Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pathophysiology Exam 1 > Chapters 37-39: Musculoskeletal System > Flashcards

Chapters 37-39: Musculoskeletal System Flashcards

1
Q

Osteoblasts

A

lay down the extracellular matrix

Results in new bone formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Osteoclasts

A

break down the extracellular matrix
Tear down old or excess bone structure
Resorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Bone Remodeling

A

Osteoblasts and Osteoclasts are formed when they are needed to remodel bone
Osteoclasts remove damaged areas of bone
Osteoblasts come after them and replace the extracellular matrix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Cartilage Tissue Composition

A

Firm but flexible connective tissue
Consists of intracellular fibers in a gel-like material
Oxygen and food can diffuse through this gel
Doesn’t need blood vessels/blood supply

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Hyaline cartilage

A

very few fibers

Shock cushion – trachea, bronchi, nasal septum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Fibrocartilage

A

some elastin fibers

Provides cushioning – Intervertebral disks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Elastic cartilage

A

many elastin fibers

Provides support – auditory canal, epiglottis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Tendons

A

Tendons attach muscles to bone and transmit load from muscle to bone, resulting in joint motion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Ligaments

A

Ligaments attach bone to bone and augment mechanical stability of a joint.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Extracellular matrix is filled with

A

collagen fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Joints

A

Union of two or more bones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Synarthroses

A

little to no mobility

Ex: Skull sutures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Diarthrosis

A

slight movement
Ex: Synovial joints
Bursae are small synovial sacs cushioning tendons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Parathyroid Hormone

A

Released when blood calcium levels decrease
Sustained PTH raises blood calcium levels three ways:
1.) From bone
2.) From kidneys
3.) From intestines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Vitamin D

A

Vitamin D is needed to absorb dietary calcium
Created in skin cells under the influence of sunlight
Absorbed from the diet as a fat-soluble vitamin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Calcitonin

A

Released by thyroid when blood calcium is too high
Inhibits the release of calcium from bone
Reduces osteoclast activity
Inhibits vitamin D activation in the kidney
Inhibits calcium reabsorption by the kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

As a result of hypocalcemia

A

PTH is released

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Man #1 developed a lung tumor that secreted constant high levels of parathyroid hormone; he became very weak and developed weak bones

A

PTH released by the parathyroid gland when serum calcium levels are low.
PTH increases calcium levels by acting on:
bone (bone cells release more calcium)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Man #2 suffered complete kidney failure; he also developed weak bones

A

In end-stage kidney disease, the activation of vitamin D is nonexistent.
Vitamin D increases intestinal absorption of calcium, and it functions in the regulation of bone formation and mineralization.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Muscle Sprain

A

An overstretching of tendons and ligaments with possible tear.
Most common location: the ankle
Occurs in response to a quick twist or pull of the muscle.

Common symptoms: Bruising, swelling, instability, and painful movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Muscle Strain

A

Often occur in the lower back and in the hamstring muscle and result from overuse of muscles

Common symptoms: Pain, weakness, and muscle spasms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Strains and Sprains Recovery

A

RICE
Collagen fibers form to create links with existing tissue
Eventually healing mass bound together with fibrous tissue
Healing up to 6 weeks
Severe damage requires surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is a fracture?

A

a partial or complete break in the bone.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Open fracture

A

aka: a compound fracture. The bone exits and is visible through the skin, or through a deep wound that exposes the bone through the skin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Closed fracture

A

aka: a simple fracture. The bone is broken but the skin is intact.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

CMS

A

Circulation, Mobility, Sensation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Greenstick

A

incomplete fracture. Partial break in continuity of bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Transverse

A

The break is in a

straight line across the bone.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Spiral

A

the break spirals around the
Bone common in a twisting injury.
Could be from abuse (throwing a child roughly)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Oblique

A

Diagonal break, across the bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Comminuted

A

the break is in three or more pieces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Clinical manifestations of bone fractures

A

Unnatural alignment, swelling, muscle spasm, tenderness, pain, impaired sensation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Treatment (Bone fractures)

A

Closed manipulation, traction (skeletal or skin), open reduction (surgery), internal fixation (opening skin/hardware), external fixation (Splints and casts/Screw)

34
Q

Stage 1: Inflammatory Healing, Fracture

A

Bleeding initially occurs between the edges of fractured bone, and a hematoma (blood and plateletes) develops during the first few hours and days. Inflammation in the area causes vascular permeability and the attraction of white blood cells to the area. Macrophages, monocytes, lymphocytes, and polymorphonuclear white blood cells (WBCs) infiltrate the bone area.

35
Q

Stage 2: Granulation tissue formation, Fracture

A

In the next phase of healing, fibroblasts arrive at the area of injury and there is a growth of vascular tissue. Nutrient and oxygen supply during this early process is significant.
Lasts approximately 2 weeks.

36
Q

Stage 3: Callus formation, Fracture

A

A callus is formed (osteoblasts/chondroblasts), in granulation tissue. These cells synthesize the extracellular organic matrix of woven bone and cartilage, producing newly formed mineralized bone within 4 to 16 weeks.

