Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

HLSC 222 - Pathophysiology Across the Lifespan > Chapter 39, 40, 41 - Alterations in Musculoskeletal and Integumentary Function > Flashcards

Chapter 39, 40, 41 - Alterations in Musculoskeletal and Integumentary Function Flashcards

1
Q

Skeletal trauma is the leading cause of death in individuals age __ to ___

A

1 to 44

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

____% of hospital visits come from fractures

A

70%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

The majority of occupational injuries in a hospital are…

A

registered nurses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the first line of defence against external forces?

A

musculoskeletal system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the role of the musculoskeletal system?

A

-mobility
-internal organ protection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Damage to the musculoskeletal system results in _______ and _______ movement

A

difficult and painful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a bone fracture?

A

a break in bone, usually accompanied by surrounding tissue damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

_____ have a higher incidence of fractures especially age ___-___

A

males; 15-24

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Adults >____ yoa also have a high incidence of fractures

A

65

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Where do fractures occur in most young people?

A

clavicle, tibia, and humerus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Workplace accidents occur most commonly in ______ and ______

A

hands and feet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which areas do fractures occur commonly in older people?

A

humerus, femur, vertebra, pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Fractures in older individuals are linked to _________

A

osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are shin splints?

A

stress on tibia from overworking your muscles (starting too fast, not allowing time to grow, not warming up)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Complete Bone Fracture

A

Bone entirely broken

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Incomplete fracture

A

bone damaged but still in one piece

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Open fractures

A

skin is open

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Comminuted fracture

A

bone breaks into more than two fragments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Linear fracture

A

runs parallel to the long axis of the bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Oblique fracture

A

occurs at a slanted angle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Spiral fracture

A

encircles bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Transverse fracture

A

straight across bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Greenstick fracture

A

bone cracks only on one side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is a pathological fracture?

A

a break at a site of pre-existing abnormality and resulting from force that would not fracture a normal bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Signs and Symptoms of Fracture

A

-swelling
-pain
-deformity
-dislocation
-crepitus
-bruising
-nerve damage
-pulselessness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Swelling at fracture site occurs due to soft tissue _______ and ________

A

edema; hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Pain from fractures occurs due to…

A

muscle spasms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Fracture pain occurs until bone fragments are __________

A

immobilized

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Crepitus

A

rubbing of bone fragments against each other

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Bruising

A

bleeding into tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Nerve Damage

A

impaired sensation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Why does pulselessness at fracture site occur?

A

compressed vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is a dislocation?

A

when joint surfaces lose contact with each other or a complete joint disruption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is a subluxation?

A

partial contact between opposing joint surfaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Subluxation can damage ________, ________, and ________

A

ligaments, nerves, cartilage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Dislocation and subluxation occur in developing joints when…

A

ligaments are underdeveloped

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Dislocation and Subluxation causes:

A

-trauma
-muscular imbalance (exercise or posture)
-joint instability from repetitive dislocations or ligament stretching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

_________ and __________ can lead to permanent disability

A

numbness and tingling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Splints protect the injured body part from moving and provide either…

A

a) restrictive movement
or
b) complete immobilization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is skin traction?

A

a short term treatment where tape is applied to skin to hold the bone in place (used in patients waiting in OR)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is skeletal traction?

A

pins drilled in the bone distal to the fraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Skeletal traction uses larger ______ to keep the bone in alignment and _____ weight to counter traction force

A

weight; body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is the most common bone where skeletal traction is used?

A

femur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Autograft

A

bone graft from the individual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is fixation?

A

a pin or rod placed in uninjured bone to help stabilize fracture site due to too much injured bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Allograft

A

bone graft from a cadaver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Xenograft

A

bone graft taken from another species

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is an example of a bone substitue?

A

artificial joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What are the 4 stages of bone healing?

A

hematoma, soft callus, hard callus, remodeling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Hematoma Stage

A

bleeding at the site of injury or surrounding tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Soft Callus Stage

A

hematoma at site forms fibrous network and a soft callus forms on the outer bone surface over the fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Hard Callus Stage

A

osteoblasts within soft callus synthesize collagen to form hard callus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Remodelling Stage

A

unnecessary callus is reabsorbed and repaired tissues are realigned

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

How often do x-rays of an injury need to be done?

A

at injury, 2 months after, 8 months after, and then 10 years after

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Most fractures heal in __-__ weeks

A

4 to 8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

________ and general health can prolong fracture healing time

A

osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Bone can form new bone without forming ___ _____

A

scar tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What is a strain?

A

tearing or stretching of a muscle or tendon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What are common areas of a strain?

A

hands, feet, knees, upper arm, thigh, ankle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What is a sprain?

A

tearing of a ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What are common areas of a sprain?

A

wrist, ankle, elbow, knee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

1st degree muscle injury

A

fibres are stretched but the muscle and joint remain stable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

2nd degree muscle injury

A

more tearing of tendon/ligament with muscle weakness and joint instability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

3rd degree muscle injury

A

inability to contract muscle with significant joint instability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

With 3rd degree injuries __________ may be required to…

A

surgery; suture ends back together

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

With surgery for muscle injuries, recovery is expected but there is a potential for _______

A

arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

How long after a strain/sprain does a healing tendon/ligament take where it can only withstand minor stress?

A

4-5 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

How many months are required for joint stability?

A

3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Excessive stretching with a muscle injury can damage recovery and result in…

A

scar tissue or poor function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What is rhabdomyolysis?

A

rapid breakdown of muscle that causes the release of intracellular contents such as enzymes, myoglobin (like Hb but in heart and muscles and only holds 1 O2 molecule), potassium into ECF and blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Rhabdomyolysis can be _______ or result in _____ _______

A

fatal; permanent disability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What can cause rhabdomyolysis?

A

-trauma from crash injuries
-medications or drugs
-excessive muscular contractions
-infectious agents
-toxins like CO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Hyperkalemia, cardiac dysrhythmia, and kidney failure are complications of ____________

A

rhabdomyolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Hyperkalemia

A

excess potassium released into circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What is the triad of symptoms associated with rhabdomyolysis?

A

-muscle pain
-weakness
-dark urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What causes dark urine with rhabdomyolysis?

A

myoglobin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Is myoglobin in urine always associated with rhabdomyolysis?

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What is the most reliable indicator of rhabdomyolysis?

A

high levels of creatine kinase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What is the function of creatine kinase?

A

add a phosphate to ADP to rephosphorylate ATP and maintain cellular ATP homeostasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What is the goal of treatment for rhabdomyolysis?

A

maintain urinary output and prevent kidney failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Rapid ___ fluids are necessary to maintain urine output

A

IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Hemodialysis may be needed to deal with __________

A

hyperkalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

What is a muscle compartment?

A

a well-defined structure compartment containing muscle and associated nerves and blood vessels enclosed by fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

What is compartment syndrome?

A

damage within the compartment but with an intact fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

With compartment syndrome, increased pressure causes decreased blood supply and can lead to…

A

hypoxia and maybe necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

What can cause compartment syndrome?

A

-increased compartment content (bleeding)
-decreased volume of compartment (cast too tight)
-burns
-snake or insect bites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Compartment syndrome results in a disturbance to the muscle’s __________

A

microvasculature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

What are the “6 P’s” used to diagnose?

A

compartment syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

What are the 6 Ps

A

pain, pressure, paresthesia, paresis, pulselessness, poikilothermia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Pain

A

out of proportion to injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Pressure

A

swelling, tenderness to affected area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Paresthesia

A

numbness/tingling due to nerve impingement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Paresis

A

muscle weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Pulselessness

A

inadequate blood perfusion to compartment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Poikilothermia

A

inability to maintain a constant core temperature independent of ambient temperature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Which of the 6 Ps are most suggestive of compartment syndrome?

A

-pain with radiation to fingers and toes
-paresthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Diagnosis of compartment syndrome:

A

manometer to measure intra-compartmental pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

What is the treatment for compartment syndrome?

A

cutting fascia to relieve pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

What is osteoporosis?

A

decreased bone mineral density and increased risk of fractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

Osteoporosis is a _______ disease

A

chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

Is osteoporosis related to aging?

A

not necessarily, but it progresses silently for decades

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

With osteoporosis, old bone is __________ faster than new bone is made

A

reabsorbed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

What are the most common sites of osteoporosis?

A

hip, wrist, and spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

Postmenopausal osteoporosis is caused by an __________ deficicency

A

estrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Secondary osteoporosis is caused by _________ dysfunction

A

endocrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

Which hormones are commonly associated with osteoporosis?

A

parathyroid hormone, cortisol, thyroid hormone, growth hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

Medication, lack of physical activity, and abnormal BMI increase risk for _________

A

osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

When does bone mass peak?

A

around 30 yoa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

After 30, risk of fractures increases and 1/6 ______ and 1/12 _____ sustain a vertebral fracture

A

women; men

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

What are the signs and symptoms of osteoporosis?

A

-bone deformity and pain from fractures
-kyphosis from vertebral fractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

______ often expose presence of osteoporosis

A

falls

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

Kyphosis

A

humpback

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

How is osteoporosis diagnosed?

A

-x-ray to determine bone mineral density
-DXA scanner

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

By the time osteoporosis is diagnosed, ___% of bone tissue could be lost

A

30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

What is a DXA scanner?

A

two x-ray beams - one high and one low and the amount of x-ray from each beam passing through bone is measured

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

Treatment for osteoporosis includes:

A

-fracture prevention
-medication to prevent bone reabsorption
-limited alcohol and caffeine
-stop smoking
-moderate weight bearing exercises to stimulate bone formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

Paget’s disease aka ______ _______

A

osteitis deformans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

What is Paget’s disease?

A

increased metabolic activity that leads to localized abnormal and excessive bone remodelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

Paget’s disease results in enlarged ____ bones and neurological problems

A

soft

118
Q

Men older than ___ and women older than ___ are at risk for Paget’s disease

A

55; 40

119
Q

How is asymptomatic Paget’s disease diagnosed?

A

x-ray

120
Q

Up to 25% of Paget’s cases involve…

A

family members

121
Q

Paget’s is caused by genetic and environmental factors (ie. _______)

A

-viruses (mumps and measles)
-Human Parainfluenza Virus (involves respiratory tract but not related to influenza)

122
Q

Paget’s disease involves excessive __________ of spongy bone which is replaced with disorganized bone at an increased rate

A

reabsorption

123
Q

With Paget’s, _______ diminish and bone marrow is replaced by extremely vascular ______ tissue

A

trabeculae; fibrous

124
Q

Paget’s causes disorganized _______ fibres

A

collagen

125
Q

Where does mineralization extend with Paget’s?

A

bone marrow

126
Q

Paget’s disease results in…

A

-increased bone fragility
-increased risk of bone tumours

127
Q

How does Paget’s affect cranial bones?

A

-asymmetrical appearance
-compress brain and lead to dementia and altered consciousness

128
Q

How does Paget’s affect long bones?

A

-both ends affected
-produces lateral curvature

129
Q

Osteomyelitis is an _________ bone disease

A

infectious

130
Q

Osteomyelitis can be caused by…

A

-bacteria
-virus
-fungi
-parasite

131
Q

What is the most common cause of osteomyelitis?

A

bacteria

132
Q

What is hematogenous osteomyelitis?

A

osteomyelitis cause by a pathogen that is carried in the blood stream

133
Q

Hematogenous osteomyelitis is more common in ________

A

children

134
Q

What is contiguous osteomyelitis?

A

osteomyelitis where the infection spreads from adjacent bones

135
Q

Contiguous

A

sharing common border

136
Q

What is the primary pathogen that causes osteomyelitis?

A

Staphylococcus aureus

137
Q

What are some specific causes of osteomyelitis?

A

-open fracture
-penetrating wound
-surgery
-diabetes
-smoking
-alcohol
-drug abuse
-chronic illness
-immunosuppressive medications

138
Q

Why is osteomyelitis associated with Sickle cell anemia?

A

SCA reduces immune ability to clear blood infections

139
Q

With osteomyelitis, pathogens provoke an immune response and S. aureus produces a ______ that destroys _______

A

toxin; neutrophils

140
Q

Why are implants a risk of osteomyelitis?

A

biofilms adhere to surfaces

141
Q

Biofilms and inflammation result from an imbalance between ________ and ________

A

osteoblasts and osteoclasts

142
Q

What do osteoblasts do?

A

create bone

143
Q

What do osteoclasts do?

A

break down bone

144
Q

With osteomyelitis, how does vessel leakage create an exudate?

A

fluid leaks out of blood vessels seals the small channels of bone called canaliculi

145
Q

What is a sequestrum and how is it created?

A

a sequestrum is a piece of dead bone that has separated from surrounding bone and it is created by inflammatory exudate that extends into the bone marrow cavity

146
Q

With osteomyelitis, osteoblasts lay new bone over ___________ bone

A

infected

147
Q

What is the treatment for osteomyelitis?

A

debridement of infected bone (surgery to remove infected and some healthy bone)

148
Q

What is the most common form of arthritis?

A

osteoarthritis

149
Q

What causes osteoarthritis?

A

physical wear and tear of a joint over time

150
Q

What is the primary defect of osteoarthritis?

A

loss of articular cartilage

151
Q

Thinning cartilage results in underlying bone becoming sclerotic meaning…

A

it becomes dense and hard

152
Q

Osteoarthritic cysts that develop on bone are under lots of pressure and their contents are forced into the ____ _____

A

synovial cavity

153
Q

What are joint mice?

A

bone projections that break off into synovial fluid

154
Q

How does osteoarthritis reduce joint ROM?

A

by thickening the joint capsule and adhering it to deformed bone

155
Q

What are the signs and symptoms of osteoarthritis?

A

-pain
-stiffness
-decreased ROM
-muscle wasting
-deformity
-swelling (due to osteocyte fragments)

156
Q

How is osteoarthritis diagnosed?

A

x-ray

157
Q

Conservative osteoarthritis treatment:

A

-exercise
-weight loss
-medication

158
Q

What medication is used for osteoarthritis?

A

Chondroitin

159
Q

In severe cases of osteoarthritis, surgery is used to:

A

-correct joint misalignment
-implant artificial joints

160
Q

Rheumatoid arthritis is a chronic _________ disease that focuses on joints

A

autoimmune

161
Q

Rheumatoid arthritis destroys _______ joints and in severe cases results in premature death

A

synovial

162
Q

________ factors contribute to rheumatoid arthritis

A

genetic

163
Q

What is the difference between osteoarthritis and rheumatoid arthritis?

A

-the synovial membrane is the first tissue affected with rheumatoid arthritis
-with RA, joint degradation is symmetrical

164
Q

Signs and Symptoms of Rheumatoid Arthritis

A

-stiffness (mostly in the morning)
-fixed flexion of small hand joints - swan neck and boutonniere

165
Q

With RA, macrophages initiate the inflammatory response which causes pannus…

A

the thickening of synovial fluid

166
Q

Pannus invades _____ tissue causing abnormal remodelling and invasion of _______ connective tissue

A

bone; fibrous

167
Q

Which areas are affected by RA?

A

fingers, feet, wrists, elbows, ankles, knees, and tissues of the heart, lungs, and kidneys

168
Q

What is the most common inflammatory arthritis worldwide?

A

Gout

169
Q

Gout aka “disease of _____”

A

kings

170
Q

Gout results from an overproduction/underexcretion of _____ acid

A

uric

171
Q

Gout has a strong _______ association

A

genetic

172
Q

90% of Gout cases are from an _____________ of uric acid

A

underexcretion

173
Q

Gout involves inflammation and joint pain, usually of the ____ ____

A

big toe

174
Q

How does gout form?

A

uric acid crystallizes when it reaches a specific limit and forms precipitates that deposit in joints

175
Q

What brings on the “gouty arthritis” pain?

