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Understanding Human Disease > Chapter 21 - Bones & Joints > Flashcards

Chapter 21 - Bones & Joints Flashcards

1
Q

what are the 5 functions of the skeletal system?

A

-reservoir of minerals (calcium and phosphorus)
-protection of organs
-production of blood cells
-movement
-shape

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2
Q

what is bone made of?

A

connective tissue

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3
Q

outer most layer of compact bone

A

cortex

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4
Q

inner spongy layer of bone

A

trabeculae

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5
Q

what is bone marrow

A

spaces between trabeculae that consist of fat and blood-forming tissue

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6
Q

osteoblast

A

build bones

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7
Q

osteoclasts

A

break down bones

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8
Q

osteocytes

A

bone cells

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9
Q

Wolff’s Law

A

muscle pulls on bone and strengthens it – strength of bone depends on activity level

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10
Q

endochondral ossification

A

lay down cartilage
bone replaces cartilage
ossification at epiphyseal plate

females don’t grow as tall because their epiphyseal plate closes sooner

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11
Q

intramembranous ossification

A

no cartilage phase occurs — usually in flat bones

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12
Q

bone mineral density

A

amount of mineral per cm of bone

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13
Q

what is an indicator of fracture risk?

A

bone mineral density

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14
Q

what factors influence bone mineral density

A

diet
physical activity
hormones
ethnicity (caucasian and asian)
age
sex

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15
Q

what is the most common affliction of bone?

A

fracture

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16
Q

causes of fractures

A

trauma OR
pathologic (diseases like cancer or osteoporosis)

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17
Q

what is osteopenia?

A

generalized loss of bone

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18
Q

what can osteopenia be caused by?

A

osteoporosis
osteomalasia (vitamin D deficiency)

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19
Q

what is the most common malignancy of bone?

A

metastatic cancer

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20
Q

what are the most common cancers of bone in children and adolescents?

A

osteosarcoma and Ewing sarcomewhat

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21
Q

what bone cancer is most common in adults?

A

multiple myeloma

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22
Q

most common symptoms associated with bone

A

pain
decreased mobility
deformity

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23
Q

symptoms associated with arthritis include

A

joint stiffness and decreased mobility
pain and inflammation

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24
Q

tests for bones

A

X-rays and CT scans (tumors)

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25
Q

serum tests

A

-calcium, phosphorus, and alkaline phosphatase (measure BMD)
-erythrocyte sedimentation rate (how fast RBC settle to measure inflammation)
-rheumatoid factor (arthritis) and uric acid levels (gout)

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26
Q

what are used to diagnose arthritis and osteomyelitis

A

cultures

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27
Q

how to diagnose bone tumor or confirm infection

A

biopsy

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28
Q

achondroplasia

A

dwarfism = mutation in fibroblast growth factor 3 (Fgfr3)
-faulty bone formation in extremities and skull bones

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29
Q

what type of genetic disease is achondroplasia?

A

autosomal dominant (one copy from one parent)

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30
Q

what are the majority of mutations in achondroplasia?

A

de novo (in sperm or egg cell)

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31
Q

osteogenesis imperfecta

A

imperfect creation of bone because of insufficient collagen formation; they become thin and delicate and break easily “brittle bone”

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32
Q

what type of genetic disease is osteogenesis imperfecta?

A

autosomal dominant

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33
Q

what does osteogenesis imperfecta increase susceptibility for?

A

bone fractures

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34
Q

how many types of osteogenesis imperfecta are there?

A

8

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35
Q

symptoms/manifestations of osteogenesis imperfecta

A

malformation of fingers and toes
spinal curvature
brittle teeth and bones
blue sclera

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36
Q

clubfoot (talipes)

A

foots grow inward toward one another

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37
Q

what is the most common congenital disorder of the legs

A

clubfoot talipes

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38
Q

cause of clubfoot

A

multifactorial inheritance (many genes)

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39
Q

how do you treat clubfoot?

A

manipulation and casts

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40
Q

fracture definition

A

any disruption in continuity of bone

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41
Q

what are fractures most often caused by?

A

trauma or pathologic fracture (underlying disease of bone)

42
Q

why does breaking a bone hurt?

A

because you tear the periosteum where pain receptors are

43
Q

simple fracture

A

bone broken in only two pieces

44
Q

comminuted fracture

A

bone is shattered

45
Q

compound fracture

A

fracture that breaks skin - potential for infection

46
Q

pathologic fracture

A

fracture through a diseased area of the bone

47
Q

greenstick fracture

A

bent bone – adolescence only because bones aren’t fully matured

48
Q

What two things must happen for a bone to heal properly?

A

broken fragments have to be close to each other and the fracture must be stabilized (cast or splint)

49
Q

healing process of a fracture

A

proliferation of osteoblasts from site of fracture and vascular channels from periosteum; immature bone and cartilage gradually remodel into mature bone

50
Q

how long does it take for a bone to heal?

