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Phys exam 3 > Connective Tissue Pathology > Flashcards

Connective Tissue Pathology Flashcards

(42 cards)

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1
Q

where is connective tissue found

A 
tendons
blood
cartilage
bone
adipose tissue 
lymphatic tissue
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2
Q

what type of disorder is Marfan Syndrom

A

autosomal dominant disorder

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3
Q

Organ abnormalities of Marfan Disorder

A

organ abnormalities

  • cardiovascular
  • aortic stenosis
  • mitral valve prolapse
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4
Q

what is the most important defect of Marfan syndrome?

A

ascending or descending aorta

there is a high incidence of dissecting aneurysm

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5
Q

Characteristics of Marfan syndrome

A

short torso long limbs

arachnodactyly
long skull

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6
Q

skeletal abnormalities of Marfan syndrome

A
  • pectus excavatum or carinatum
  • weak ligaments, tendon, joint capsules
  • scoliosis
  • hyperflexibility
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7
Q

eye abnormalities of Marfan syndrome

A
  • dislocation of the lens
  • severe myopia due to the elongation of eye
  • retinal displacement
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8
Q

Ehlers-Danlos Syndrome

A

a group of inherited connective tissue disorders

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9
Q

6 types of Ehlers-Danlos Syndrome

A
  • Hyper-elasticity & fragile of the skin
  • Joint hypermobility
  • Bleeding diathesis
  • Severe kyphoscoliosis
  • Blindness from retinal hemorrhage
  • Bladder rupture
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10
Q

3 types of Neurofibromatosis

A
  • Type 1 – von Recklinghausen Disease (NF1)
  • Type II – Central Neurofibromatosis (NF2)
  • Type III – Schwannomatosis
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11
Q

most common autosomal dominant disorder

A

Type 1 – von Recklinghausen Disease (NF1)

1 in 3,500 people of all races

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12
Q

what are Type 1 – von Recklinghausen Disease (NF1) disfiguring neurofibromas and cade-au-lait spots

A
  • benign tumors of peripheral nerve or schwann cells

- areas of dark skin pigmentation (95% of people display six or more spots)

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13
Q

what percentage of people develop cutaneous and subcutaneous neurofibromas in late childhood and adolescence

A

90%

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14
Q

Type II – Central Neurofibromatosis (NF2)

A
  • bilateral 8th cranial nerve tumor
  • meningiomas
  • gliomas
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15
Q

Type III – Schwannomatosis

A

occurs in ~1 in 40,000 births

symptoms usually first appear in adult hoood

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16
Q

What is Type III – Schwannomatosis characterized by?

A
  • Multiple nerve sheath tumors (schwannomas) and associated pain
  • Symptoms limited to one area of the body
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17
Q

what type of disorder is Mixed Connective Tissue Diseases (MCTD)

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A

autoimmune disorder

18
Q

Mixed Connective Tissue Diseases (MCTD) is a combination of what diseases?

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A

SLE
(butterfly rash, Raynaud’s, arthraglia)

Systemic Sclerosis
(swollen hands, esophageal hypomotility, pulmonary fibrosis)

Dermatomyositis & Polymyositis
(Proximal muscle weakness with or without soreness)

19
Q

Treatment of Mixed Connective Tissue Diseases (MCTD

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A

corticosteroids

20
Q

Mixed Connective Tissue Diseases (MCTD) multi-organ involvement

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A
  • Lungs, hearts, kidneys
  • Lymphadenopathy
  • GI disorders
  • Sjogren’s Syndrome
21
Q

Mixed Connective Tissue Diseases (MCTD) Neuro involvement

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A
  • Peripheral neuropathies
  • Aseptic meningitis
  • Cerebral infarct/hemorrhage (OCCUR IN 10% OF PPL)
  • Trigeminal sensory neuropathy
22
Q

Polymyalgia Rheumatica (PMR) symptoms

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A

diffuse pain & stiffness in shoulder and pelvic girdle

23
Q

Polymyalgia Rheumatica (PMR) more likely to occur in women or men

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A

women - 2x incidence

24
Q

Chief complaint Polymyalgia Rheumatica (PMR)

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A

Difficulty with ADL & IADL for no identifiable reason

  • rolling in bed
  • trouble standing up
  • trouble on stairs
  • trouble w/ dressing because of shoulder pain
25
Clinical Presentation of Polymyalgia Rheumatica (PMR)
- Starts unilaterally - then bilateral and symmetric - joint synovitis (wrist & MCP) - diffuse distal extremity edema - carpal tunnel syndrome - tenosynovitis
26
Diagnose & Treatment of Polymyalgia Rheumatica (PMR)
Rapid response to prednisone within one week
27
Prednisone Caveats in PMR
``` Weight gain Mood swings Cataracts Glaucoma DM Easy bruising Cushing syndrome Osteoporosis ```
28
PRM Cautions
Up to 20% develop giant cell arteritis
29
Myofascial Pain Dysfunction
local or regional trigger points within a muscle hyperirritable taut muscle palpation can lead to local or referred pain
30
active trigger points
pain at rest with activity of specific muscle
31
latent trigger point
- no pain but there is restricted and/or weakness of muscle | - increased muscle tension and shortening
32
satellite trigger point
one that develops in a different part of the muscle in different muscles within the referred pain pattern
33
what causes trigger points
- overload or stretching - direct impact - posture - psychological stress - repetitive physical stress - structural abnormalities - overwork fatigue - radiculopathy - indirect activation - visceral disease
34
pathogenesis of Myofascial Pain Dysfunction
dysfunction of motor end plates - greater spontaneous EMG activity - sensitized nociceptors associated with dysfunctional MEPP (radiation to dorsal horn)
35
Theory of "taut band"
Trauma = release of excessive amounts of Ca2+ from the sarcoplasmic reticulum The contraction is sustained = decreased blood flow =Decreased ATP production =Anaerobic metabolism
36
clinical presentation of Myofascial Pain Dysfunction
a palpable, taut, painful band within a muscle with characteristic and reproducible referred pain in response to sustained pressure
37
Clinical Management of Myofascial Pain Dysfunction
``` injection (dry needling) Cryotherapy Ultrasound Sustained pressure Fluoromethane Post-isometric stretch ```
38
Fibromyalgia
A chronic, system neuroendocrine condition with specific tender musculoskeletal points
39
Fibromyalgia Systemic dysregulation
- Neurologic - Immunologic - Endocrine - Enteric
40
Trigger Points (MPS)
-local tenderness, taut band, local twitch response, jump sign single or multiple occurs in skeletal muscle may cause specific referred pain pattern
41
Tender Points (FMS)
- local tenderness - occur in specific locations that symmetrically located - do not cause referred pain
42
Fibromyalgia Tender Point
18 points -bilateral & symmetrical diagnosis of FMS usually made if 11 or more tender points are located

Phys exam 3 (5 decks)

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