A

crystallization that initiates the inflammatory depositys

176
Q

Risk factors for gout:

A

-older male
-alcohol
-red meat
-fructose
-increasing BMI

177
Q

Signs and Symptoms of gout:

A

-kidney stones
-sluggish urine output
-crystals harden and erode bone and cartilage, increasing the size of the joint

178
Q

Uric acid is a breakdown product of _______ nucleotides (_______ and _______)

A

purine (guanine and adenine)

179
Q

How does the body normally get rid of uric acid?

A

kidneys

180
Q

How to WBCs contribute to gout inflammation?

A

WBCs engulf crystallized urate which causes them to rupture

181
Q

What is a contracture?

A

loss of full passive range of motion

182
Q

____________ occur secondary to joint, muscle, and soft tissue limitations

A

contractures

183
Q

Physiological contracture:

A

-absence of muscle action potential
-calcium pump failure (even in presence of ATP) shortens muscles

184
Q

Physiological contracture is present in _____ disease

A

McArdle’s

185
Q

Physiological contracture can be ________

A

temporary

186
Q

Pathological contracture is _________ muscle shortening caused by muscle spasms or weakness

A

permanent

187
Q

What is an example of a pathological contracture?

A

achilles tendon

188
Q

Pathological contractures occur despite plentiful _____ and normal ______ _____

A

ATP; action potential

189
Q

Are lower or upper extremity pathological contractures more common?

A

lower

190
Q

___________ contractures are common with strokes and neuromuscular diseases like ________ _______

A

pathological; muscular dystrophy

191
Q

Disuse atrophy is muscle wasting to to reduction in muscle fibre size from…

A

prolonged inactivity

192
Q

Disuse atrophy can occur within ______ of inactivity

A

weeks

193
Q

A normal individual on bed rest loses muscle strength at a rate of ___%/day

A

3%

194
Q

________ can also cause muscle atrophy and weakness

A

aging

195
Q

How is disuse atrophy treated/prevented?

A

-forceful contractions
-passive lengthening exercises
-brisk walking

196
Q

At what point does regeneration of muscle fibres become impaired?

A

after 1 year

197
Q

What is fibromyalgia?

A

a chronic musculoskeletal syndrome characterized by diffuse pain, fatigue, and increased sensitivity to touch

198
Q

Why is fibromyalgia often misdiagnosed?

A

absence of systemic or localized inflammation

199
Q

Who is most affected (90%) by fibromyalgia?

A

women age 30-50

200
Q

New research on fibromyalgia suggests role of __________

A

inflammation

201
Q

FM is a result of _____ dysfunction with amplification of _____ transmission and interpretation

A

CNS; pain

202
Q

FM alteration in genes affect s_____, c________, d_______ (NTs involves in stress and sensory processing)

A

serotonin, catecholamines, dopamine

203
Q

Where does FM pain begin?

A

neck and shoulders (then becomes generalized)

204
Q

What is scoliosis?

A

abnormal rotational curvature of the spine

205
Q

Scoliosis is more common in which age group?

A

adolescent girls

206
Q

What are “non-structural” causes of scoliosis?

A

causes other than the spine itself

207
Q

What are “structural” causes of scoliosis?

A

vertebral rotation

208
Q

What are the 3 types of scoliosis?

A
  1. idiopathic
  2. congenital (bone deformity prior to birth)
  3. teratological
209
Q

Idiopathic scoliosis accounts for ___% of cases

A

80%

210
Q

What is teratological scoliosis?

A

scoliosis caused by another systemic syndrome like cerebral palsy

211
Q

When does the scoliosis curvature progress?

A

during growth periods

212
Q

Idiopathic scoliosis rapidly progresses during ______ _______

A

growth spurts

213
Q

Efficacy of scoliosis treatment depends on…

A

hours the brace is worn

214
Q

______ are 5x more likely to have a case of curvature becoming greater than 20%

A

girls

215
Q

What is kyphosis?

A

spinal curve over 50%

216
Q

Kyphosis requires a _______ __________ to stop progression

A

spinal fusion

217
Q

Bracing is less effective in _________ and ________ scoliosis and surgery is often required

A

congenital and teratological

218
Q

Reduced pulmonary function occurs with curvatures >___°

A

60

219
Q

Risk of right-side heart failure occurs with curvatures >___°

A

80

220
Q

______ disturbances occur due to thoracic and lumbar deformity

A

GI

221
Q

What are the two types of muscular dystrophy?

