Exam 1 Flashcards
(212 cards)
1
Q
What are the most common sites involved in Paget’s Disease
A
Cranium and long bones of LE
2
Q
Mechanism of action of Polysynaptic Inhibitors
A
Decrease polysynaptic reflex activity, which causes a decrease in alpha motor neuron excitability
3
Q
Bacteria spread from preexisting infections from other body sites by the blood
A
Hematogenous osteomyelitis
4
Q
Best therapy for chronic osteomyelitis
A
Minimal response to antibiotics; aggressive surgery
5
Q
What happens to the Soleus in humans during the chronic stage (>3 yrs) of a SCI?
A
80% drop in torque
Complete change to FT muscle fibers, no longer fatigue resistant
6
Q
Life threatening complications of Rhabdomyolysis
A
Myoglobinuric acute renal failure, hyperkalemia, cardiac arrest, compartment syndromes
7
Q
Segmental fracture
A
Complete fracture resulting, fracture with 2 or more pieces in a single bone that don’t interconnect.
8
Q
What is the structure and function of bone?
A
Calcified CT: Ca added to collagen/CT matrix
Homeostatic storage of Ca and P for blood
9
Q
Spasms involves what kind of injury
A
Increased tenson of skeletal muscle after musculoskeltal injuries/inflammation. Involves nerve impingement, muscle strain/overuse, chemical or mechanical stimuli in PNS
10
Q
Solutions for drugs and rehab
A
Schedule PT when sedative effects are minimal, discuss weakness implications with MD, for spasticity use PT to promote normal physiological motor control, for spasms use PT to improve strength/posture/flexibility/proper body mechanics
11
Q
Adverse reactions for drugs in rehab
A
Muscle weakness, decreased muscle tone, sedation, dizziness, ataxia
12
Q
Treatment of osteosarcoma
A
Chemo (30% can be completely cured), resection of tumor
13
Q
A genetic defect that results in a mutation of gene for Type I collagen which results in defective bone or osteoid formation
A
Osteogenesis imperfecta
14
Q
Common fracture sites of the elderly
A
Proximal femur, proximal humerus, vertebrae, pelvis
15
Q
Myositis
A
Inflammatory muscular conditions caused by injury or an infectious pathogen
16
Q
Gabapentin (Neurontin) mechanism of action
A
Decrease spasticity by raising level of inhibition in spinal cord, decreasing excitation of alpha motor neuron
17
Q
-sarcoma
A
Malignant cancers; metastasize to other tissues
18
Q
Steps in growth of the epiphyseal plates:
A
A region of cartilage grows and lengthens the bone–>cartilage cells die–>BVs, bone marrow, and bone cells invade empty space depositing collagen and minerals–>epiphyseal plates close 18-20 y/o
19
Q
Most common malignant tumors are derived from:
A
Metastasized tumors from other organs
20
Q
Late complications of Rhabdomyolysis
A
Compartment syndromes, ischemia, systemic disorders, death
21
Q
Dowager’s Hump
A
compression fracture of the vertebrae resulting in back pain/kyphosis; also seen in postmenopausal women
22
Q
Osteomyelitis cast care
A
Cover rough edges, monitor pt sensation/circulation/drainage, Increased temp, redness, localized heat, and swelling need to be reported
23
Q
Risk factors Rhabdomyolysis
A
Trauma, untrained individuals in extreme exercise, Meds (Statins, AZT), alcohol abuse, etc.
24
Q
2 factors that contribute to degree of immobilization-induced atrophy:
A
Degree: number of joints muscle crosses
Normal use and % slow twitch muscle fibers
25
Clinical features of Osteoarthritis
Pain relieved by rest, joint stiffness 15-20 minutes after sitting/sleeping, reduced ROM, crepitus, deformities (varus/valgus), muscle spasm, contractures, atrophy
26
Features of Myotonic dystrophy
Weakness/atrophy of face, slurred speech/ptosis, well-preserved posterior cervical muscles, limited muscle involvement in limbs, frontal baldness
27
Symptoms in the hands and feet for Osteoarthritis
"DOH"
Heberden's Nodes at DIPs
Hallux valgus and bunion at 1st MTP
28
Fibrous union
Bony fracture defect is replaced with a fibrous scar instead of mineralized bone
Too much stress: disrupt BF
29
Malignant bone tumor of young people. More in men. (10-25)
Osteosarcoma
30
What is the fiber size of the spinal ST soleus fibers?
2700 um2
31
-oma, -blastoma
Benign cancers; can't metastasize
32
Myelogenic tumors
Originate from bone marrow cells
33
Arthrodesis
Surgical immobilization or fusion of jt causing artificial ankylsos
34
Avascular necrosis of the vertebrae; seen as kyphoscoliosis in adolescents
Scheuermann's Disease
35
Gouty Arthritis
Metabolic disease characterized by disturbance in purine metabolism resulting in Na urate crystals
36
Adverse effects of Polysynaptic inhibitors
Drowsiness, nausea, vertigo, dependence, death
37
Clinical features of benign bone tumors
Appear as bumps on outer bone or nodules inside bone
| Pain if tumor is expansive, removed is cause pain
38
How is pus created in infection?
Neutrophils die b/c of bacteria and acid pH
39
Clinical features Osteoporosis
back pain/kyphosis, 15cm of height lost, long bone fractures, Ca/P/alkaline P levels normal, 30-50% reduction via X-ray
40
Arthroplasty
Reshaping the joint and implanting an artificial joint surface or prosthesis
41
Softening of bone w/o loss of bony matrix, but loss in mineralization of bone by Ca and/or P
Osteomalacia
42
Death of bone not caused by bacteria:
Aseptic necrosis
43
Characteristics of Chondrosarcomas
Large malignant tumor that infiltrates trabeculae in spongy bone. Occurs most in metaphysis or diaphysis of long bones
44
Mild form of Osteogenesis imperfecta
Later in life that can increase susceptibility to bony fractures
45
What is spasticity
Injury to the CNS. Involves Increase tonic stretch reflex, tone, muscle weakness, discrease visco-elastic properties
46
Treatment giant cell tumors
Cryosurgery and resection, bone grafts, amputation
47
Mechanism of action for Diazapam (Valium)
Increase central inhibitory effects of GABA. Has sedative effects in the brain
48
Compression Fracture
Fracture is wedged or squeezed together on 1 side of bone
49
Special concerns for Botox in Rehab patients
Complement rehab, allow for aggressive PT to prevent reinjury, PTs need to identify pts who don't need meds anymore
50
Remodeling of bone is done in response to:
Structural needs: support
| Biochemical roles: Ca and P metabolism
51
Rhabdomyolysis effects on the kidneys
Heme casts causes obstruction, tubular necrosis, renal ischemia, electrolyte abnormalities
52
Causes of Secondary Osteoarthritis
Joint trauma, long-term stress, instability, neurologic disorders (Charcot, diabetic neuropathy), Hemophilia, HyperPTH (chronic bleeding in jts)
53
Symptoms of Ewing's Sarcoma
Pain/swelling progressive, flulike symptoms (low-grade fever)
54
Clinical features Rheumatoid Arthritis
"Flare" consists of increased pain, swelling, decreased function/ROM, low grade fever, loss of appetite, fatigue, anemia
55
Later symptoms of myotonic dystrophy
proximal limb weakness, myotonic symptoms, slow steady progression of disease associated with organ system abnormalities
56
Clinical manifestations of Osteomyelitis
Fever, pain, guarding, over metaphysis of bone
57
What other bodily abnormalities will result in Osteogenesis Imperfecta (reduction Type I collagen)
Thin skin, thin dental enamel, floppy mitral valve, bluish hue to normally white sclera of eye
58
Treatment for Osteomyelitis
Antibiotics
Surgery
Duration of treatment: 3-6 wks
Parenteral-oral antibiotics
59
Compartment syndrome
Edema around fracture applies pressure to regional BVs causing loss of blood supply to muscle and muscle death
60
Treatment of Ewing's Sarcoma
Surgery, radiation, chemo
61
Tumor of adult women (20-40). Some are malignant and some are benign
Giant Cell tumors
62
Adverse effects of statins and Rhabdomyolysis reduced by:
Cautious use of statins w/ impaired renal function, use lowest ED, careful monitoring, discontinue statins w/ muscle toxicity
63
S/S compartment syndrome
Decrease motor function, diminish reflexes, pain, burning, paresthesias
64
Mechanism of Action for Baclofen
Binds to GABA-B (G-protein mediated) inhibiting transmission w/in spinal cord
65
Steps of muscle fiber repair
Damaged cellular components digested-->Satellite cells proliferate-->Satellite cells form myotubes and muscle fibers regaining cell function
66
What does local swelling and redness mean?
