Bioscience And Nursing Musculoskeletal System Flashcards

1
Q

Bone functions

A

Support
Protection
Store minerals and triglycerides
Maintain homeostatic blood calcium levels
Blood cell production (haemotopiesis)
Movement

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2
Q

Origin

A

Fixed point of muscle attachment (bone don’t move when muscle contracts)

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3
Q

Insertion

A

Moveable point of muscle attachment (bone moves when muscle contracts)

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4
Q

Axial skeleton

A

Made up of bones of the skull, vertebral column and rib cage

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5
Q

Appendicular skeleton

A

Made up of bones of upper limbs (arms, forearms & hands), lower limbs (thighs, legs & feet)
Shoulder (pectoral) girdles & pelvic girdle

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6
Q

Long bones

A

Long slender bones, have a shaft (diaphysis) & bone ends (epiphysis) e.g humerous

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7
Q

Short bones

A

Small cube shaped bones e.g tarsals, carpals, patella

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8
Q

Flat bones

A

Thin, flat & often curved e.g sternum, ribs & scapula

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9
Q

Irregular bones

A

Complex shaped bones e.g vertebrae & hip bones

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10
Q

Bone structure

A

Contains: connective tissue, adipose tissue, osseous tissue & hyaline cartilage

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11
Q

Osseous tissue

A

Connective tissue which contains specialised cells & a matrix

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12
Q

Matrix

A

Consists of ground substance, collagen fibres & calcium phosphate crystals

makes bones flexible hard and strong

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13
Q

Collagen fibres

A

Gives bones flexibility and tensile strenght

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14
Q

Calcium phosphate crystals

A

Makes bones hard and provide compressive strenght

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15
Q

Bone without crystals

A

Has tensile strength but lacks compressive strength-soft and flexible

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16
Q

Bone without collagen fibres

A

Hard with compressive strength, lack flexibility & tensile strength-brittle

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17
Q

Osteoprogenitor cells

A

Stem cells which differentiate into osteoblasts

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18
Q

Osteoblasts

A

Bone building cells-produce and secrete collagen fibres and ground substance

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19
Q

Osteoclasts

A

bone reabsorbing cells-breakdown matrix and release stored minerals

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20
Q

Osteocytes

A

mature bone cells which maintain the matrix

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21
Q

layers of bones

A

outer layer of compact bone & internal layer of spongy bone

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22
Q

outer connective tissue membrane=periosteum

A

covers compact bone, contains blood vessels & nerves

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23
Q

internal connective tissue membrane=endosteum

A

covers spongy bone

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24
Q

yellow bone marrow

A

stores adipose tissue

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25
Q

red bone marrow

A

making of RBC’s (hematopoiesis)

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26
Q

spongy bone

A

contains trabeculae (thin needle-like structures)

lighter than compact bone-reduces weight off skeleton

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27
Q

trabeculae function

A

resist forces from all directions without breaking

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28
Q

interstitial growth

A

new cartilage is formed on the epiphyseal plate & old cartilage is turned to bone-diaphysis gradually lengthens

Bone remains strong because growth is at the top and bottom at the same time

interstitial growth makes bones longer, occurs at epiphyseal gate

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29
Q

appositional growth

A

makes bones grow wider-occurs on outer surface of all bones.

step 1. osteoblasts secrete layers of new matrix onto bone surface-becomes contact bone & bone widens

step 2. (In long bones) osteoclasts remove old matric from inner surface, enlarges medullary cavity, so bones don’t become too heavy.

occurs at bone surface

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30
Q

Bone deposition

A

Osteoblasts produce new matrix

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31
Q

Bone remodelling

A

Maintain bone mass & strength. Replaces old matrix with new matrix. Involves bone resorbtion & bone deposition

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32
Q

Bone resorption

A

Osteoclasts break down old matrix

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33
Q

What decreases bone mass

A

Age & decline in sex hormones-rate of bone resorption exceeds the rate of bone deposition

Loss of calcium phosphate crystals and collagen fibres = thin, weak brittle bones

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34
Q

Factors affecting bone remodelling

A

Good amounts of vitamins C, A, D, K & B12 as well as calcium and phosphate

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35
Q

Comminuted fracture

A

Bone fragmented into 3 or more pieces

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36
Q

Compression fracture

A

Bone is crushed

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37
Q

Greenstick fracture

A

Bone is bent and cracked but it’s an incomplete break

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38
Q

Spiral fracture

A

Ragged break that occurs when excessive twisting forces are applied to a bone

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39
Q

Epiphyseal

A

Bone breaks along the epiphyseal plate

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40
Q

Transverse fracture

A

Bone completely breaks along the diaphysis

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41
Q

Depressed fracture

A

Broken bone is pressed inwards

42
Q

Avulsion fracture

A

Tendon or ligament pulls off a fragment of bone

43
Q

Pathological fracture

A

Caused by a disease that weakens bone structure e.g osteoporosis

44
Q

Colles fracture

A

Break at distal end of radius

45
Q

Scaphoid fracture

A

Common carpal bone fracture

46
Q

Potts fracture

A

Break in medial malleolus of the tibia and/or lateral malleolus

47
Q

Treatment of fracture

A

Reduction-bone realignment

Immobilisation of realigned bones

Rehabilitation-restore function

48
Q

Fracture Repair step 1

A

Haematoma Forms
Torn blood vessels, clot forms, site swollen and sore

49
Q

Fracture Repair step 2

A

Fibrocartilaginous Callus Forms

Fibroblasts produce collagen fibres
Chondroblasts produce cartilage
Fibrocartilaginous Callus splints broken bone ends

50
Q

Fracture Repair step 3

A

Bony Callus of Spongy Bone Forms

Fibrocartilaginous callus is replaced by spongy bone
Bone ends united

51
Q

Fracture Repair step 4

A

Bone Remodelling

Compact bone replaces spongy bone at diaphysis
Osteoclasts remove excess bone
Bone returns to normal shape

52
Q

Osteomalacia (adults) & Rickets (children)

A

Poorly mineralised bones-lack calcium phosphate crystals

Bones=soft, flexible

Causes=vitamin D deficiency or not enough calcium intake

53
Q

Osteogenesis Imperfecta (Brittle bones disease)

A

Affects quantity and quality of collagen fibres
Brittle bones-fracture easily
No cure

54
Q

Osteoporosis

A

Reduction in bone mass affects bone function
Reduced amount of matrix components=porous, light, fragile easily fractured bones

55
Q

Joint

A

Point of contact between 2 or more bones. Holds skeleton together and give skeleton mobility and flexibility

56
Q

Synarthrosis joint

A

Immovable joint

57
Q

Amphiarthrosis joint

A

Slightly movable joint

58
Q

Diarthrosis

A

Freely movable joint

59
Q

Fibrous joint

A

No joint cavity
Fibrous tissue unites articulating bones
Are synthetic or amphiarthrotic

60
Q

Cartilaginous joint

A

Cartilage (hyaline or fibrocartilage) unites articulating bones
No joint cavity
Synarthotic or amphiarthrotic

61
Q

Synovial joint

A

Articulating bone ends are covered in articular cartilage
Joint cavity present
Diarthrotic joint
Allow wide range of movement

62
Q

Pivot joint

A

Allows rotation e.g proximal radio ulnar joint

63
Q

Plane joint

A

Allows gliding movement e.g intertarsal joint

64
Q

Condular joint

A

Allows flexion, extension, addiction, abduction & circumduction e.g metacarpophalangeal (knuckle & wrist joints)

65
Q

Saddle joint

A

Allows flexion, extension, adduction, abduction & circumduction e.g carpometacarpal joint of the thumb

66
Q

Hinge joint

A

Allows flexion & extension e.g elbow, knee & ankle joints

67
Q

Ball & socket joint

A

Allow flexion, extension, abduction, adduction, circumduction & rotation e.g hip & shoulder joints

68
Q

Skeletal muscles components

A

Muscle fibres, cells, connective tissue, blood vessels & neurons

69
Q

Muscle fibres

A

Surrounded by 3 connective tissue sheaths

70
Q

Endomysium

A

Surrounds each individual muscle fibre

71
Q

Perimysium

A

Surround a bundle (fascicle) of muscle fibres

72
Q

Epimysium

A

Surrounds the entire skeletal muscle

73
Q

Tendon

A

Formed when 3 membranes blend together attach muscle to bone

74
Q

Myofibriles

A

Composed of contractile units (sacromere) extend entire length of muscle fibres

75
Q

Sacromeres

A

Composed of thick and thin myofilaments

76
Q

Thick myofilments

A

Composed of myosin

77
Q

Thin myofilaments

A

Composed of actin

78
Q

Steps in muscle contraction

A
  1. Primary motor cortex sends message to lower motor neurons about muscle contraction
  2. Lower motor neuron conducts somatic motor output from CNS to a skeletal muscle
  3. Axon terminals of a lower motor neuron forms a synapse (neuromuscular junction) with a muscle fibre
79
Q

Events stimulating a muscle contraction

A
  1. Somatic motor output in form of an action potential travels along the axon of a lower motor neuron to axon terminals
  2. Voltage gated Ca2 (calcium) channels open and Ca2+ enters axon terminal
  3. Ca2+ entry causes synaptic vesicles to release ACH into the synaptic cleft
  4. ACH diffuses across the synaptic and binds to chemically gated ion channels on sarcolemma
  5. Channels open-influx of Na+
    -sarcolemma depolarises
    -graded potential produced
  6. Graded potential opens voltage gated Na+ channels in sarcolemma-action potential produced
  7. Action potential travels along the length of sarcolemma
  8. The action potential travels the length of the t tubules deep into muscle fibre
  9. Action potential stimulates sarcoplasmic reticulum Ca2+ release channels to open
  10. Ca2+ flows into cytoplasm of the muscle fibre
  11. Binding of Ca2+ to troponin pulls tropomyosin away from actin active sites
  12. Myosin heads bind to the active sites forming cross bridges & contraction begins
80
Q

Process of contraction

A
  1. Myosin heads bind to the actin sites on thin myofilaments
  2. Myosin heads pull the thin myofilament towards centre of sacromere (m line) then detach ATP breaks detachment of myosin & actin

Cycle repeats

81
Q

Muscle relaxation steps

A
  1. ACH within synaptic cleft is degraded by the enzyme acytlecholmesterase (ACHE)
  2. Sarcolemma (SR) return to its rmp
  3. Calcium release channels in sr close
  4. Calcium ions ultimately pumped back into SR
  5. Troponin returns to its original shape
  6. Tropomyosin blocks actin active sites
82
Q

Ligament

A

Bone to bone

83
Q

Tendon

A

Muscle to bone

84
Q

Osteoporosis

A

Low bone mass & microarchitectural deterioration of bone tissue
Bone loss occurs slowly

Risk factors: family history, increase in age, vitamin d deficiency & early menopause

85
Q

Inflammatory conditions

A

Rheumatoid arthritis
Ankylosing spondylitis

86
Q

Degenerative disease

A

Osteoarthritis
Osteoporosis

87
Q

Treatment of fractures, tissue injuries & dislocation

A

Rest
Ice
Compression
Elevated
(R)efferal

88
Q

Why do an Neurovascular Assessment

A

Injuries & haemorrhage can cause interruptions to nerve & vascular supply—early detection is important
Distance of limbs from heart and lack of potential secondary sources of supply place them at risk

89
Q

How to complete an NVO

A

Assessing pulse
Neurological functioning of limbs
Will determine vascular or neurological function

NVO
Pain
Pulse
Pallor
Paresthesia
Paralysis

90
Q

Compartment syndrome

A

Build up pressure within a compartment compromises tissue perfusion
Build up reduces capillary blood flow to said space

Plaster cast
Tissue fascia
Bandage

91
Q

Nurse interventions for diagnostic tests

A

Prepare patient for respective scan
Patient must lie still
Assess for conditions which may require special consideration e.g for disability etc
Check for allergies to contrast agent
Past arthrogram applies compression bandage to joint if prescribed & rest for 12 hours
Administer analgesia as required

92
Q

Ankylosing spondylitis

A

A systemic inflammatory condition of the skeleton. A disease of the cartilaginous joints of the spine & surrounding tissues (occasionally large synovial joints (hips, knees & shoulders) may be involved). Back pain is a common characteristic. Complicates osteoporosis because of the inflammatory process & bone turnover. Systemic effects of uveitis in 20-25% of cases

93
Q

Atrophy

A

Age and disease can cause the loss of muscular function as fibrotic tissue replaces contractile muscle tissue. The decrease in muscle size is called atrophy

94
Q

Crepitus

A

A grating sound at the point of abnormal movement

95
Q

Frozen shoulder (adhesive capsulitis)

A

Fibrous tissue form in the joint capsule causing stiffness, limitation of motion & pair

96
Q

Gouty arthritis

A

Joint effusion or synovial thickening seen as a bulge or pullness in grooves on either side of the olecranon process. Redness & heat beyond the synovial membrane. Over secretion of uric acid or renal defect resulting in decreased uric acid which results in hyperarianaemia which can cause urate or crystal deposition

97
Q

Joint effusion

A

Excessive fluid within the joint capsule. May present as swelling & bony landmarks are obscured

98
Q

Articular capsule

A

Outer tough layer stabilises articulating bones
Inner membrane produces synovial fluids

99
Q

Joint cavity

A

Holds synovial fluid separates articulating bones

100
Q

Synovial fluid

A

Shock absorbing median supplies chondroblasts with O2 and nutrients-remove wastes

101
Q

Ligaments

A

Allow movement-stabilises the joint