ankles, and knees are affected. ___ is usually spared (unlike osteoarthritis). ____________ (central zone of necrosis) are present
diagnosis: _____ narrowing, loss of ________, and _____ are seen on x-ray
lab findings: ___ autoantibody against ___ portion of ___ (rheumatoid factor), _____ And high _____ in synovial fluid
***** treatments on slide
rheumatoid arthritis symmetric chronic thickening synovitis pannus inflammation cartilage, ankylosis autoimmune disease IgM women HLA-DR4 stiffness PIP (swan-neck) ulnar DIP rheumatoid nodules joint space cartilage osteopenia IgM, Fc, IgG neutrophils, protein
abnormal ______ curvature of the spine
occurs in ___ of the population
-most causes are _____(cause is unknown) in adolescent ______
-the spinal curvatures lead to an asymmetry of the ____, so one shoulder is higher than the other, and the pelvis is _____
-large curvatures caused pronounced disabilities
scoliosis 4% idiopathic girls trunk tilted
deposits of ________ (monosodium urate:MSU) due to defective metabolic pathway of _______ metabolism
they deposit on the small joints of ___ and ___ causing inflammation
-two types: ____ gout is the most common form. idipathic pathogensis for _______.
secondary gout is seen with ______, ________ syndrome (X-linked ______ enzyme), and presents with mental retardation and self ______. _____ insufficiency - decreased renal excretion of uric acid
-increase of _______ in diet or _____ Can make gout worse
lab diagnosis: ________: drawing fluid from your affected joint. When examined under the microscope, your joint fluid may reveal urate crystals (needle shaped crystals with negative birefringence under polarized light).
_________: to measure the uric acid level in your blood. Blood test results can be misleading, though. Some people have high uric acid levels, but never experience gout. And some people have signs and symptoms of gout, but don’t have unusual levels of uric acid in their blood.
gout uric acid crystals purine hands, feet primary hyperuricemia leukemia, lesch-nyhan HGPRT mutilation renal protein alcohol joint test blood test
acute gout: treatment
_______: non steroidal anti-inflammatory drugs. NSAIDS may control inflammation and pain in people with gout
___________: such as the drug prednisone, may control gout inflammation and pain. may be administered in ____ form or injected into the _______. side effects may include _______ bones, poor ______ healing and a decreased ability to fight _________
- medication that blocks urac acid production. drugs called _________ inhibitors, including ______ (Zyloprim, Aloprim) and _______, limit the amount of uric acid your body makes. this may lower your blood’s uric acid level and reduce your risk of gout
acute attack corticosteroids pill, joint thinning, wound, infection xanthine oxidase allopurinal febuxostat
chronic gout treatment:
_______: a type of pain reliever that effectively reduces gout pain by preventing polymerization of _______ into microtubules and inhibits ______ migration and _________
_______ improves your kidneys’ ability to remove uric acid from your body. this may lower your uric acid levels and reduce your risk of gout, but the level of uric acid in your urine is increased
colchicine tubulin leukocyte phagocytosis probalan
