Flashcards in Musculoskeletal System Deck (199):
watery flow; referring to joint fluid
lack of strength
instrument to cut
rounded depression in the pelvis that joins the femur
outward extension of shoulder blade; articulates w/ clavicle
shaft of long bone
end of long bone
large process proximal ulna
bone building cell
bone cell that reabsorbs bone
Malignant bone tumor, most commonly in long bones. More common in males, peak age 10-20.
Bony growth arising from the surface of the bone, most common type is a bunion.
Swelling of the metatarsophalangeal joint near the base of the great toe, usually from wearing improper shoes (narrow toe box). Enlarged bursa often develops over the site. Aka hallux valgus
Bunion (treated w/ bunionectomy)
Break in a bone or bones
Fracture w/ no open wound
Fracture w/ open wound
Distal radial fracture
Bone is in multiple pieces
Bone is partially broken
One fragment of bone is driven into another
Twisting fracture most commonly of the tibia
Malignant tumor arising from osteoblasts, highly malignant. 1/2 in the knee region. Symptoms are pain w/ weight bearing, at rest, and at night, fracture w/ minor trauma, lesion, and a mass. Commonly metastasis to the lungs. Bimodal distribution (adolescents & >65yo).
Osteogenic sarcoma (osteosarcoma)
Excess organic bone matrix secondary to defective or inadequate bone mineralization. Usually a disease of the older population (50-80). Increased alkaline phosphatase & low serum calcium. Symptoms include bone pain, tenderness, muscle weakness. Caused by vitamin D deficiency, decreased sunlight exposure & poor nutrition, also drug induced by dilantin.
Osteomalacia (Rickets when it occurs in children)
Acute or chronic infection of the bone & its structures caused most commonly by bacteria & rarely by other organisms. May be acquired by hematogenous, contiguous, or direct inoculation such as trauma or surgery. Commonly seen in older adults but hematogenous is bimodal. More common in males. Signs/symptoms - abrupt onset of high fever, irritability, malaise, restriction of movement in the involved extremity, signs of local inflammation, joint destruction.
Multifactorial skeletal disease characterized by severe bone loss & disruption of skeletal micro-architecture sufficient to predispose to atraumatic fractures (common in vertebral column, upper femur, distal radius, proximal humerus, pubic rami & ribs). Signs/symptoms - backpain, kyphosis, scoliosis, loss of height, atraumatic fractures. Risk factors - dietary, immobilization, cigarettes, caffeine, malabsorption, steroids, excess thyroid, postmenopausal loss in caucasian & asian women very common.
Congenital abnormality of the hind food, patient cannot stand with the sole of the foot flat on the ground. Short tendons are lengthened & long tendons are shortened
Talipes (club foot)
Chronic, usually progressive condition in which inflammatory changes & new bone formation occurs at the attachment of tendons and ligaments to bone. Sacroiliac joint involvement is the hallmark, "bamboo spine". More common in caucasian men w/ symptoms beginning in early 20s. Signs/symptoms - subgluteal or low back pain/stiffness (duration >3 months, worse in morning or at rest, wake up to walk off stiffness), pleuritic chest pain, loss of lumbar lordosis.
Inflammatory reaction to urate crystal in joints, bones, and subcutaneous structures. Initially a hyperacute arthritis which may progress to a chronic arthritis. Predominate age 30-60, more common in males. Signs/symptoms - severe pain, swelling, redness & warmth in one or two joints (75% monoarticular), exquisite tenderness, propensity for first MTP joint (Podagra). Recurrent attacks last longer & occur more frequently w/ each recurrence.
Most common form of joint disease involving progressive loss of articular cartilage and reactive changes at joint margins & in subchondral bone. Prominent age is >40, leading cause of disability in those >65. Male = female. Signs/symptoms - slowly developing joint pain which follows the use of the joint, morning stiffness of s), decreased ROM, tenderness usually absent, crepitus (cracking, grinding sounds) in late stages
Chronic systemic inflammatory disease of unknown etiology w/ a predilection for joint involvement. May be extra-articular (rheumatoid nodules, ateritis, neuropathy, scleritis, pericarditis & splenomegaly). Women 2x more than men, 30-60 yo onset. Signs/symptoms - joints most often involved are wrists, knees, elbows, shoulders, ankles, MTP's, subtalar joints; causes swelling, joint hear, joint deformity, morning stiffness, pain on PROM, early joint destruction.
Rheumatoid arthritis (RA)
Most common cause of peripheral nerve compression; median nerve is compressed.Tends to affect the dominant hand, 1/2 of pt's have bilateral symptoms though. 40:60 (females>males). Signs/symptoms - tingling sensations in the fingers, burning pain int he fingers esp at night, finger sensory loss (all mostly on palmar side medial to pinky). Often relieved by shaking the hand. Tinel's & phalen's signs are positive.
Carpal tunnel syndrome
Displacement of a bone from its joint, commonly acromioclavicular, shoulder, or rarely hip.
Restoration of the bones to normal positions; closed reductions are manipulative and open reductions require surgical incision
Partial or incomplete dislocation
Fluid-filled cyst arising from the joint capsule or a tendon, most commonly in the wrist, Unknown etiology
Herniated disc/Herniated nucleus propulsus (HNP)
Abnormal protrusion of a fibrocartilaginous intervertebral disc into the neural canal or spinal canal. Posterolateral herniation is the most common form. Also known as a "slipped disk". May cause sciatica (pain radiating down the leg). Treated w/ PT, drugs, or surgery (microdiskectomy - removal of a portion of the protruding disk).
Multisystem infection caused by Borrelia burgdorferi transmitted by Ixodid ticks (deer ticks). Males = females. Risk factors - exposure to tick infested area between May & September
Stage 1 of Lyme
erythema migrans rash (bulls-eye) <--KNOW THAT NAME!!, flu-like symptoms
Stage 2 of Lyme
one or more organ symptoms; neuro (15%), cardiac (8%)
Stage 3 of Lyme
chronic arthritis, neurologic syndromes
An injury to the ligaments around a joint without rupture. Ligaments are strong flexible fibers that hold bones together, when they're stretched too far or they tear the joint will become painful & swell.
Multisystem autoimmune inflammatory condition characterized by a fluctuating chronic course. Female>male 10:1, 30-50yo onset. Signs/symptoms - arthritis, fever, anorexia, malaise, weight loss, skin lesions, oral ulcers, eye pain/redness, chest pain and/or SOB, pallor, malar rash, photosensitivity. Black/hispanic/asian/native americans > caucasians.
Systemic lupus erythematosus (SLE)
Inherited progressive diseases of muscle w/ wide ranges of clinical expression. Fat replaces functional muscle cells. Motor dysfunction, muscle weakness, muscular atrophy all occur. Multiple types.
Most common form of muscular dystrophy
Duchenne muscular dystrophy
Systemic connective tissue disease characterized by inflammatory and degenerative changes in proximal muscles. Signs/symptoms - symmetrical proximal muscle weakness causing difficulty arising from sitting/lying positions, difficulty kneeling, climbing/descending stairs, raising arms etc. Joint pain, swelling, dysphagia, respiratory impairment, sometimes characteristic rash.