37
Q

Stage 4: Lamellar bone deposition, Fracture

A

A strengthening phase where ossification is beginning. The meshlike callus of woven bone is replaced by sheets (lamellae) of mineralized bone that are organized parallel to the axis of the bone and are mechanically stronger than bone of a callus.

38
Q

Stage 5: Remodeling, Fracture

A

Remodeling of the bone at the site of the healing fracture by osteoclasts and osteoblasts. The formation is sculpted and refined by the mechanical stresses imposed on the bone. Adequate strength commonly occurs in 3 to 6 months.

39
Q

The use of anti-inflammatory or cytotoxic medication such as steroids or immunosuppressive agents during the bone’s healing process can alter the inflammatory response and inhibit healing.

A

True

40
Q

Malunion

A

Bone doesn’t align correctly at all when trying to heal

41
Q

Nonunion

A

Bone doesn’t align at all when trying to heal

42
Q

Fracture blister

A

fluid causing infection from dermis to epidermis

43
Q

Fat embolism

A

fat droplets ending in venous blood. In patients with a long bone fracture

44
Q

Compartment Syndrome

A

Blood flow to affected area is compromised because of increased venous pressure, leading to decreased arterial inflow, ischemia, and edema.
Results in pain out of proportion to injury
Evaluated by catheter to muscle
Immediate fasciotomy and débridement
Emergency treatment may be required to save an affected limb.

45
Q

Rhabdomyolysis

A

Complete breakdown of muscle where muscle is broken down into blood stream and causes damage to the kidneys (Protein pigment myoglobin into extracellular space and bloodstream)

Classic triad: Muscle pain, weakness, and dark urine (from myoglobin)
Treatment: Rapid intravenous hydration: To maintain adequate kidney flow
Hyperkalemia: May require temporary hemodialysis

46
Q

A person has rhabdomyolysis. Which typical clinical manifestation will the nurse find upon assessment?

A

Dark Urine

47
Q

Bursitis

A

Are sacs lined with synovial membrane and filled with synovial fluid; sacs (bursa) are located among the tendons, muscles, and bony prominences.

48
Q

Epicondylitis

Tennis Elbow

A

Is inflammation of a tendon where it attaches to a bone.
Tennis elbow: Lateral epicondylitis
Treated by RICE, NSAIDS, physical therapy

49
Q

Osteomyelitis

A

an infection of bone, either acute or chronic.
Bacteria are the usual infectious agents.
Primary infection of the bloodstream
Iatrogenic causes
Antibiotics are difficult to reach bacteria, lack of blood

50
Q

What could cause osteomyelitis?

A
  1. ) An open injury to the bone
  2. ) An infection from elsewhere in the body
  3. ) A minor trauma
  4. ) Bacteria in the bloodstream (bone could still form)
  5. ) A chronic open wound or soft tissue infection
51
Q

Staphylococcus aureus

A

The bacteria most commonly causing osteomyelitis.

Bone inflammation is marked by edema, increased vascularity & leukocyte activity.

52
Q

Symptoms of Osteomyelitis

A

Localized bone pain and/or tenderness in the infected area

The overlying skin may be red, hot and swollen, containing pus – inflammatory response
Spasms of associated muscles

Hallmark Feature:
Presence of bone sequestrum (dead bone separated from living bone)

53
Q

Risk Factors for Osteomyelitis

A 
Long term skin infections 
Poor blood circulation, i.e. high blood pressure, cigarette smoking, high cholesterol and diabetes. 
Prosthetic joints 
Hemodialysis 
ANYTHING that is foreign to our body
54
Q

Chronic osteomyelitis

A

Lack of oxygen/nutrients causes bone tissue to die.
Blood poisoning/Sepsis can occur if untreated

Treatment: IV/Oral antibiotics, surgical draining and cleaning of bone.

55
Q

Osteoporosis

A

Silent Disease (no symptoms) characterized by

(1) loss of bone mass
(2) increased bone fragility
(3) increased risk for fractures

more common in aging women. half of women over 50 experience osteoporosis related fracture in lifetime (hip, wrist, vertebrae) especially R/T falls

56
Q

Osteoporosis - Pathology

A

Bone resorption exceeds bone formation
Trabeculae (spongy tissue) lost and outer cortex thins
Minimal stress leads to fracture

57
Q

Pathological fracture is also called

A

Spontaneous fracture

58
Q

Risk factors for Osteoporosis

A

Women, age, family history, Caucasian/Asian, Low body weight and small frame

Calcium deficiency, menopause, cigarettes, excessive alcohol, sedentary lifestyle

Use of specific medications
aluminum-containing antacids, corticosteroids, anticonvulsants, prolonged heparin therapy, antiretroviral

59
Q

Osteoporosis Signs and Symptoms

A

Loss of height in vertebral column
Progressive curvature of spine (kyphosis)
Low back pain
Fractures of spine, hip, pelvis, humerus

