M3: Musculoskeletal System

Question 1

A Break in a Bone

Answer 1

Fracture

Question 2

An Open Fracture where there is broken skin

Answer 2

Compound fracture

Question 3

The Displacement of
Joint Surfaces with Abnormal Articulation

Answer 3

Dislocation

Question 4

Restoration of a fracture or dislocation to the correct alignment.

Answer 4

Reduction

Question 5

Medical device for immobilizing limbs/spine
to prevent further injury

Answer 5

Splint

Question 6

Vessels /Nerves
Damage due to injury > functional impairments.
Can pull / tear /compress /rupture surrounding nerves/vessels

Answer 6

Neurovascular compromise

Question 7

Bleeding/Swelling into a
muscle compartment > Compress vessels/nerves.

Answer 7

Compartment syndrome

Question 8

The longer the delay before reduction, the more
difficult it becomes, as the muscles around the
joint contract.
* Delay can also result in significant joint &
ligament damage > Impairment of function.

Answer 8

DISLOCATIONS

Question 9

Loss of limb or Extreme Tissue-loss resulting in
permanent functional impairment of that limb.

Answer 9

DISMEMBERMENT

Question 10

o Reduces Pain
o Reduce Bleeding
o Promote Healing
o Reduce risk of Further Compromise
(Bone/Neuro /Vascular/Functional)

Answer 10

Splinting

Question 11

o Reduce Pain
o Restore Function
o Reduce risk of Further Compromise(Neuro/Vascular/Functional)

Answer 11

Reduction

Question 12

(Osteolytic Bone
Metastasis, or Osteoporosis

Answer 12

Pathological Fracture

Question 13

1. (1-3days) - Hematoma & Inflammation (Blood Clot + Fibrin Mesh)
2. (1-3weeks) - Soft Callus (Deposition of Osteoid + Granulation Tissue + Fibroblasts)
3. (1-2mths) - Hard Callus (Mineralization of Osteoid)– NB: VISIBLE ON XRAY
4. (>2mths) - Remodeling of Woven Bone with Lamellar Bone

Answer 13

BONE REMODELING

Question 14

• destruction of old bone matter by Osteoclasts

Answer 14

Resorption

Question 15

deposition of new bone matter by Osteoblasts

Answer 15

Apposition

Question 16

Muscle Ischemia/Necrosis due to Compartment Syndrome > pain, Swelling,
Inflammation, DIC, Rhabdomyolysis > Limb Amputation

Answer 16

Crush Syndrome

Question 17

A fracture that is perpendicular to the long axis of the bone

Answer 17

Transverse

Question 18

A fracture where the break spirals around the bone, often caused by a twisting force.

Answer 18

Spiral

Question 19

A diagonal fracture that is not perpendicular or parallel to the bone axis

Answer 19

Oblique

Question 20

A fracture that is a straight line without any deviation.

Answer 20

Linear

Question 21

A fracture where the bone is not completely broken into two parts.

Answer 21

Incomplete

Question 22

A fracture where the bone ends are driven into each other

Answer 22

Impacted

Question 23

A type of incomplete fracture, common in children, where one side of the bone is broken, and the other side is bent

Answer 23

Greenstick

Question 24

A fracture where the bone is broken into multiple fragments.

Answer 24

Comminuted

Question 25

A fracture where the broken bone penetrates the skin, exposing it to the external environment

Answer 25

Compound (or Open)

Question 26

ETIOLOGY: * Anything that causes increased Uric Production or decreased Urea Excretion (Eg. High Protein/Alcohol Diet) * (NB: Also Secondary Causes. Eg. Renal Failure, Thiazides, Hypothyroidism, Hemolysis, Obesity) PATHOGENESIS: * Derangement in Purine Metabolism > Hyperuricemia > Monosodium Urate Crystal Deposition in Joint tissue> Forms “Tophi͟”>Chronic Inflammation > Destruction of the tissue

Answer 26

CRYSTRAL ARTHROPATHIES - Gouty Arthritis

Question 27

ETIOLOGY: * Degenerative Wear & Tear PATHOGENESIS: * Mechanical, then Inflammatory: Cartilage Hydration Decreases with Age > Less Resistant to Friction > Cartilage Erosion > Exposure of Bone > Grinding > Mechanical Damage & Inflammation

Answer 27

OSTEOARTHRITIS (DEGENERATIVE)

Question 28

ETIOLOGY: * Genetic Autoimmune PATHOGENESIS: * Genetic (HLA-DR4 &-DR1 Genes) > Rheumatoid Factor Production (AntiIgG Ab) > Autoimmune> Macrophage- Mediated Local Joint Inflammation & Destruction MORPHOLOGY: * Erosion of the Articular Cartilage down to the bone. * Pannus - Inflamed thickened hyperplastic synovium with papillary projections (NB: Normal synovium is very thin and smooth and shiny) * Fibrous Ankylosis (Bone Fusion)

Answer 28

RHEUMATOID ARTHRITIS (COMMONEST)

Question 29

ETIOLOGY: * Joint Infection caused by bacteria causing severe pain, swelling, fever. COMMON CAUSES: * N.gonorrhoea, S.aureus, Other less commons PATHOGENESIS: * Routes of Spread– Hematogenous (Commonest), Direct from Adjacent Tissue, Iatrogenic.

Answer 29

SEPTIC ARTHRITIS

Question 30

Type of Osteoporosis: (Typically Vertebrae & NOF; females only) Decreased Estrogen > Increased Osteoclast Activity

Answer 30

Type 1: Postmenopausal Osteoporosis

Question 31

(Affects all bones, males & females) Decreased replicability or synthetic ability of the Osteoblast > decreased Osteoblastic activity

Answer 31

Type 2: Senile Osteoporosis

Question 32

PATHOGENESIS: * Inc. Osteoclast/ dec. Osteoblast Function Imbalance > inc. Bone Resorption > Porous Bones and Dec. Bone Mass (Bone Mineral Density) MORPHOLOGY: * Trabeculae are Thinner & Fewer than Normal CLINICAL FEATURES: * Often Asymptomatic until Fracture

Answer 32

OSTEOPOROSIS (DEGENERATIVE BONE DISEASE)

Question 33

ETIOLOGY: * Bone Infection = Bacterial, Viral or Fungal. PATHOGENESIS: * Bacterial– S.aureus (Commonest), Pseudomonas(Iatrogenic), H. influenzae (Children) MORPHOLOGY: * Macro: Local Swelling & Redness * Micro: Medullary Inflammation & edema CLINICAL FEATURES: * History of Infection at Another Site + Direct Trauma to the Area * Local Tenderness and swelling Heat at Metaphysis and dec. ROM ͘ * (+ Signs of Acute Sepsis – Fever, Chills, Dehydration, Lethargy)

Answer 33

OSTEOMYELITIS