Skin rash characteristic of polymositis
Antinuclear antibody test (ANA)
Most common performed screening test for autoantibodies in patients suspected of having systemic rheumatic disease. Positive test does not confirm disease
Erythrocyte Sedimentation Rate (ESR/Sed Rate)
Rate at which erythrocytes settle out of anticoagulated blood in one hour. Inflammatory and necrotic processes cause an alteration in the blood proteins. Erythrocytes “clump” together in a columnlike manner (Rouleaux formation). Not really specific to any disease, just shows something is wrong. Helpful in diagnosing temporal arteritis and polymyalgia rheumatica
an area of cartilage tissue that is constantly being replaced by new bone tissue as the bone grows. aka growth plate
strong, fibrous, vascular membrane covering the surfaces of bones except at the epiphyses; also has extensive nerve supply
flared portion of the bone lying between the epiphysis and the diaphysis
Smooth, slick, strong covering of the ends of long bones and the surface of any bone that meets up with another bone to form a joint.
layer of dense, hard, bone that lies under the periosteum in all bones
minute spaces filled w/ blood vessels found in compact bone
central hollowed out shaft of long bones containing yellow marrow (which is chiefly composed of fat cells)
Aka spongy or trabecular bone, much more porous & less dense than compact bone
Opening or hollow region serving as a connection for bones or passageways for blood vessels and nerves. Examples are fissure, foramen, fossa & sinus
Enlarged area that extends from bones as an attachment for muscles, tendons, and ligaments. Examples are bone head, condyle, epicondyle, trochanter, tubercle & tuberosity.
One of the mineral constituents of bone. Calcium phosphate is the major calcium salt in bones.
Flexible, rubbery connective tissue. Found in the immature skeleton at the epiphyseal growth plate and on joint surfaces.
Dense, connective tissue protein strands found in bone and other tissues
Skull bones; ethmoid, frontal, occipital, parietal, sphenoid & temporal
Flat, round, plate-like structure. An intervertebral disk is a fibrocartilaginous substance between two vertebrae.
Bones of the face; lacrimal, mandibular, maxillary, nasal, vomer, zygomatic
Soft spot (incomplete bone formation) between the skull bones of an infant
Opening of the occipital bone through which the spinal cord passes
Fibrous tissue connecting bones to other bones; supports, strengthens & stabilizes the joint
Round process on both sides of the ankle joint; the lateral malleolus is part of the fibula and the medial malleolus is part of the tibia
Upper portion of the sternum, articulates w/ the medial aspect of the clavicle
Round projection on the temporal bone behind the ear
MD who specializes in bone, joint, and muscle conditions
process of bone formation
Mineral substance found in bones in combination w/ calcium
MD specializing in rehab
Area of confluence of the two pubic bones in the pelvis joined by a fibrocartillaginous disk
Red bone marrow
found in cancellous bone; site of hematopoiesis
12 pairs of curved bones that form the chest wall; true ribs are the first 7, false are 8-10, floating are 11&12
Depression in the sphenoid bone where the pituitary gland is located
hollow, air filled cavity within a bone
Pole-like process extending downward from the temporal bone on either side of the skull
Immovable joint between bones, such as the skull
Connection on either side of the head between the temporal bone of the skull and the mandibular bone of the jaw
Fibrous connective tissue connecting muscles and bones
supporting bundles of bony fibers in cancellous (spongy) bone
Individual segment of the spine composed of the vertebral body, vertebral arch, spinous process, transverse process & lamina enclosing the neural canal
Lower, narrow portion of the sternum
acetabulum (hip socket)
carpals (wrist bones)
clavicle (collar bone)
ribs (true, false, floating)
Benight exostoses composed of cartilage and bone, usually found on the metaphyses of long bones near the epiphyseal plates
Open reduction, internal fixation. Insertion of metal plates, screws, rods, or pins to stabilize the bone.