60
Q

Osteoporosis - Prevention

A

Diet rich with Vitamin D and Calcium, weight bearing exercise, no smoking/limited alcohol

61
Q

Paget Disease

A 
More common in men
AKA osteitis deformans
State of increased metabolic activity in bone (Regions of excessive bone turnover)
New bone is disorganized
Deformation and fracture common
62
Q

Osteomalacia

A

Bone is not mineralized properly; it is not rigid
It is caused by a deficiency of vitamin D lowers the absorption of calcium from the intestines
Mineralization is inadequate or delayed

63
Q

Osteoarthritis

A 
AKA Degenerative Joint Disease (wear and tear)
idiopathic disease (what caused it?)
Low-grade inflammation results in pain in the joints
Caused by abnormal wearing of the cartilage 
Destruction or decrease of synovial fluid that lubricates those joints.

Age, weight, mechanics are biggest factors

With age, water content of the cartilage decreases due to a reduced proteoglycan content in the ECM.

64
Q

Proteoglycan

A

responsible for directing movement of water and solutes through the ECM.

65
Q

Collagen fibers

A

provide support to cartilage

can become susceptible to degradation (Thinning of cartilage)

66
Q

Cytokine (IL-1 & TNF)

A

stimulate protease enzymes that destroy joints in osteoarthritis

67
Q

Osteophytes

A

Spurs, or broken corners of the bone

68
Q

Osteoarthritis Clinical Manifestations

A

Joint pain, worsened with activity, relieved by rest

Crepitus (popping sound) & grinding with joint movement

69
Q

Heberden’s Nodes

A

Distal interphalangeal joints

Farthest part down

70
Q

Bouchard’s nodes

A

Proximal interphalangeal joints

2nd part down

71
Q

Rheumatoid Arthritis

A

Chronic autoimmune disease (systemic)
Genetic predisposition
Presence of rheumatoid factors (RF test)

Symmetric & polyarticular joints, Early morning pain & stiffness

Swan neck deformity
Boutonniere deformity

72
Q

Symptoms of Rheumatoid Arthritis

A

Fatigue, weakness, anorexia, weight loss, low-grade fever
Elevated ESR (sed rate) & CRP
Presence of RF
Rheumatoid nodules around blood vessels

73
Q

Rheumatoid Arthritis Evaluation

A 
Four or more of the following:
Morning joint stiffness lasting at least 1 hour
Arthritis of three or more joint areas
Arthritis of the hand joints
Symmetric arthritis
Rheumatoid nodules 
Abnormal amounts of serum rheumatoid factor
Radiographic changes
74
Q

Rheumatoid Arthritis Treatment

A

Surgery (joint replacement, removal of synovial fluid), NSAIDS, Physical therapy, Therapeutic exercise

75
Q

Ankylosing Spondylitis

A

Inflammatory joint disease of the spine or sacroiliac joints causing stiffening and fusion (ankylosis) of the joints
Systemic, immune inflammatory disease

Unknown cause but strong association with human leukocyte antigen B27 (HLA-B27)

Begins with inflammation of the fibrocartilage, particularly in the vertebrae and sacroiliac joint.
Inflammatory cells infiltrate and erode the fibrocartilage.
As repair begins, scar tissue ossifies and calcifies; the joint eventually fuses.

76
Q

Clinical manifestations of Ankylosing Spondylitis

A

Low back pain, stiffness, pain, and restricted motion, “bamboo” spine
Loss of normal lumbar curvature

77
Q

Ankylosing Spondylitis Treatment

A

Physical therapy (posture), NSAIDS, corticosteroid injections to inflamed joints

78
Q

Gout

A

Body produces too much uric acid (Overproduction)
Or
Body excretes too little uric acid (Underexcretion)
and forms acid crystals in joint or kidneys

79
Q

Hyperuricemia

A

Uric acid overproduction
Accounts for 10% of hyperuricemia
Caused by: Paget’s disease, Chronic kidney disease, etc.

80
Q

Uric Acid

A

High levels of purines (waste product) are found in organ meats (liver, brains, kidney), anchovies, herring, mackerel.
Alcohol and some drugs may affect purine excretion.

81
Q

Gouty Inflammation

A

Stage 1: Asymptomatic Hyperuricemia
Uric acid levels elevated to 9-10 range (normals ~ 3 – 6), no symptoms

Stage 2: Acute Gouty Arthritis
Sudden onset, acute pain, redness, swelling
Usually in the big toe, may affect another joint
Fever, chills
“Attack” lasts hours to weeks
60% have recurrent attack in 1 yr

82
Q

Stage 3 of Gouty Inflammation and treatment

A

Stage 3
Chronic Tophaceous Gout: Tophi (urate crystals deposits) develop in cartilage, synovial membranes, tendons, soft tissues
Pain, ulceration, nerve damage

Drink 3-4 quarts of fluids daily
Avoid alcohol (especially BEER… NOOO!!!!)
Low purine diet

Pathophysiology Exam 1 (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions