Musculoskeletal System Flashcards
(33 cards)
How do fractures naturally heal immediately (blood vessels) ?
- blood vessels cause haematoma which fills the fracture gap
- provides a fibrin meshwork to allow formation of granulation tissue
How do fractures heal naturally?
- inflammatory cells release cytokines to activate osteoblast and osteoclast
- development of cartilage cap (1 week)
- bone deposition begins to strengthen callous
What may hinder fracture healing?
- bones not aligned
- area not immobilised
- if fracture site contains dead bone
- infection
What is osteoporosis when looking at the bones?
- decrease in bone mass and density
- can lead to fractures
What are the hormonal influences of osteoporosis?
- lack of oestogen (increases bone resorption and deceases bone formation)
- calcium metabolism and vitamin D deficiency
- certain drugs
What is the drug of choice in treating osteoporosis?
- alendronic acid
What is arthritis and its characteristics?
- inflammation of the joints
- pain, swelling, stiffness, warmth and redness in joint
- restricted movement
- can get bone thickening or outgrowth (osteophytes)
What are the risk factors in osteoarthritis (progressive deterioration in weight bearing joints) ?
- increasing age
- female sex, menopause
- obesity
- pre-existing joint deformity
- excess mechanical stress
- family history / genetics
- hypermobility
- other diseases
What are the features of osteoarthritis?
- morning stiffness
- pain worse with movement
- reduced range of movement
- progressive reduction in mobility
- joint effusions (fluid in the joints)
- crepitus (sounds like crackles )
Rheumatoid arthritis is an auto immune disorder. What happens in in it?
rheumatoid factors help to form immune complexes in the circulation
- generates inflammation in synovium
- membranes thicken
- chronic inflammation leads to cartilage and joint destruction
- other tissues can be involved eg. lungs and vessels
What are the features of rheumatoid arthritis?
- usually affects small joints of hands and feet
- pain
- swelling and deformities (swan neck deformities)
- fever, fatigue, generalised pain
- joints often stiff without prior activity
How is rheumatoid arthritis diagnosed?
- morning stiffness that last over an hour
- effects 3 or more joints
- arthritis typical of hand joints
- symmetric arthritis
- rheumatoid nodules
- serum rheumatoid factor
- typical radiographic changes
- must have 4 of these
Crystal arthropathies are associated with intra-articular crystals. What are two examples of this?
- gout
- pseudogout
- crystals in the joint space
What can cause gout?
- drugs (aspirin, diuretics)
- alcohol
- renal disease
- hypothyroidism
- dehydration
What happens in gout?
- raised uric acid (produced by breakdown of xanthine oxidase) - usually excreted by kidneys
- deposits as crystals in the joint
- repeated attacks lead to chronic arthritis
What is the difference between what is deposited in the joints in gout and pseudogout?
gout - uric acid
pseudogout - calcium pyrophosphate
What are the features of gout?
- sudden onset excruciating burning joint pain
- redness, warmth, tenderness, stiffness
- usually first attack involved big toe
- subsequent stacks are less severe
Where does psuedogout usually appear?
knees and ankles
What can happen with the crystals in psuedogout?
crystals in cartilage can enlarge and rupture
- shows symptoms of arthritis
What are the causes of pseudogout?
- can be hereditary
- associated with osteoarthritis
- trauma or surgery
- more common with increasing age
What is septic arthritis?
inflammation of the joint caused by bacterial infection
Where does septic arthritis usually affect?
the knee
What does septic arthritis cause/symptoms
- severe pain, swelling, redness and heat in affected joint
- difficulty moving joint
- tends to develop quickly over a few hours or days
- Some people have high temp
- can cause sepsis which can case death
How do you treat septic arthritis?
- iv antibiotics
- may require washout of the joint
- can cause sepsis! serious !
