Diseases Of Musculoskeletal System

Question 1

Paget’s disease

Describe and name three stages.

Answer 1

Hyperplasia of tissue: hyperplasia hyperplasia of bone tissue aka disordered bone.
1-Osteolytic stage-surge of osteoclastic activity osteoclasts remove old cells
2-osteoclastic-osteoblastic stage- surge of bone formation
3-Osteosclerotic stage- scarring stage
Begins in middle adulthood - can affect heart function: from increased bone formation. many have minimal symptoms varying from minor to major

Question 2

Rickets/osteomalacia

Answer 2

From decreased vitamin D or abnormal absorption of vitamin D, bones have decreased mineralization - calcium levels not normal, get deformities, rickets-childhood disease, osteomalacia-adult disease, malacia means softening

Question 3

Osteonecrosis (avascular or aseptic Necrosis)

Answer 3

Death of bone tissue because no oxygen to cells due to injury-ischemic injury to bone-results infarction of bone tissue-clinically: depends on location. is a silent condition. Ultimately leads to arthritis. Can be from prolonged steroid therapy. Subchondral-pain during physical activity pleased. medullary-silent.

Question 4

Osteomyelitis

Answer 4

Infectious, inflammation of bone and bone marrow. Pyogenic from bacteria Staphylococcus aureus.
through these routes-hematagenous dissemination, soft tissue infection and joint, or implantation from fracture, example: bedsores can go through all layers and reach the bone causing osteomyelitis.
-and spread from Tb (1-3% of people) infection in her lungs through the blood. Called Potts disease when vertebral bones affected.

Question 5

Tumors in bone forming tissue name two

Answer 5

Osteoma- benign. Head and neck most common location. Reactive versus neoplastic growths.
Osteosarcoma-20% of primary bone cancer’s. 75% of patients are under 20 years old (when bones are growing). Most common location long bones of extremities, around knees. Clinically appears painful enlarging masses pulmonary metastasis usually present at time of diagnosis,most common, long-term survival with therapy 60 to 70%.

Question 6

Cartlidge forming tumors

Answer 6

• Osteochondroma a.k.a. exostosis. Attached to bone by stalks, painful. Cartlidge overlies the bone.
• Chondroma-benign tumors of Cartlidge usually within the medulla - endochondroma. on surface of the bone-juxtacortical chondroma. clinically can be painful or lead to fractures.
• Chondrosarcoma-malignant tumors of the cartilage, half as frequent as osteosarcoma. Most common sites or pelvis, shoulder and ribs. Clinically-painful enlarging masses. metastatic potential correlates to the grade of the disease.

Question 7

Metastatic bone lesions

Answer 7

More common than primary malignant bone tumors.
Occurs by: direct extension or lymphatic or hematogenous spread or intraspinal seeding.
Most common for adults in the prostrate or breast or kidney and lung.
And children-Neuroblastoma, Wilms tumor, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma.

Question 8

osteoarthritis degenerative joint disease

Answer 8

Arthritis is inflammation of the joint space most common is osteoarthritis disorder primary feature the degeneration of articular Cartlidge. Cartlidge is worn away from the inflammation in the joints, the fluid causing the inflammation is toxic to the Cartlidge; the Cartlidge becomes full of holes and pits. pathologically the smooth bone is devoid of Cartlidge eburnation forms the skin becomes smooth as Ivory. - osteophytes otherwise known as joint mice. Causes: age, dramatic injury, developmental deformities, obesity, metabolic diseases.

Question 9

Gout. Another form of arthritis.

Answer 9

Accumulation in tissue of uric acid, results in recurrent episodes of acute acute arthritis, Uris acid is usually excreted by the kidneys but can become crystallized crystals deposit in joints for a tophus a white crumbly material in the joint space. Big toe is a common location. If it is genetic it’s called primary get out if it is secondary it’s from a kidney disorder or hyper hyperuricemia from an unknown reason.

Question 10

Infectious arthritis is supprative (Pus forming) arthritis.

Answer 10

CAUSES: sepsis. In children it’s from hemophilia influenzae, late adolescence or early adulthood it’s from gonococcus. Adults it’s from staph aureus.

Question 11

Lyme arthritis

Answer 11

Borrelia burgdorferi from deer ticks.
Stage one- skin lesion looks like bull’s-eye.
Stage two- skin lesions lymphadenopathy, joint and muscle pain, cardiac arrhythmias, meningitis.
Stage 3- 2 to 3 years after bite leads to severe arthritic changes.

Question 12

Ganglion/synovial cysts

Answer 12

Small cyst located near joint capsule. synovial fluid in the cyst.

Question 13

Muscle pathologies

X linked muscular dystrophy (Duchene)

Answer 13

Most severe and common form of MD. One per every 3500 live births.

Question 14

Myasthenia Gravis

Answer 14

Autoimmune disorder of neuromuscular junction, characterized by muscle weakness, three persons out of every 100,000, thymoma or thymic hyperplasia in 65% of people affected. Antibodies are to acetylcholine receptors on muscle. Can lead to respiratory compromise double vision, drooping eyelids: eventually can lead to respiratory compromise.

Question 15

Osteogenesis imperfecta

Answer 15

A.k.a. brittle bone disease. Is a group of hereditary disorders. Genetic disease affecting Cartlidge development. Too little bone develops. Extreme bone fragility. Intrauterine fractures.(babies can’t form)

Question 16

Achondroplasia

Answer 16

Major cause of dwarfism. Most common form of genetic dwarfism. Occurs in homozygous and heterozygous variants. Homozygous are fatal. (Homozygous is two parents carrying the gene).

Question 17

Osteoporosis

Describe and name two types

Answer 17

Bones become porous, bone density testing, disruption of bone formation and reabsorption, bone shape is same but inside is no longer dense and strong, bone fragility, clinically depends on which bonds are involved: the thoracic or lumbar will lead to spinal deformities; femoral necks, pelvis, spine can lead to prolonged bed rest and pulmonary thromboembolism. Weight bearing bones problematic: fractures don’t heal. Women affected earlier than men (estrogen loss).
Two types: senile and postmenopausal. Postmenopausal from decreased estrogen which leads to Bone loss.