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Pathophysiology > musculoskeletal > Flashcards

musculoskeletal Flashcards

1
Q

fracture

A

is a break in the continuity of a bone

  • complete: totally broken
  • incomplete: hairline fracture
  • open - through the skin
  • closed - stays inside skin
  • comminuted: broken into many pieces
  • linear: extends the length of the bone
  • oblique: diagnal through the bone
  • spiral: twisting fracture
  • transverse: across the bone
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2
Q

Greenstick facture

A

perforates one cortex and splinters the spongy bone. outer breaks and inside just bends (kids)

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3
Q

Torus fracture

A

buckling of cortex of the bone (kids)

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4
Q

Bowing

A

bone bends but does not break (kids)

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5
Q

pathologic bone breaks

A

a disease causes the bones to break, not trauma

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6
Q

stress facture

A

stress on the bone is cumulative and ultimately causes a fracture

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7
Q

fatigue fracture

A

bigger muscles than bones and causes micro fractures to develop in the cortex of the bone

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8
Q

hip fracrures

A
  • intertrocanteric fracture: breaks at the neck of the hip bone, easy fix
  • intercapsular fracture: breaks at the head of the femur in the pelvic socket. all blood dies and needs a hip replacement NECROSIS
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9
Q

Bone Fractures

A
  • cause damage to the surrounding tissue, periosteum, blood vessels in the cortex and marrow
  • bone tissue destruction triggers an inflammatory response
  • procallus formation
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10
Q

callus formation

A
  1. hematoma fracture
  2. blood clot
  3. procallus. blood clot replaced by fibroblasts that lay down collagen
  4. osteoblast activity. new bone. fracture callus
  5. osteaoclasts and phagocytes create healed and healthy bone
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11
Q

Bone Fracture Manifestations and treatment

A

manifestations: unnatural alignment, swelling, muscle spasm, tenderness, pain, impaired sensation, possible muscle spasms

Treatment: surgery, reset bones. closed manipulation, traction (pull muscles), open reduction. internal and external fixation (pins put in)

if improper reduction or immobilization = nonunion, delayed union, melanin

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12
Q

dislocation

A

temorary displacement of two bones. loss of contact between articular cartilage

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13
Q

subluxation

A

contact between articular surfaces is only partially lost (some contact still exists)

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14
Q

tendon

A

muscle to bone

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15
Q

ligaments

A

bone to bone

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16
Q

strain

A

tear or injury to a TENDON or muscle

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17
Q

sprain

A

tear or injury to a LIGAMENT

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18
Q

avulsion

A

complete separation of a tendon or ligament from its bony attachment site

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19
Q

muscle strain

A

sudden, forced motion causing the muscle to become stretched beyond normal capacity

  • local muscle damage
  • muscle strains can also involve the tendons
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20
Q

care for strains and sprains

A

Rest, ice, compression, elevation

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21
Q

tendinitis

A

inflammation of the tendon

22
Q

tendinosis

A

painful degradation of collagen fibers

23
Q

bursitis

A

inflammation of a bursa (joint)

  • skin over bone, skin over muscle, muscle and tendon over bone
  • caused by repeated trauma
  • septic bursitis is caused by a wound infection
24
Q

epicondylitis

A

inflammation of tendon where it attached to a bone

  • Tennis elbow: lateral epicondyle (backhand, lateral)
  • golfers elbow: medial epicondyle. medial, swing in front
25
Q

rhabdomyolusis

A

life-threatening complication of severe muscle trauma with muscle cell loss
- skeletal muscle breaks open. overexageration of muscles with heavy weights. kidney damage

26
Q

crush syndrome

A

crushing trauma, car accident.

27
Q

compartment syndrome

A

releases myogolbin into blood

  • volkman ischemic contracture = forearm.
  • leaves in permanent flexed state
  • pressure in compartments cuts of blood supply and causes necrosis
28
Q

osteoporosis

A

porous bone

  • pooly mineralized bone
  • bone density = <648mg/cm2
  • reduced bone mass/density, imbalance of bone resorption and formation
  • bone histology usually normal but lacks structural integrity.
  • overaction of osteoCLASTS
  • compression fractures in discs
  • potential causes: decreased levels of estrogen and testosterone, decreased activity levels, inadequate vitamin d, c or mg++
  • post-menopausal women
29
Q

osteoclasts

A

break down bone

30
Q

osteoblasts

A

make new bone

31
Q

latrogenic osteoporosis

A

cuased by mediation or physician

32
Q

regional osteoporosis

A

confined to a certain section, dissuse or immobilization of a limb

33
Q

postmenopausal osteoporosis

A

bone loss occurs in middle-aged women. estrogen deficiency

34
Q

glucocorticoid-induced osteoporosis

A

steroid-induced

35
Q

age-related bone loss

A

older age

36
Q

kyphosis

A
  • exaggerated rounding of thoracic and coccyx

HUNCHBACK

37
Q

lordotic

A
  • abrnomal inward curvature of cervical and lumbar

SWAYBACK

38
Q

osteomalacia

A

deficiency of vitamin d

  • inadequate or delayed mineralization
  • SOFT BONES
  • rickets
  • pain, bone fractures, vertebral collapse, bone malformation
39
Q

osteomyelitis

A

caused by stapholacoccus infection

  • open wound is most common cause, also can be from blood born infection
  • sepsis

manifestations: acute and chronic inflammation, fever, pain, necrotic bone

Treatment: antibiotics, surgery, hyperbaric o2 therapy

40
Q

synovial joints

A
  • moveable, fluid-filled
  • articular cartilage
  • articular capsule
  • thickening in fibrous capsule = ligaments
41
Q

inflamm vs. non-inflamm joint disease

A
  • absence of synovial membrane inflame
  • lack of systemic signs and symptoms
  • normal synovial fluid analysis
42
Q

osteoarthritis (ONLY NON-INFLAMM)

A
  • degeneration and loss of articular cartilage, sclerosis of bone underneath cartilage, formation of bone spurs (osteophytes)
  • DEGENERATIVE JOINT DISEASE
  • incidence increases with age
  • Bone to bone rubbing!
  • idiopathic - we don’t know why it happens
  • knees, back, hips
43
Q

osteoarthritis

A

local areas of damage and loss of articular cartilage, new bone formation to joints

  • manifestations - pain, stiffness, enlargement of the joint, tenderness, limited motion, deformity
  • not sistemic, isolated in certain areas
44
Q

rheumatoid arthritis

A
  • inflammatory joint disease - autoimmune
  • systemic autoimmune damage to connective tissue, primarily in joints (synovial membrane)
  • fever, leukocytosis, malaise, anorexia, hyperfibrinogenemia
  • an be infectious or not infectious: did it start with inflammatory or come from infection or genetics or environment?
  • presence of RA or RF
  • antibodies IgG and IgM against antibodies. antibodies against antibodies
  • systemic, symmetrical in presenting symptoms

PATHOGENESIS: cd4 helper t cells becomes activated in the synovial going and release cytokines - recruitment and retention of inflame cells in the joint subliming - cycle of altered cytokine and signal transduction pathways

45
Q

RA Evaluation

A

4 or more of the following:

  • morning joint stiffness lasting at least 1 hour
  • arthritis of three or more joint areas
  • arthritis of hand points
  • symmetric arthritis
  • rheumatoid nodules
  • abnormal amounts of serum RA factor
  • radiographic changes
46
Q

ankylosing spondylitis

A

inflamm joint disease of the spine or sacroiliac joints causing stiffening and fusion of the joints
- systemic, immune inflame disease
- joint can become fixed through joint fusing. seen in spine when lose posture and flexibility
ENTHESIS; site where ligaments, tendons and joint capture are inserted into bone
- unknown cause
- symptoms: low back pain, stiffness, pain, restricted motion, loss of normal lumbar curvature

47
Q

Gout

A
  • URIC ACID body’s control disrupted for production or excretion
  • high levels UA and then CRYSTALIZES
  • US = byproduct of protein breaking down
  • crystals deposited in connective tissue throughout the body

Mechanisms for crystal deposition: lower body temps, decreased albumin, changes in ion concentration and PH, trauma

Clinical Stages: asymtomatic hyperuricemia, acute gout arthritis, tophaceous gout

48
Q

disorders of skeletal muscle

A

contracture: loss of blood flow at upper extremity. shortening or contraction of muscle without stimulus

stress-induced muscle tension: neck stiffness, back pain, clenching teeth, hand grip, headache. chronic anxiety

49
Q

disuse atrophy

A

reduction in normal size of muscle cells as a result of prolonged inactivity = bed rest, trauma, casting, nerve damage

Treatment: isometric movements, passive lengthening exercises

50
Q

Fibromyalgia

A

chronic widespread joint and muscle pain

- vague symptoms: sensitivity to touch, absences of inflammation, fatigue, sleep disturbances

51
Q

toxic myopathies

A

most common = alcohol abuse

  • acute attack of muscle weakness, pain and swelling
  • chronic weakness in a drinker of long duration
  • necrosis of individual muscle fibers `
52
Q

bone tumors

A

originate from bone cells, cartilage, fibrous tissue, marrow, vascular tissue
- osteosarcome = most common form

Pathophysiology (13 decks)

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