Chapter 26: bones and joints Flashcards
1
Q
skeletal tissue and structure
- give the body its ______ form
- protect ______
- promote efficient ______ despite the forces of gravity
- store ______ and other materials needed for ______
- produce ______
A
structural vital organs movement salts metabolism RBCs
2
Q
connective tissue that provides a smooth articulation surface for other bones
A
cartilage
3
Q
where bones interact
A
joint
4
Q
a form of dwarfism caused by impaired ______ in the growth plate; common cause of dwarfism; caused by mutation of the gene for the ______ (FGFR3). most mutations are sporadic and related to ______ paternal age. mental function, life span and fertility are ______ affected
A
achondroplasia (congenital and genetic bone diseases) cartilage proliferation fibroblast growth factor receptor gene 3 increased not
5
Q
- bones defect caused by mutations of the gene for collagen.
- clinical features:
a) multiple ______ of bone (can mimic child abuse, but ______ is absent), ______: thinning of scleral collagen reveals underlying veins, hearing loss due to middle ear bone easily fractured
A
osteogenesis imperfecta (congenital and genetic bone diseases)
fractures
bruising
blue sclera
6
Q
thick bones resulting from a defect in the function of ______. clinical features include bone fractures, ______, cranial nerve ______ etc. Treatment: ______
A
osteopetrosis (congenital and genetic bone diseases) osteoclasts anemia palsies bone marrow transplant
7
Q
- infection of marrow and bone (occurs in children)
- most commonly ______; arises via ______ spread (bacteria in the blood). bacterial infection (children) seeds ______. open wound bacteremia (adults) seeds ______.
- common agents: ______: (90% of cases), ______: sexually active young adults, ______: sickle cell disease, ______: diabetics or IV drug abusers, ______: involves vertebrae (Pott disease)
- clinical features: ______ pain with systemic signs of ______ (fever and leukocytosis), ______ focus (abscess) of bone on x-ray. diagnosis is made by ______ or bone ______.
- treatment: ______
A
osteomyelitis bacterial hematogenous metaphysis epiphysis staphylococcus aureus N. gonorrhoeae salmonella pseudomonas mycobacterium tuberculosis bone infection lytic blood culture aspiration antibiotic therapy
8
Q
- reduction in bone mass. results in ______ bone with an increased risk for ______
- risk of osteoporosis is based on peak ______ (in early adulthood) and afterwards
- factors may be involved: ______ (vitamin D receptor differences), diet, decreased ______ (menopause) and lack of exercise
- subdivided into two groups: primary and secondary
- clinical features: ______ pain and fractures in weight-bearing areas such as ______, hip, and distal ______. bone density is measured using a ______ scan. Lab tests: ______ normal (excludes osteomalacia)
- treatment: exercise, ______, and ______- limit bone loss
- ______: induce apoptosis of osteoclasts
- SERM (selective estrogen receptor modulator)
- ______ are contraindicated (worsen osteoporosis)
A
osteoporosis porous fracture bone mass genetic estrogen bone pain vertebrae radius DEXA PTH vitamin D calcium bisposphonates glucocorticoids
9
Q
- softening of bones as a result of inadequate ______ of the organic matrix (______)
- due to low levels of ______, which result in low serum ______ and ______ (lab findings for rickets and osteomalacia
- ______ is normally derived from the skin upon exposure to sunlight (______) and form the diet (______). activation requires ______ by the liver followed by ______ by the proximal tubule cells of the kidney.