Infection has spread out of the metaphysis into subperiostal space
67
Pathophysiology Paget's Disease
| 3 phases:
```
Destructive phase (Inc. osteoclast)
Mixed phase (destructive phase = new bone)
Osteosclerotic phase (thickened trabeculae, abnormal compact bone)
```
68
Signs of Rheumatoid Arthritis
"PBR"
Bouchard's Nodes at PIPs
Deformity and dislocation at MCP jts, ulnar deviation of fingers w/ anterior slippage of PIPs
69
How are chondrosarcomas rated?
Grade I-III based on maturity and level of cartilage cell differentiation.
Grade III is the worse.
70
Neurovascular injury
damage to arteries and nerves around the injury site
71
S/S fat embolism
w/in 1 week post surgery. Subtle behavior and orientation changes, Dyspnea, chest pain, diaphoresis, pallor, cyanosis, rash
72
Botox mechanism of action
Bind to ACh containing vesicles at NMJ, block release of ACh
73
Treatment Gouty Arthritis
Meds for control of inflammation and uric acid, rest, elevation, ice or moist heat (uric acid more likely to precipitate out with ice)
74
How are growth plate injuries classified?
I-V depending on tissue involvement
| I and II are best possible diagnosis
75
Botox and its use for local spastic disorders
CVA
76
Adverse effects of Dantrolene
Muscle weakness, hepatotoxicity, fatal hepatitis, drownsiness/dizziness/nausea
Not an effective drug
77
Primary Osteoporosis
Idiopathic (young w/ normal gonad fxn)
Postmenopausal
Senile
78
How does the Soleus muscle become faster after transection?
Sarcoplasmic reticulum changed increased Ca transport ability
79
What are the 3 stages of muscle fiber repair
I. Inflammation: macrophages digest
II. Proliferation of Satellite cells (3-4 days)
III. Synthesis of new myofibrillar proteins (~6 mos)
80
Symptoms of Osteoarthritis
Pain in buttocks/upper anterior/medial thigh, "+" Patrick's test
Pain crepitus, effusion during WB
Affects facet joints, radicular pain
81
Complications of intrathecal baclofen
Pump malfunction leading to OD, catheter obstruction, tolerance with long-term
82
Transverse fracture
Complete fracture resulting in smooth or serrated surfaces perpendicular to the long axis of bone. Caused by direct or indirect forces. Usually bending
83
Factors effecting fracture healing
Age (children faster), general health (diabetes, PVD), Nutrition smoking, local infection
84
Factors that disrupt healing of fractured bone
Appropriate immobilization, too much immobilization: reduces mineralization
Too little immobilization: reduce BF
85
Eburnation
Abnormal pressure produces sclerosis of bone underneath the cartilage
86
Joint destruction causes inflammation
Non-inflammatory disease
87
Mechanism of Action for Dantrolene
Only muscle relaxant that directly exerts its effect on skeletal muscle cells, impairs release of Ca from SR during excitation
88
Benefits of Polysynaptic inhibitors
Improve S/S of spasms, decrease pain/tenderness, increase ROM, less restrictions in ADLs
89
Most common cause of aseptic necrosis of bone
Avascular necrosis
90
Autosomal-dominant pattern that is the most common and serious of the myotonic disorder
Myotonic myopathies
91
Cautions for Polysynaptic inhibitors
Hyperthyroidism, glaucoma, urinary retention, enhances effect of alcohol/barbiturates/CNS depressants
92
Atrophy results from a decrease in what 2 components of muscle?