A

Duchenne and Myotonic

222
Q

DMD is causes by an ___ linked mutation in ________ gene that causes alterations or deletions of the muscle protein dystrophin

A

X; dystrophin

223
Q

What is the most common childhood dysrophy?

A

Duchenne Muscular Dystrophy

224
Q

What does dystrophin do?

A

anchors actin cytoskeleton to muscle fibres of the basement membrane

225
Q

What happens to poorly anchored muscle fibres?

A

they tear during repeated contraction causing free CALCIUM to enter the cell and kill it

226
Q

How does Duchenne Muscular Dystrophy (DMD) present?

A

-muscle weakness (pre-school children)
-difficulty walking
-large calves
-weakness starting in pelvic area

227
Q

Why do large calves occur with DMD?

A

muscle fibres are replaced with fat and connective tissue

228
Q

How is DMD diagnosed?

A

-blood creatine kinase level
-if positive, genetic testing of dystrophin gene

229
Q

With DMD, the blood creatine kinase level can increase to _____ times the normal level

A

100

230
Q

Type 1 Myotonic Muscular Dystrophy (MMD) occurs due to a mutation on the ______ gene

A

DMPK

231
Q

Type 2 Myotonic Muscular Dystrophy occurs to a mutation on the ________ gene

A

CNBP

232
Q

What is the “anticipation” mechanism of type 1 MMD?

A

where children of mothers who have MMD have a more severe form of MMD

233
Q

The disease hallmark of MMD is myotonia meaning…

A

difficulty relaxing after a contraction

234
Q

What are the symptoms of MMD?

A

-muscle weakness
-cataracts
-cardiac conditions
-wheelchair

235
Q

How is MMD diagnosed?

A

-genetic testing
-test for repeated expression of CTG triplet

236
Q

________ are ineffective at treating MMD

A

steroids

237
Q

Treatment for MMD:

A

-ROM exercises
-bracing
-surgical release of contractures

238
Q

What causes pressure ulcers?

A

-unrelieved pressure
-shearing forces
-friction
-moisture

239
Q

What is a decubitus ulcer?

A

when pressure interrupts normal blood flow to the skin and underlying tissue

240
Q

Risks for pressure wounds include:

A

-immobilization
-prolonged moisture exposure
-neurological disorders
-malnutrition
-dehydration

241
Q

Redness from prolonged pressure on the skin returns to normal with…

A

repositioning or stimulation

242
Q

If pressure continues and blood flow is blocked, the tissue becomes __________

A

hypoxic

243
Q

Shearing or friction of hypoxic tissue can cause __________ and _________

A

detachment and necrosis

244
Q

Stage 1 Pressure Wound

A

-skin inflamed but unbroken
-ulceration can be prevented with repositioning

245
Q

Stage 2 Pressure Wound

A

-broken skin
-site is tender and painful
-epidermis and dermis involved

246
Q

Stage 3 Pressure Wound

A

-below dermis
-fat tissue involves

247
Q

Stage 4 Pressure Wound

A

-visible muscle, bone, ligaments, or tendons

248
Q

The best treatment for pressure wounds is…

A

early detection and prevention

249
Q

Pressure Ulcer Treatment:

A

-frequent skin assessment
-repositioning
-promoting movement
-special beds to prevent friction and moisture
-nutrition
-hydration

250
Q

First degree burns require _____ treatment and usually heal within ___ to ____ days with no scarring

A

no; 3-5

251
Q

Possible 1st degree burn symptoms:

A

-nausea
-vomiting

252
Q

Who is vulnerable to first degree burns?

A

young and old experiencing dehydration

253
Q

A 2nd degree superficial partial thickness burn presents as ______ ______ _______ that develop within minutes of injury

A

fluid-filled blisters

254
Q

With 2nd degree superficial partial thickness burns, _______ sensors remain intact

A

pain

255
Q

How long do second degree superficial partial thickness burns take to heal? Is there scarring?