- ______ is due to low vitamin D in children (less than ______ years old), resulting in abnormal bone ______. ______: soft leg bones can’t carry weight, ______: flawed teeth mineralization, pigeon-breast deformity
- ______: due to low vitamin D in adults. diffuse ______ pain, muscle weakness and increased risk of fracture
- treatment: ______ supplement and treating the underlying cause
A
rickets and osteomalacia mineralization osteoid vitamin D calcium phosphate vitamin D 85% 15% 25-hydroxyltion 1-alpha-hydroxylation rickets 10 mineralization bowlegs delayed dentition osteomalacia back vitamin D
10
Q
- imbalance between osteoclast and osteoblast function. usually seen in late adulthood (average age ______). idiopathic cause. three phases: ______, ______ and ______ phases
- clinical features: bone pain- due to ______, increasing hat size- ______ is commonly affected, ______ loss, ______ face and isolated elevated ______ (liver enzyme)
- treatment: ______ (inhibits osteoclast function) and ______ (induces apoptosis of osteoclasts)
A
page's disease of bones >60 years destructive, mixed, osteosclerotic micro-fractures skull hearing lion-like alkaline phosphatase calcitonin bisphosphonates
11
Q
- ______ describes increased pressure within a muscle compartment of the arm or leg. it is most often due to injury that causes ______ in a muscle, which then causes ______ in the muscle. this pressure increase causes ______ damage due to decreased ______.
- pathogenesis: compartment syndrome develops when ______ or ______ occurs within a compartment. because the ______ does not stretch, this can cause increased pressure on the ______, ______, and ______ in the compartment
- blood flow to the muscle and nerve cell is disrupted. without a steady supply of ______ and ______, nerve and muscle cells can be damaged
A
compartment syndrome bleeding increased pressure nerve blood supply swelling bleeding fascia capillaries nerves muscles oxygen nutrients
12
Q
- occurs as a complication of an injury. often it is due to a fracture of the ______ or ______ in the forearm or the ______ and ______ in the lower leg that causes significant ______ in one or more of the compartments. bleeding can also be due to a badly ______ muscle. crush injury may cause both bleeding and swelling of muscles, common causes include:
- a person in an auto accident where their legs are trapped and compressed with heavy debris, which are subsequently freed from the debris after a period of time
- when a blood vessel is damaged and subsequently repaired through ______. the above conditions are due to the compartment swelling and may occur after the blood supply is re-establshed (______) to an area that has lost it for a period of time.
- compartment syndrome may be a complication of ______ or ______ that are applied too tightly
- symtoms: pain which is more ______ than what would be expected from the injury itself. using or stretching the involved muscles ______ the pain. there may also be ______ or ______ sensations in the skin. numbness or ______ are late signs of compartment syndrome. they usually indicate permanent tissue injury
- treatment: acute compartment syndrome is a ______. there is no effective nonsurgical treatment. ______ of the patient prior to surgery is via two large ______ with pain medication. your doctor will make an incision and cut open the skin and fascia covering the affected compartment. this procedure is called a ______.
- sometimes the swelling can be severe enough that the skin incision cannot be closed immediately. the incision is surgically repaired when swelling subsides. sometimes a ______ is used
A
acute compartment syndrome radius ulna tibia fibula bleeding bruised surgery reperfusion swelling bandages casts intense increases tingling burning paralysis surgical emergency stabilization bore IVs fasciotomy skin graft
13
Q
- causes pain or cramping during exercise. this pain subsides when activity ______. it most often occurs in the ______. symptoms may also include: ______, difficulty moving the ______ and visible muscle ______
- treatment: ______, orthotics (inserts for shoes), and ______ medicines are sometimes suggested. some athletes have symptoms that are worse on certain ______ (concrete vs. running track, or artificial turf vs. grass). symptoms may be relieved by switching surfaces.
- if conservative measures fail, ______ may be an option. similar to the surgery for acute compartment syndrome, the operation is designed to open the ______ so that there is more room for the muscles to ______. also, this surgery is typically an elective procedure, not an emergency.
A
chronic compartment syndrome stops legs numbness foot bulging physical therapy anti-inflammatory surfaces surgery fascia swell
14
Q
benign bone tumors
A
osteoma (associated with Gardner’s syndrome)
chondroma
giant cell tumor (benign in most cases but may recur)
15
Q
malignant bone tumors
A
osteosarcoma
chondrosarcoma
Ewing’s sarcoma