Myofibril protein
| Cross-sectional area
93
Tumor of the very young. More in men. (5-20)
Ewing's sarcoma
94
Vitamin D Deficiency for Osteomalacia caused by:
Inadequate intake/exposure to sunlight (synthesis Vit. D), abnormal intestinal absorption that effect fat absorption, Kidney tubular defects
95
Risk factors Osteonecrosis
Corticosteroid use, Lupus, Cushing's disease, cancer therapies, obesity, etc...
96
Treatment of Chondrosarcomas
Surgical excision of tumor or complete amputation
97
Primary Osteoarthritis
Neither cause nor risk factors known
98
Symptoms of Osteosarcoma
Intermittent pain/swelling increasing in severity and duration, Pain worse at night, pathological fractures
99
What happens to neural activity of muscles during immobilization
Neural activity of muscles remains the same during the entire period of immobilization
100
Clinical features of Gouty arthritis
Initial acute attack usually occurs in single jt -- most common 1st MTP JT
101
Results in flattening of the femoral head caused by ischemic necrosis
Legg-Calve-Perthes Disease
| AKA: coxa plana
102
What are the forms of Dichlorodifluoromethane?
Vapocoolant spray: topical use only
103
Pathophysiology of Rheumatoid Arthritis
Inflamed synovial membrane-->cells into joint cavity/synovial fluid-->:tissue repair (proliferation) via new synovial cells/new BVs-->Joint pannus-->secretion of lytic enzymes-->destroys synovial tissue/hyaline cartilage/underlying bone-->jt becomes immobile-->jt space obliterated w/ JP creating ankyloses (collagen scar)
104
Death of bone caused by bacteria:
Septic necrosis
105
Myelogenic tumors includes 2 types of tumors:
Giant cell tumors
| Myelomas
106
Secondary Osteoarthritis
Caused by chronic, excessive, or abnormal forces that damage joint surfaces, underlying bone, and leads to jt instability
107
What are the stages of bone healing?
I. Hematoma (2-3 days)
II. Fibrous lattice
III. Cell proliferation: osteoblasts from soft callus (4 wks)
IV. Stage of clinical healing: hard callus from soft callus (4-12 wks)
V. Stage of radiologic healing: Callus completely reabsorbed- looks like normal bone
108
What is the fiber size of the Soleus muscle?
4200 um2
109
Purpose of skeletal muscle relaxants
Treat conditions associated with hyperexcitable skeletal muscle
110
Incidence of Osteomyelitis
More common in:
| children, long bones, immunocompromised
111
Tumors are intraosseous cysts usually located in epiphysis of femur, tibia, radius, humerus. May extend into local soft tissue
Giant cell tumors
112
Pseudoarthrosis
Movement occurring between 2 bony fragments attached through fibrous nonunion
Too much stress
113
Who is hematogenous osteomyelitis more common in?
Children
114
Avascular necrosis of the navicular bone
Kohler's disease
115
Most common site of avascular necrosis of bone
femoral head in hip jt
116
Proliferation of immune cells. Tumors can cause cortical and medullary bone damage and spread to the bone marrow
Myeloma
117
Symptoms of Chondrosarcomas
Insidious onset of local swelling/pain; Pain intermittent at 1st than becomes more intense/constant. Awakens individual at night.l
118
Symptoms of myeloma
Weakness, fatigue, weight loss, anorexia, bone pain which increases.