A

3-4 weeks; scarring unusual

256
Q

What do 2nd degree deep partial thickness burns look like?

A

waxy white

257
Q

How long do 2nd degree deep partial thickness burns take to heal?

A

weeks

258
Q

How is necrotic tissue dealt with for second degree deep partial thickness burns?

A

surgical removal

259
Q

With 2° deep partial thickness burns, a ________ of own skin may be required

A

graph

260
Q

2nd degree deep partial thickness burns may have hypertrophic scarring which is?

A

a thick, raised scar

261
Q

Third degree burn characteristics:

A

-full thickness
-dry, leathery
-loss of dermal elasticity

262
Q

Third degree burns require escharotomy which is?

A

cutting through burned skin to release pressure and prevent compartment syndrome

263
Q

What is eschar?

A

dead tissue that forms over healthy skin

264
Q

With 3rd degree burns all ______ ________ have been destroyed

A

nerve endings

265
Q

Fourth degree burns require _____ _______ or reconstructive surgery

A

skin grafting

266
Q

_____ and _____ degree burns are considered medical emergencies

A

3rd and 4th

267
Q

What is the rule of 9s?

A

a surgery requirement of 4th degree burns to estimate the total % of body surface burned

268
Q

All areas of the body constitute 9% of total body area except for the…

A

groin area which is 1%

269
Q

How many burn phases are there?

A

3; burn shock, Ebb, flow

270
Q

What is the burn shock phase?

A

phase of combination of CV hypovolemia and cellular hypovolemia

271
Q

With the burn shock phase, massive fluid loss increases capillary permeability and fluid shifts to…

A

interstitial spaces

272
Q

Burn shock phase results in… (2)

A

-decreased blood volume
-decreased cardiac output

273
Q

Why are several litres of fluid lost to evaporation each day of the burn phase?

A

integumentary and pulmonary damage = loss of ability to regulate water evaporation

274
Q

In the Ebb phase, blood is shunted away from the _______, _________, and ______ in the first 24 hours

A

liver, kidneys, and gut

275
Q

In the Ebb phase, after 24 hours capillary integrity is restored and edema resolves signalling…

A

the end of the burn shock phase

276
Q

The flow phase is a state of hypermetabolic response of increased…

A

catecholamines, cortisol, and glucagon

277
Q

____________ occurs in the flow phase due to increased insulin resistance and muscle loss

A

hyperglycemia

278
Q

The flow phase can last up to ___________

A

2 years

279
Q

What is the goal of burn treatment?

A

fluid resuscitation and nutrition

280
Q

With burn treatment, the first ________ is critical

A

24 hours

281
Q

How is fluid restoration done? Why is it important to monitor?

A

IV; prevention of fluid overload

282
Q

How is fluid overload prevented?

A

Parkland formula

283
Q

Parkland formula: ____ mL of Ringer’s lactate per __________ of body weight per % ________ burned

A

4; kilogram; total body surface area (TBSA)

284
Q

The amount of IV fluids given is ______ during the first 8 hours post injury and the rest in the next ____ hours

A

half; 16 - (total = 24hrs)

285
Q

What is Ringer’s lactate?

A

IV fluid for dehydration, having surgery, or receiving IV meds

286
Q

What is frostnip?

A

superficial frostbite with pain increasing during rewarming

287
Q

What is chilblains?

A

partial thickness frostbite

288
Q

Chilblains has a _______ tone

A

purple

289
Q

With chilblains chronic ________ can form

A

vasculitis

290
Q

What is vasculitis?

A

inflammation of blood vessels

291
Q

What is frostbite?

A

-frozen tissue
-ice crystals formed

292
Q

Frostbitten tissue has a ______ appearance

A

white

293
Q

Frostbitten tissue is numb with no sense of _______

A

pain

294
Q

Is frostbite reversible?

A

potentially

295
Q

What is flash freeze?

A

rapid formation of ice crystals associated with contact with cold metals or volatile liquids

HLSC 222 - Pathophysiology Across the Lifespan (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions