Musculoskeletal Function Flashcards
(97 cards)
1
Q
Skeletal Trauma
A
Fractures and Dislocations
2
Q
Support Structure Trauma
A
Sprains and strains
Tendinopathy and bursitis
Muscle strains
3
Q
What is a Fracture
A
A break in the continuity of a bone
4
Q
Classifications of bones
A
Complete, Incomplete, Open (compound), Closed (simple), Comminuted
5
Q
What else can a fracture be classified under
A
Linear, oblique, spiral, transverse or greenstick
6
Q
What is a pathologic fracture
A
Break at the site of a preexisting abnormality
7
Q
What is a Stress fracture
A
Due to being subjected to repeated stress
EX. Athletics
8
Q
What are the 2 types of stress fractures
A
Fatigue- abnormal stress
Insufficiency- lack normal ability to deform and recover
9
Q
What is a transchondral fracture
A
Fragmentation and separation of portion of articular cartilage
10
Q
What are the 2 parts of the body that can regenerate itself
A
Fractures (bones)
Liver
11
Q
What are the steps in a fracture (4)
A
- Periosteum and blood vessels disrupted
- Bleeding from ends and neighbouring soft tissue
- Clot forms in medullary canal
- Adjacent bone tissue dies which stimulates intense inflammatory response
12
Q
How long does it take for vascular tissue to invade the area which leads to blood flow to increase to the bone
A
48 hours
13
Q
How is a fracture healed
A
- Bone forming cells activated to produce subperiosteal procallus along the bone shaft and over the break
- Osteoblasts synthesize collagen and matris to form a callus
- Remodelling occurs, tebeculae formed along lines of stress
14
Q
Clinical manifestation of Fractures
A
- Vary according to type of fracture, site and associated soft tissue damage
15
Q
Signs and symptoms of fractures
A
Impaired function, unnatural alignment, swelling, muscle spasm, tenderness, pain and impaired sensation
16
Q
What is the position of bone affected by
A
pull of attached muscles, gravity, direction and magnitude of fracture force
17
Q
What is the immediate pain due to in a fracture
A
trauma
18
Q
What is the secondary pain due to in a fracture
A
soft tissue or muscles
19
Q
Treatment of fractures
A
Must realign bone fragments (reduction) (most done by closed reduction)
Traction to maintain reduction
External fixation used external frame of clamps
Open reduction- Surgery
20
Q
What are the 2 types of traction
A
Skin or skeletal
21
Q
What is a dislocation
A
A temporary displacement of 2 bones in which the bone surfaces lose contact entirely
Often accompany a fracture
22
Q
What is a subluxation
A
The displacement of 2 bones in which the bone surfaces contact is only partially lost
Often accompany a fracture
23
Q
What age are dislocations and subuxations most common
A
Below the age of 20
23
Q
What bones are most common for dislocations & subluxations
A
Shoulder, elbow, wrist, finger, hip and knee
24
What often also occurs when a dislocation and subluxation is present
A fracture, bruised nerves, vessels, ligaments, supporting structure, soft tissues, pain, edema, limited motion and deformity
25
What is a ligament
A band of fibrous connective tissue that connects bones at a joint
26
What is a tendon
Tendon: fibrous connective tissue that attaches skeletal muscle to bone
27
What is a strain
A tear in a tendon
28
What is a sprain
A tear in a ligament
29
What happens when you injure a tendon or ligament
Inflammation develops between the torn ends, granulation tissues form containing macrophages, fibroblasts and capillary buds
Within 5 days, collagen forms
30
When can a tendon start to withstand pull
After 5 weeks but the entire process could take years to repair (longer than a break)
31
What is a rotator cuff tear
A tear through supporting tendons
32
Signs and symptoms of tendon and ligament tears
Pain, edema, changes in tendon or ligament contour, dislocation and subluxation of bones, tenderness
33
Where can bursas be found in the body
Can occur in the shoulder, elbow, hip or knee
34
What can be done for bursitis
Drainage or injection
35
What happens in a muscle tear
Muscle fibres are torn resulting in bleeding
36
Do fibres heal
No, other fibres compensate
37
What is primary osteoarthritis
Idiopathic: may be inherited (no known cause)
38
What is secondary osteoarthritis
Associated with joint stress, congenital abnormalities or joint instability caused by trauma
39
What is osteoarthritis
Erosion of articular cartilage
40
What is subchondral sclerosis
Thickening and hardening of bone underneath cartilage
40
What are osteophytes
Formation of bone spurs
41
What makes osteoarthritis worse
aging
42
Where does osteoarthritis affect the most
Hands, wrists, neck, lower back, hip, knees, ankles and feet
43
What can osteoarthritis be associated with
Trauma, long term stress, inflammation, joint instability, neurological disorders, congenital, hemtological disorders, congenital, hematologic or endocrine, drugs
(all accelerate cartilage loss)
44
What happens to cartilage in osteoarthritis
Cartilage turns yellow, brownish, surface areas flake off, becomes thin or absent, bone becomes unprotected (sclerotic), cartilage coated osteophytes can grow outwards, joint capsules become thickened
45
What happens when spurs break off with osteoarthritis
Irritate synovial membrane
46
Clinical manifestations of osteoarthritis
Occurs in 50s or 60 year olds, pain and stiffness in one or more joints, aggravated by weight bearing and relieved by rest, nocturnal pain not relieved by resting
47
What could pain be caused by in osteoarthritis
articular distention
48
What is articular distention
Stretching of joint capsule or fibrous shrinking irritated by movement
49
What could cause joint effusion be caused by
osteophyte fragments in synovial cavity, drainage of cysts from diseased subchondral bone or acute trauma to joint structures
50
What is joint effusion
Why could there be inflammation exudate or blood in the synovial cavity
51
What can happen in osteoarthritis
Limited range of motion, crepitus (grating or creaking), changes in ambulation, affected joint more symptomatic after use
52
How is osteoarthritis diagnosed
Through clinical assessment, X-ray, CT scan, MRI
53
What is the conservative treatment of osteoarthritis
Rest, ROM exercises, use of aids, weight loss, analgesic and inflammatory drugs
54
Treatments for osteoarthritis
Conservative treatment
Surgical treatment
55
What is rheumatoid arthritis
Autoimmune disease, chronic inflammation of connective tissue, affects synovial membrane by lining the joint cavity, inflammation spread to other tissues, causes pain, joint deformity and loss of function
56
What are the most affected rheumatoid arthritis joints
Fingers, feet, wrists, elbows, ankles, knees
May affect lungs, heart, kidneys, skin
57
What group does Rheumatoid Arthritis most often affect
Women
*lessens during pregnancy but exacerbated during postpartum
*increases with age
58
What happens in Rheumatoid Arthritis
Autoantibodies attack host tissue (are called rheumatoid factors)
59
What obscures Rheumatoid Arthritis
Genetics, environmental factors, hormonal factors, reproductive system
60
Signs and symptoms from Rheumatoid Arthritis
Stiff, tender and painful joints, Morning stiffness that last more than 1 hour
Progresses from smaller joints to weight bearing joints
Joint swelling that is widespread and symmetric
Joint deformities, loss of joint motion, contractures, muscle atrophy, Rheumatoid nodules found in areas of pressure or trauma,
61
What are Rheumatoid nodules
Swellings
aggregates of inflammatory cells and are usually in the elbows and fingers, scalp, back, hands and feet
*Can be found in the skin, heart, lungs and spleen
62
What is the diagnosis for Rheumatoid Arthritis
Diagnosis on PE, x-ray, blood tests
63
What is the treatment for Rheumatoid Arthritis
Conservative: rest of joint and body, heat and cold, physical therapy, hi calorie and vitamin rich diet
Drugs: corticosteroids, anti-inflammatory, immunosuppressants
Surgery: decrease inflammatory effusion and remove pannus, fix deformity or replace joint
64
What is ankylosing Spindylitis
Chronic inflammatory joint disease characterized by fusion of spine and sacroiliac joints
65
Who is more susceptible to getting Ankylosing Spondylitis
3:1 male to female ratio
65
What is the most known symptom of Ankylosing Spondylitis
Bamboo spine
65
What is Gout
Excess uric acid in blood that causes precipitation of urate crystals in joints
66
How is Gout treated
NSAID's, Allopurinol and water
67
What is a contracture
Shortening of muscles
Can be physiological or pathological
68
What is a Physiological contracture
Occurs in the absence of muscle action potential
69
What is Pathological contractures
May be a response to pain or secondary to scar formation (burns)
70
What is the diagnosis and treatment for physiological contractures
Failure of calcium pump in presence of ATP- temporary if underlying pathology reversed
71
What is Osteomyelitis
Infectious bone disease caused by bacteria, viruses, fungi or parasites
72
Why is Osteomyelitis hard to treat
Bone contains multiple channels that encourage proliferation of infectious cells (natural defenses do not penetrate), Tiny vessels (easy damaged and obstructed easily), bone cells destroyed by infection are not easily replaced
73
How is Osteomyelitis categorized
By pathogen
74
What is Exogenous osteomyelitis
Infection from the outside of the body- spread from soft tissues to bone
75
What is endogenous osteomyelitis
Infection carried in blood from other sites within the body- spreads from bone to soft tissue
76
What are special characteristics of endogenous osteomyelitis (3)
- Most often caused by staph aureus
- Most commonly from subcutanous, sinus, ear or dental infection
- Spine, pelvis and small bones most often affected
77
What are special characteristics of Exogenous osteomyelitis (3)
- often caused by shallow human bites or fist blows to the mouth
- most common pathogen is staph aureus
- direct contamination with bone can occur with fractures, surgery with implants, or IV sites of drug users
78
Diagnosis and treatment of osteomyelitis
- elevated WBC
-Bone scan very sensitive
- CT, MRI
- IV antibiotics
- If chronic use surgical debridement
- Hyperbaric O2 therapy
79
What is Osteoporosis
Reduced bone mass or density
80
What is a BMD of a patient with osteoporosis
BMD of -2.5 SD
Severe osteoporosis is below -2.5 SD
81
When is peak bone mass acheived
mid 20s
82
What are the symptoms of Osteoporosis
Back pain, kyphosis, height loss, improper fit of clothing, protruding abdomen, negative body image
83
Risk factors for osteoporosis
Smoking, lack of physical activity, excess alcohol consumption, low calcium and vitamin D, thinness, genetics, premature menopause
84
Main factors for those at risk of osteoporosis
BMD, fracture history, age, family history
85
Clinical manifestations of osteoporosis
Dependant on bones involved, pain, fractures, bone deformity
86
What is bone generation directly related to
Physical activity, calcium intake, vitamin D, hormone levels
87
Secondary treatment of osteoporosis
HRT- estrogen allows for bone to absord
Calcitonin- acts as an anti-resorptive agent
Bisphosphonates- effects osteoclasts
88
What is the acronym for treatment of osteoporosis
C- calcium
D- Vitamin D
E- exercise
F- prevent falls
G- gain weight
S- stop smoking
89
what medication should a patient with osteoporosis go on
statins- lovostatin
significantly increases bone growth
90
Osteoporosis diagnosis
Bone mineral density test, x-ray, ct scan, serum test (calcium, phosphorus, alkaline phosphatase
91
What is the treatment for osteoporosis
prevent bone loss with vitamin supplements of Ca and vit D, fracture prevention, weight bearing exercises
92
Who should have the bone mineral density test done
women over 65, people who are under 65 and have 1 major symptom or 2 minor symptoms
93
What are the different kinds of bone tumors
Fibroblasts (osteoblasts, chondroblasts and fibroblasts)
Reticulum (blood cell precursors)