Loss of bone mass due to osteoporosis producing posterior curvature of the spine in the thoracic region. Changes in spine can cause a loss of as much as 6-9" in height.
any type of joint
sac of fluid near a joint; promotes smooth sliding of one tissue against another
Crescent-shaped fibrocartilaginous structure found in the knee
Space between bones at a synovial joint; contains synovial fluid produced by the synovial membrane
Viscous fluid within the synovial cavity, similar in viscosity to egg white which accounts for the term
freely movable joint
tissue lining the synovial cavity; it produces synovial fluid
Injury involving overstretching of the muscle
movement away from the midline of the body
movement towards the midline of the body
backward (upward) bending of the foot
straightening of a flexed limb
fibrous membrane separating and enveloping muscles
bending a limb; decreasing the angle between bones
Insertion of a muscle
Connection of the muscle to a bone that moves
Origin of a muscle
Connection of the muscle to a stationary bone
Bending the sole of the foot downward towards the ground
turning the palm downward
circular movement around a central point. Internal rotation is towards the center of the body, external rotation is away from the center of the body
Muscle connected to bones; voluntary or skeletal muscle
Turning the palm upward
Muscle connected to internal organs; involuntary or smooth muscle
fibrous connective tissue
sole of the foot
skeletal (striated) muscle connected to bones
muscle and flesh
Rheumatoid factor (RF)
The blood of many persons with RA contains a macroglobulin-type antibody called rheumatoid factor (RF), although RF can be found in people w/ other diseases. Test measures antibodies directed against the Fc fragment of IgG
Serum calcium (Ca)
Measures the concentration of total and ionized calcium in the blood to reflect parathyroid function, calcium metabolism, and malignancy activity. Calcium is bound to albumin so if albumin is low, serum calcium can be falsely low as well
Serum creatine kinase (CK)
Enzyme found in higher concentrations in the heart and skeletal muscles and in much smaller concentrations in brain tissue. This test is used as a specific index of injury to myocardium and muscle. CK can be divided into three isoenzymes: BB/CK1, MB/CK2, MM/CK3.
Uric acid test
Uric acid is formed from the breakdown of nucleonic acids and is an end product of purine metabolism; transported by the plasma from the liver to the kidney, where it is filtered and about 70% is excreted. The remainder is excreted into the GI tract and degraded. Overproduction of uric acids occurs when there is excessive cell breakdown and catabolism of nucleonic acids (gout), excessive production and destruction of cells (leukemia), or an inability to excrete the substance produced (renal failure)
Procedure in which a needle is inserted into a joint in order to remove fluid. Purpose is usually twofold: removal of excess fluid will usually decrease symptoms of pain and improve joint mobility and the fluid removed can be used to diagnostic of a certain problem
Radiographic examination of a joint after the injection of a dye-like contrast material and/or air to outline the soft tissue and joint structures on the images.
Operation for construction of a new movable joint (shoulder, elbow, hip, knee, MTP joints in the foot and certain joints in the hand). Three methods are in general use: excision arthroplasty, half-joint replacement arthroplasty, and total replacement arthroplasty.
visual examination of the interior of joints with special surgical instruments
Dual-energy absorptiometry (DEXA or DXA) is the most common and preferred method of measuring bone mineral density because of its precision and low radiation exposure. It can assess fracture risk with ease and patient comfort. Test scores are reported with a T-score and a Z-score. T-score is the number of standard deviations for the patient compared with normal young adults with mean peak bone mass; fracture risk increases 1.5 to 2.5 time for every SD. The Z-score is defined as the number of SDs for the patient compared with normal persons in the same age category
Nuclear scanning test that identifies new areas of bone growth or breakdown; can be done to evaluate damage to the bones, detect cancer that has spread to the bones, and monitor conditions that can affect the bones (including infection and trauma). A bone scan can often detect a problem days to months earlier than a regular X-ray test.
Test that assesses the health of the muscles and the nerves controlling the muscles; a needle electrode is inserted through the skin into the muscle & electrical activity detected is displayed on an oscilloscope, and may be heard through a speaker. After placement of the electrodes, the patient will be asked to contract the muscle (for example, by bending your arm). The presence, size, and shape of the wave form -- the action potential -- produced on the oscilloscope provide information about the ability of the muscle to respond when the nerves are stimulated.
plays an integral role in evaluation of the patient with neuromuscular disease (essential element in the assessment of a patient with suspected myopathy)