module 11: Musculoskeletal and Reproductive Disorders Flashcards
(69 cards)
1
Q
name the classification of fractures
A
- complete
- incomplete
- open
- closed
2
Q
what is a complete fracture?
A
the bone is broken entirely
3
Q
what is a comminuted fracture?
A
two or more fragments present
4
Q
what is a spiral fracture?
A
encircles the bone
5
Q
what is a transverse fracture?
A
straight across
6
Q
what is an oblique fracture?
A
at an angle
7
Q
what is a linear fracture?
A
along the length of the bone
8
Q
what is a greenstick fracture?
A
only one side is broken
9
Q
what is a torus fracture?
A
the outer portion of the bone buckles, but does not break
10
Q
what is a bowing fracture?
A
in bone pairs
- one bone breaks, but the other only bends
- difficult to treat since there are 2 different situatiions
11
Q
what is an open fracture?
A
skin is broken
12
Q
what is a closed fracture?
A
skin is intact
13
Q
Describe the three causal classifications of fractures.
A
- sudden injury
- results of a fall, blow, or massive muscle contraction
- pathologic
- due to. prior disease that weakens a bone
- stress
- in normal bone due to repeated stress
14
Q
Outline the 6 stages of fracture healing.
A
- a clot forms in the medullary cavity, under the periosteum and between the ends of bone fragments
- adjacent bone tissue dies (necrosis)
- torn blood vessels are unable to perform exchange of nutrients to site
- inflammation occurs
- phagocytotic cells move in and remove dead tissue
- fibroblasts lay down collagen fibers and cartilage
- fibrocartilaginous callus= procallus os formed between bone ends
- osteoblasts within the procallus synthesize bone matrix, forming bony callus
- the callus is remodelled by osteoblasts and osteoclasts
15
Q
Define dislocation and subluxation and where these are most likely to occur.
A
- dislocation = displacement of one or more bones in a joint in which opposing surfaces lose all contact
- shoulder, elbow, wrist, finger, hip, and knee
- subluxation = partial dislocation; displacement of one or more bones in a joint in which opposing surfaces lose only some contact
- same joints as above
16
Q
Define kyphosis, lordosis and scoliosis and name one cause for each.
A
- kyphosis: increased curvature of upper spine
- brought about through diseases causing loss of bone density in vertebrae or fusion of joints between vertebrae
- lordosis: excessive curvature of lower spine
- brought about through misaligned vertebrae
- scoliosis: lateral deviation of the spinal column, with/without rotation
- can be idiopathic, due to systemic conditions, conditions not directly affecting spine, etc.
17
Q
Define sprain, avulsion and strain and where these are most likely to occur.
A
- strain: tearing or stretching of a muscle or tendon
- most coming in lower back, and neck portion of spine
- sprain: tearing of a ligament
- most common in ankle
- avulsion: complete separation of ligament from bone
18
Q
Define osteoporosis, and the general process that leads to this condition.
A
- decrease in mineralized bone mass, leading to fragile bones
- general process:
- old bone is being reabsorbed faster than new bonw is bein deposited, resulting in bones losing density
19
Q
Name 4 hormones that can affect bone density and how their influence is possible
A
- estrogen: osteoclast inhibiting activity
- decrease in estrogen = presence of more bone resorbing cells
- long term corticosteroid use
- hyperthyroidism
- oversecretion of cortisol
20
Q
Describe differences in male and female bone density and the age at which peak bone density occurs.
A
- the decrease in bone protecting hormones (testosterone, estrogen) in men is more gradual than in women, so there is slower loss. of bone in men than women during aging
- men also begin with dense bones, so osteoporotic levels are reached at an older age
21
Q
Name the hormone linked to post-menopausal osteoporosis and describe how this hormone affects bone density?
A
- estrogen
- has an overall osteoclast inhibiting activity.. decrease in estrogen = more bone resorbing cells
22
Q
What are 4 risk factors associated with osteoporosis?
A
- age
- sex
- long term corticosteroid use
- endocrine disorders
- alcoholism
23
Q
Name 3 clinical manifestations of osteoporosis
A
- kyphosis: hunched back due to vertebral collapse
- fractures: due to thin and sparse traberculae in spongy bone and porous compact bone
- fractures of long bones, radius, ribs, and vertebrae
24
Q
Define osteomyelitis
A
infectious bone disease
25
describe exogenous osteomyelitis
* most common
* caused by pathogens entering joint
26
describe hematogenous osteomyelitis
* pathogens are carried in the blood from site of infection elsewhere in the body
27
What is the primary causative organism for osteomyelitis?
staphylococcus aureus
28
Describe the pathogenesis of hematogenous osteomyelitis in children
* affects affects area in metaphyseal region close to the growth plate in long bones
* purulent exudate develops within bone and beneath periosteum
* cuts off blood supply and causes bone in cortex to die = sequestrum (involucrum)
29
Describe the pathogenesis of hematogenous osteomyelitis in adults
* long bones no longer have conditions that favour bacterial attachment
* usually affects the axial skeleton
30
Outline the clinical manifestations of osteomyelitis.
* bacteremia
* pain
* loss of movement of affected area
* infection can become chronic
31
Define osteoarthritis, outline its primary and secondary causes describe where they occur in the body.
* local areas of loss of articular cartilage, new bone formation of joint margins (osteophytosis), subchondral cone changes, variable degrees of mild synovitis, and thickening of the joint capsule
* usually in hands, hips, or spine
32
Describe the pathological changes that occur to joints during the development of osteoarthritis.
primary defect = loss of articular cartilage
* early in disease, articular cartilage changes structure
* surface flakes off and underlying layers develop cracks
* exposed articular bone becomes hardened and may develop cysts
* cartilage coated projections of bone at the edges of the joint (osteophytes) may grow out and alter the anatomy of the joint
* small pieces of these projections may break off (joint mice) and go into the synovial cavity
* synovitis and joint effusion develop
* joint capsule becomes thickened and may stick to the underlying bone = restricted movement
33
Describe the clinical manifestations of osteoarthritis, including the causes of joint enlargement and how this affects joint function.
* appear around 50-60
* pain in one or more joints
* primary signs:
* pain
* stiffness
* swelling
* deformity of joints
* stiffness usually only in first few minutes of use
* swelling due to bone enlargement around the joint
* may also be due to inflammatory exudate or blood entering the joint cavity = increase synovial fluid
* ROM limited due to cartilage degeneration
34
Define rheumatoid arthritis and outline how it differs in etiology from osteoarthritis
* chronic, systemic, inflammatory autoimmune disease distinguished by joint swelling and tenderness, and destruction of synovial joint
* first tissue affected = synovial membrane
* involves the production of antibodies (rheumatoid factors) that react to portions of host antibodies present in the synovial membrane
35
Describe the underlying pathogenesis of rheumatoid arthritis, the role played by the immune system and the significance of rheumatoid factor.
* unknown, but probably due to interaction of genetic factors with inflammatory mediators
* rheymatoid factors = antibodies produced that bind to IgG and activates complement protein = further stimulates immune response
36
Describe the pathogenesis of joint destruction in rheumatoid arthritis, including the inflammatory processes involved.
* an unknown antogen in the synovial tissue triggers immune response
* b cells produce antibodies (RF) against the Fc portion of IgG
* RF form complexes with IgG = activation of complement proteins = further stimulates immune response
* immune cells and large production of cytokines stimulate edema and production of granulation tissue (pannus)
* pannus has fibroblasts to release collagen = inhibits joint movement and destroy the joint
37
Define pannus and describe its role in the process of joint destruction of rheumatoid arthritis.
pannus = granulation tissue consisting of lymphocytes, macrophages, fibroblasts, and mast cells
* can grow over and erode articular cartilage and bone, expanding and destroying the joint
38
Outline the clinical manifestations of rheumatoid arthritis
* begins with general systemic maifestations of inflammation
* fever
* fatigue
* weakness
* joints become painful, tender, and stiff
* stiffness lasts for about 1 hour
* initial joints affected are hands, and wrists
* loss of ROM can progress into deformities
* loss of mobility = atrophy of surrounding muscles
39
Define ankylosing spondylitis, including how it is manifested and probable underlying pathogenesis.
* chronic inflammatory joint disease of the sarcroiliac joint and the vertebral column
* characterized by excessive bone formation that occurs at the joint = fusion of the joint
* primary affects men between 15-40
* progression
* fibrocartilage in vertebral joints becomes inflamed
* damage occur from macrophages and lymphocytes
* fibroblasts repair the damage, secreting collagen and eventually becomes ossified
* fusion of the joints
40
Define equinovarus, including how it is manifested and probable causation
* clubfoot
* one or both feet turn inward and downward
* can be positional, idiopathic, or as a result of another syndrome
* can be corrected by manipulation and casting begun soon after birth
41
Define dysplasia of the hip, including how it is manifested and probable causation.
* imperfect development of the hip joint, ranging from unstable to dislocation
* numerous causes
* may be corrected with pavlik harness
* 2-3 weeks if successful
* if not successful, requires surgery and body casting
42
define primary dysmenorrhea
painful mesntruation due to monthly releas of prosglandins from endometrium
43
define secondary dysmenorrhea
panful mentrruation releated to pelvic pathological conditions and can occur anytime in cycle
44
define primary amenorrhea
lack of menstruation caused by hypothalamic-pituitary-ovarian axis disorder
45
define secondary amenorrhea
lack of menstruation for at least 6 months after establishing normal mentrual cycle
* caused by ovarian, pituitary, or hypothalamic dysfunction, anorexia nervosa, etc
46
Define anovulatory cycle
a menstrual cycle in which ovulation, or the release of an egg from the ovaries, does not occur
47
Define dysfunctional uttering bleeding (DUB) and describe its underlying causation and manifestations in relation to anovulatory cycles.
* heavy or irregular bleeding in the absence of disease
* ovulation does not occur, so no progesterone is produced
* estrogen continues to be produced, resulting in a very thick endometrium
* is estrogen levels decrease due to degeneration of follicles, or endometrial tissue exceeds supporting capacity of estrogen produced, heavy bleeding can result
48
Define retrograde mensturation
when a woman's menstrual flow moves in the wrong direction
49
Define endometriosis, including its possible etiology and manifestations.
* presence of functioning endometrial tissue outside of the uterus
* possible etiology:
* could be retrograde mentrustion
* remnants from embryonic development
* spread through lymph/blood
* manifestations:
* inflammation and pain in surrounding tissues
* fibrosis
* scarring
* adhesions
50
Describe cervical cancer, including its cause, associated risk factors and detection.
* second most common cancer of women
* almost exclusively caused by HPV
* risk factors:
* early intercourse/multiple sex partners
* history of STI's
* smoking
* immunosuppression
* 90% of cervical cancers can be detected early through the use of Pap smears and HPV testing
51
Describe endometrial cancer, including its incidence and associated risk factors
* most prevalent malignancy of female reproductive tract
* primary risk factor = unopposed estrogen exposure resulting in hyperplasia
* mostly occurs in post-menopausal women
52
Describe ovarian cancer, including its incidence and prognosis, associated risk factors and detection.
* causes more deaths than any other cancer of the female reproductive system
* risk factors:
* increasing age
* family history
* higher frequency of ovulation
* risk is reduced by factors that suppress ovulation
* early stages very difficult to detect
53
Define the following terms in relation to breast disorders: galactorrhoea
* secretion of breast milk in a nonlactating breast
* caused by hormonal imbalances, pituitary tumour
* usually benign
54
Define the following terms in relation to breast disorders: mastitis
inflammation of the breast, usually from infection occurring during lactation
55
Define the following terms in relation to breast disorders: ductal disorders
* benign epithelial tissue tumours that manifest with a bloody nipple discharge
56
Define the following terms in relation to breast disorders: intraductal papillomas
benign epithelial tissue tumours that manifest with a bloody nipple discharge
57
Regarding benign breast tumours, outline the terms fibrodenoma including appearance, age occurrence, and manifestation
* seen in premenopausal women (30-50)
* firm, rubbery, sharply-defined mass, easily moeable
* asymptomatic
* not throught to be pre-cancerous
* surgically removed
58
Regarding benign breast tumours, outline fibrocystic changes including appearance, age occurrence, and manifestation
* same age range (30-50)
* most frequent breast lesion
* granular breast masses that are more prominent and painful during luteal portion of the cycle
* term encompasses a wide variety of changes, from cysts to proliferative lesions with atypical cells
59
Outline the incidence, pathogenesis and initial manifestation breast cancer
* most common cancer in women and the leading cause of death in women
* most breast cancers arise from the epithelium of the ducts, but can occur in the lobules or in the stroma
* edges of the lesion can invade local tissue, which is then followed by malignant cells scattering into the lymph nodes
* cancer can metastasize into other body sites
* first sign is usually a painless lump
60
Describe six risk factors associated with breast cancer
* hormonal changes
* giving birth at more than 35 years
* family history
* age
* lobular involution
* breast density
61
describe how hormonal changes is a risk factor for breast cancer
* length of exposure to estrogen and progesterone has been observed to have an effect
* early menarche and late menopause increases the risk
62
describe how family history is a risk factor for breast cancer
* specific gene mutations have been linked with increased risk
63
describe how lobular involution is a risk factor for breast cancer
* the glandular structures and connective tissue between the glands are replaced with fatty tissue `
* more this occurs, the lower the risk of cancer
64
Regarding disorders of the male reproductive system, define the following terms: cryptorchidism
a condition in which one or both of the testes fail to descend from the abdomen into the scrotum
65
Regarding disorders of the male reproductive system, define the following terms: hydrocele
a type of swelling in the scrotum that occurs when fluid collects in the thin sheath surrounding a testicle
66
Regarding disorders of the male reproductive system, define the following terms: varicocele
an enlargement of the veins that transport oxygen-depleted blood away from the testicle
67
Describe torsion of the testis, including its common causes, manifestation and treatment
* when the testis rotates on its axis, interrupting its blood supply
* usually cogenital abnormalities of tunica vaginalis or spermatic cord exists that predispose
* causes ischemia
* must be corrected withing 6 hrs of symptoms to preserve 100% normal function
68
Describe “benign prostatic hyperplasia” (BPH) including its incidence and manifestation
* age related, non-malignant enlargement of the prostate gland
* \> 50% men older than 60 have BPH
* becomes a problem if enlargement interferes with passage of urine through urethra
* manifestations
* frequent urges to urinate
* delay in starting urination
* decreased force of flow
69
Describe cancer of the prostate gland, including risk factors, detection, location and manifestaions.
* increases with increasing age- more than 85% diagnosed men older than 65
* prostate specific antigen (PSA)
* compound secreted by prostate cells that can be used to screen for prostate cancer
* confirmation through biopsy
* risk factors:
* diet
* inflammation
* hormones
* genetic factors
* tumour usually located in periphery of prostate
* manifestations:
* bone pain at sites of bone metastasis
* enlargement of lymph nodes
* liver enlargement
* mental confusion associated with brain metastases ›