A

6-8 weeks

51
Q

osteomyelitis

A

bacterial infection of bone and marrow

52
Q

etiology of osteomyelitis

A

organisms gain access to bone via:
-spread of infection from somewhere else in the body
-following trauma or surgery to bone itself

53
Q

manifestations of osteomyelitis

A

-fever
-local pain and tenderness

54
Q

how to diagnose osteomyelitis

A

X-ray

55
Q

how to treat osteomyelitis

A

antibiotics
surgery if needed

56
Q

complications of osteomyelitis

A

spread of infection (endocarditis or sepsis)
amputation of limb

57
Q

osteoporosis

A

absolute reduction of total bone mass – histology is normal but lacks structural integrity

58
Q

is osteoporosis age related?

A

yes; one third of the population over 85 have it

59
Q

who is more at risk for osteoporosis?

A

women; especially after menopause due to decreased estrogen levels

60
Q

symptoms of osteoporosis

A

none

61
Q

what can result from osteoporosis

A

increased mortality
loss of independent living
decreased mobility

62
Q

causes of osteoporosis

A

primary: age, declining estrogen
secondary: excess cortisol, increased PTH

63
Q

at what age does your bone mass peak?

A

25-30

64
Q

risk factors of osteoporosis

A

age
ethnicity (caucasian and asian)
genetics
skeletal frame size (smaller)
decreased estrogen/testosterone
decreased physical activity
excess intake of phosphorus, alcohol, nicotine
inadequate vitamin D, calcium, potassium, magnesium

65
Q

manifestations of osteoporosis

A

vertebral fractures
lumbar lordosis and kyphoscoliosis (hunchback)
pulmonary embolism (fractures of the neck, pelvis, spine)

66
Q

how to diagnose osteoporosis

A

DEXA (dual-energy x-ray absorptiometry)

67
Q

can osteoporosis be reversed?

A

no - once the bone is gone, it’s gone (osteocytes cannot regenerate themselves)

68
Q

treatment for osteoporosis

A

medication:
-osteoclast inhibitory
-estrogen mimetic
-synthetic PTH

69
Q

osteopenia

A

lower than normal bone mineral density (precursor to osteoporosis)

70
Q

osteomalacia

A

softening of bone from poor mineralization

71
Q

cause of osteomalacia?

A

vitamin D deficiency

72
Q

what is osteomalacia called in children?

A

rickets

73
Q

complications of osteomalacia

A

deformity, increased fracture risk

74
Q

scoliosis

A

abnormal S-shaped curvature of sping

75
Q

kyphosis

A

abnormal forward bending of upper spine (hunchback)

76
Q

potential causes of spine deformities

A

arthritis
congenital
osteoporosis
idiopathic

77
Q

complications of spine deformities

A

impairment of activity
breathing problems
back pain

78
Q

hematopoeitic cancer is what percentage of bone cancers?

A

40% - most common

79
Q

what are benign cysts and tumors of the bone called?

A

osteomas

80
Q

what are primary malignant bone tumors called?

A

osteosarcomas

81
Q

what is the most common malignant tumor of the bone in children?

A

osteosarcoma

82
Q

symptoms of osteosarcoma

A

bone pain
progressive enlargement of mass
pathologic fracture

83
Q

is osteosarcoma more common in males or females?

A

males

84
Q

where do osteosarcomas usually occur

A

the ends of long bones

85
Q

is metastases common in osteosarcomas

A

yes

86
Q

arthritis

A

degeneration of synovial joints

87
Q

arthroscopy

A

tool with a lighted camera to visualize joint space

88
Q

osteoarthritis

A

degenerative joint disease – “wear and tear” of joints from old age

89
Q

what joints does osteoarthritis affect?

A

weight-bearing big joints, small joints of hands and feet

90
Q

primary classification of osteoarthritis

A

unknown or multifactorial

91
Q

secondary classification of osteoarthritis

A

related to another disease

92
Q

etiology of osteoarthritis

A

cartilage becomes thin and the bone surfaces rub together producing bone cysts

93
Q

treatment of osteoarthritis

A

replace the joint

94
Q

risk factors for osteoarthritis

A

increased age
joint trauma; long-term stress
endocrine disorders
drugs
obesity

95
Q

rheumatoid arthritis

A

systemic autoimmune disease affecting the joints; produces chronic inflammation and thickening synovial membrane

96
Q

what is often associated with rheumatoid arthritis

A

rheumatoid factor; an autoantibody in blood and synovial tissues (attacks immune system)

97
Q

is rheumatoid arthritis age associated?

A

no

98
Q

clinical course of rheumatoid arthritis

A

malaise, fatigue, and generalized joint pain
-joints then become swollen, warm, painful and stiff

99
Q

treatment for RA

A

immunosuppressants or NSAIDs

100
Q

Gout/gouty arthritis

A

too much uric acid in the blood and other body fluids; crystals made of uric acid deposit in tissues throughout the body

101
Q

where does gouty arthritis usually occur

A

big toe (50%), heel, ankle, inside of foot, knee, wrist, elbow

102
Q

contributing factors of gout

A

age
male
obesity
high intake of alcohol and red meat
genetic predisposition

Understanding Human Disease (10 decks)

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