Can be treated incorrectly for discogenic back pain or arthritis
119
How to use Dichlorodifluoromethane
Spray from origin to insertion, sweep the target and referral zone
120
Special considerations for Gabapentin (Neurontin)
Effective when used with other antispasticity drugs, also for chronic pain
121
General rule of thumb for ST and FT muscle fibers
Slow get fast
| Fast stay fast
122
Pathophysiology of Rhabdomyolysis with normal sarcolemma function
Protects hypertonic intracellular muscle fluid (cytosol) from massive ECF flooding into muscles, Na/K ATP pumps maintain cation gradients and normal IC electronegativity
123
Clinical features Paget's disease
Asymptomatic or minor skeletal pain, compression of cranial nerves, Tib/Fib bow-leg, Osteosarcoma can develop
124
Inflammatory process causes jt destruction
Inflammatory disease
125
Tizanidine (Zanaflex) mechanism of action
Alpha 2 adrenergic agonist in CNS. Relieve spasticity after a neurological injury.
126
Preventative role for PT and Osteomyelitis
Strict aseptic routine for wound care, monitoring/protection of wounds, avoid skin around pins/wires, avoid massage/mechanical stimulation
127
Pathophysiology Fat embolism
fat globules are emboli from either subcutaneous tissue or bone marrow that settle in lung tissue and can block pulmonary vessels
128
Adverse reactions of Tizanidine
Sedation, dizziness, dry mouth, hypotension, less weakness than baclofen/diazepam
129
Surgical treatment for Legg-Calve-Perthes Disease
Usually cast for 6-8 wks after surgery, return to normal activity in 3-4 mos
130
Legg-Calve-Perthes disease and PT
Maintain full ROM
131
Avascular necrosis of the lunate bone
Kienbock's disease
132
Skeletal muscle response to injury
Damaged cell parts removed (inflammation/degeneration)-->damaged cell replaced with new tissue (tissue healing/regeneration)
133
Most common sites of metastases for Osteosarcoma
Long bone metaphysis, knee joint, mandible, lungs via the blood
134
Treatment of Rhabdomyolysis
Refer to MD, Systemic fluid control, acid/base control, restore electrolytes (Ca, K, Na)
135
Common primary malignant bone tumors for men
Osteosarcoma, chondrosarcoma, ewing's sarcoma
136
Uses of Dichlorodifluoromethane
Manage pain and muscle spams and myofascial pain
137
What disorders is spasticity involved with?
CP, MS, SCI, CVA
138
What is the hierarchy of muscles susceptible to atrophy with immobilization? (Most to least)
Soleus > Plantaris > Vastus intermedius/vastus lateralis > Gastroc > Tib ant/RF
139
Malignant primary bone tumor composed of undifferentiated small cells. Arises from stem cells in medullary cavity of bone and be found in shaft or diaphysis of bone.
Ewing's Sarcoma
140
Best therapy for Acute osteomyelitis
Good response to antibiotics; limited surgery
141
Oblique fracture
Complete fracture resulting in fracture line at 45 degrees. Caused by bending force with some axial compression
142
Osteomyelitis Implications for PT
Drainage, pain w/ movement, low-grade fever, swelling/redness, control WB
143
Osteomalacia of long bones
Rickets
144
Conservative treatment for Rheumatoid Arthritis
Anti-inflammatory drugs, rest, gentle/regular AROM exercises (reduce ankylosis), moist heat or ice, splinting
145
Bone tumor incidence from Lowest to Highest
<15-->30-35-->after 35-->16-21
146
Pathophysiology of Osteomyelitis
Bacterial seeding-->inflammation-->pus (dead neutrophils) and swelling-->BF block-->Sequestra and Involucrum-->predisposition of fractures or sinus tract escapes pus
147
What is the most common bacteria that causes Osteomyelitis
Staph. A.
148
Describe Type I and Type II growth plate injuries
Type I: Separation of growth plates
| Type II: Involvement of cortex of the bone
149
Treatment of Myeloma
Palliative care, spinal cord decompression, radiation, chemo
150
How drugs interfere with rehab
Motor control problems, functional decline for daily activities, decreased alertness, weakness, tolerance and dependence
151
Inflammation of the bone caused by an infectious organism
Osteomyelitis
152
Spiral fracture
Complete fracture resulting in fracture line encircling bone like a spiral staircase. Caused by twisting force with the distal part fixed
153
Skeletal muscle relaxants for muscle spasms
Diazapam (valium), Polysynaptic inhibitors (Cyclobenzaprine, Metaxalone, Carisoprodol, Orphenadrine, more), Dichlorodifluoromethane
154
Inherited autosomal trait that is a genetic defect of endochondric ossification of the epiphyseal plates
Secondary Achondroplastic Dwarfism
155
Surgical treatment for Rheumatoid Arthritis
Synovectomy, Soft-tissue release (d/t valgus deformity), Arthroplasty, Arthrodesis
156
Adverse reactions of Diazapam (Valium)
Hypotension, rash, muscle weakness, ataxia, incoordination, euphoria, respiratory depression, dependence, withdrawal, death
157
What is the fiber size of spinal + exercised soleus ST fibers?
3000 um2
158
Pathological traits of Primary and Secondary Osteoarthritis
Joint narrowing, thinning/softening cartilage, erosion, eburnation, fluid filled bone cysts, osteophytes, joint swelling and inflammation
159
Where is myeloma most located at?
Low back, upper spine, pelvis, ribs, sternum
160
What is intrathecal Baclofen
Pts with severe, intractable spasticity, into subarachnoid matter, small amount to elicit effects, less side effects, implanted surgically through catheter
161
Risk factors Osteomyelitis
Trauma/infection, drug addicts, sickle cell anemia, Screws and external fixators
162
Open physis (growth plate fx)
Growth abnormality with premature partial or complete closure of physis
Can stop bone growth resulting in short leg or arm
163
Secondary Osteoporosis
```
Endocrine (HyperPTH, T2D, Cushings)
Malabsorption (GI, hepatic disease)
Renal failure
RA
Respiratory disease
Neoplasms
Chemical dependency
Amenorrhea
```
164
Delayed union of fracture
Fracture takes longer to heal in bony regions with low blood supply
Distal tibia and navicular or scaphoid
165
Clinical features Osteomalacia
Nonspecific bone pain, muscle weakness, rickets, Varus tibia
166
More severe form of Osteogenesis imperfecta
Infant born with many fractures in utero
167
Diagnosis of Osteomalacia based on
Symptoms, Lab findings of low Ca and/or P, elevated PTH
168
Osteophytes
Formation of bone spurs
169
Uses of Dantrolene
Severe Spasticity, traumatic cord lesions, advanced MS/CP/CVA, Malignant hyperthermia
170
What is the classic myotonic response to mechanical stimulus
Reflex hammer to Thenar eminence causing sustained muscle contraction
171
Common fracture sites of the young
Tibia, clavicle, distal humerus
172
Common primary malignant bone tumors for women
Giant Cell tumor
173
Symptoms Gouty Arthritis
Severe pain caused by exercise, physical/emotional stress, swelling/heat/pain on palpation, redness at 1st MTP jt, systemic symptoms
174
Comminuted fracture
Complete fracture resulting in at least 3 bone fragments that interconnect. Caused by high energy trauma
175
What is the mechanism of action for Spasticity?
Loss of supraspinal inhibition of alpha/gamma motor neurons leading to excitability of alpha motor neurons below site of injury
176
Cautions of Dichlorodifluromethane
Allergic rxns, vascular insuffiencies, avoid inhaling/contact with eyes, store away from high frequency ultrasound equipment
177
Adverse effects of Gabapentin (Neurontin)
Dizziness, sedation, fatigue, ataxia
178
Agents used for spasticity
Baclofen (lioresal), Dantrolene (Dantrium), Diazepam (Valium), Gabapentin (Neurontin), Tizanidine (Zanaflex)
179
Symptoms Giant Cell tumors
Pain, local swelling, limitation of movement
180
Pharmacology for Spasms
Depressants of spinal polysynaptic reflex arc
181
Sequestrum
dead bone and pus
182
Loss of estrogen at menopause results in how much bone loss per year?
1-3%
183
Causes of Rhabdomyolysis
Diseases, trauma, medication side fx, toxins
184
Osteomalacia
Inadequate mineralization of the organic bony matrix; wide seams of osteoid in bone that weakens or softens bony matrix
185
Chronic systemic inflammatory disease with features of chronic inflammation of synovial joints
Rheumatoid Arthritis
186
What happens to the Soleus in humans during the acute stage (<5 wks) of an SCI?
10% drop in torque
| Still fatigue resistant
187
Signs of Rhabdomyolysis in the blood
HyperK, HypoCa, HyperP, LDH, Carbonic anahydrase III
188
Describe Type IV and V Growth plate injuries
IV: Goes up into joint and into metaphysis
V: Compressive force
189
Treatment for Legg-Calve-Perthes disease
Initial 1-2 wks bed rest followed by gradual WB. Conservative RX may continue for 2-4 yrs
190
Botox and its local use for generalized spastic disorders
CP
191
What happens to the ST muscle fibers after transection?
Become similar to FT muscle fibers
| Soleus time to peak isometric tension decreased 50%
192
Surgery indications for Osteomyelitis treatment
Prolonged fever, erythema, pain/swelling, persistent bacteremia; abscess; sinus tract
193
Exogenous osteomyelitis
Invasion of bone by infectious organism from outside the body
194
Diagnosis S/S of Rhabdomyolysis
Muscle pain, 5x normal CPK, dark urine (myoglobinuria)
195
What else is affected as Myotonic dystrophy progresses?
Cardiac/respiratory involvement/failure, GI dysfunction, testicular atrophy, cataracts, mental disability,
196
Malignant tumor of adults. More in men. (35-60)
Chondrosarcomas
197
Pharmacology for Spasticity
Modify stretch reflex arc, interfere with skeletal muscle contraction
198
Paget's disease
Associated with osteomalacia, increase in remodel rate of bony tissue resulting in disorganized and excessive amount of bony tissue
199
Cellular mechanism for atrophy
Protein synthesis rates decrease and protein degradation increase-->(2 wks) degradation decreases to less than control-->New state of homeostasis (~30 days)
200
Fracture problems common with Post traumatic arthritis
Intracapsular fracture
201
Etiology of Osteonecrosis
D/t bony tissue ischemia
202
Summary of changes in muscle properties after SCI
Muscle weaker-->ST to FT conversion-->Muscle fatigues faster-->WB can hypertrophy muscle fibers in leg
203
What is the denervation response of muscle?
Increased ACh sensitivity, spontaneous EMG at rest, muscle fib, no response to currents delivered at >20Hz
204
Adverse effects of Baclofen
Less sedation, drowsiness, confusion/hallucinations, fatigue, weakness, withdrawal
205
Age-related changes in metabolism results in how much loss of total bone mass per year?
.5%
| After 30, bone resorption exceeds bone formation
206
How is bony ischemia caused:
Injury disrupting the arterial supply or thrombus disrupting the microcirculation to the bone
207
S/S Legg-Calve-Perthes disease
Usually unilateral, in 4-8 y/o, limping w/ hip pain in grown region or along entire length of thigh to the knee, reduced ROM, pain relieved by rest.
208
Rhabdomyolysis
A clinical and biochemical condition resulting from disruption or damage to the integrity of the sarcolemma of skeletal muscle
209
Inherited autosomal trait that is a genetic defect of endochondral ossification in the long bones.
Primary Achondroplastic dwarfism
210
Greenstick Fracture
Incomplete fracture resulting in break in only 1 cortex of bone. Caused by minor direct or indirect force
211
Reduction of total bone mass/bony matrix, or demineralization of bone
Osteoporosis
212
Clinical features of Achondroplastic Dwarfism
Short arms and legs on normal torso. Tor
