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PAS- PATHOPHYSIOLOGY > Chapter 45 > Flashcards

Chapter 45 Flashcards

1
Q 
musculoskeletal injuries 
pathologic 
-Break occurs at the site of a \_\_\_\_\_. 
stress
-\_\_\_\_\_ and \_\_\_\_\_ such as repetitive and strenuous activities that occur during athletics
A

preexisting abnormality
Fatigue
insufficiency

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2
Q

The bone is not straight

  • Improper reduction or immobilization of a fractured bone may result in _____, _____, or _____.
  • _____ is the healing of a bone in a nonanatomic position that could result in the bone not being straight.
A

nonunion
delayed union
malunion
Malunion

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3
Q

Subluxation

  • _____ between the bones in the joint only partially lost
  • _____ is the temporary displacement of a bone from its normal position in a joint. If the contact between the two surfaces is only partially lost, then the injury is referred to as a subluxation.
A

Contact

Dislocation

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4
Q

a _____ is fibrous connective tissue that attaches skeletal muscle to bone

A

tendon

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5
Q

Tear or injury to a tendon (fibrous connective tissue that attaches skeletal muscle to bone)

A

Strain

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6
Q

Tear or injury to a ligament (fibrous connective tissue that connects bones)

A

Sprain

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7
Q

_____

  • Is inflammation of a tendon where it attaches to a bone
  • _____: Lateral epicondylitis-tissue degeneration or irritation of the extensor carpi radialis brevis tendon.
A

Epicondylitis

Tennis elbow

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8
Q

Epicondylitis
clinical manifestation
-pain resulting from _____ and _____ injuries is usually described as _____ and _____, persisting over the distribution of the tendon or ligament.

A

tendon
ligament
sharp
localized

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9
Q

Rhabdomyolysis

  • Release of _____ from damaged striated muscle cells injuries!!
  • Life-threatening complication of severe muscle trauma with muscle cell loss
  • -_____ versus _____
  • -_____ syndromes
  • Rapid breakdown of _____ that causes the release of _____ contents
  • _____ into extracellular space and bloodstream

other causes rhabdomyolysis
-Sedatives and narcotics, particularly _____, _____ (a hypolipidemic agent), and the _____ acid often cause rhabdomyolysis and myoglobinuria.

A 
myoglobin
crush syndrome
crush injuries
compartment
muscle
intracellular
protein pigment myoglobin
street heroin
clofibrate
antifibrinolytic aminocaproic
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10
Q

Rhabdomyolysis
-_____ is an excess of myoglobin (an intracellular muscle protein) in the urine. Muscle cell damage releases the myoglobin.

The most severe form is often called _____. Less severe and more localized forms of muscle damage are called _____.

A

Myoglobinuria
crush syndrome
compartment syndromes

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11
Q

Rhabdomyolysis
classic triad:
_____ pain, _____, and _____ (from myoglobin)

A

muscle
weakness
dark urine

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12
Q 
Osteoporosis 
Bone density
-Normal bone
--833 mg/cm2
-Osteopenic bone: \_\_\_\_\_ bone mass
--833 to 648 mg/cm2
-Osteoporosis
--
A

Decreased

648

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13
Q

Osteoporosis
potential causes
-decreased _____

types:

  1. _____- only classic regional osteoporosis is associated with disuse or immobilization of a limb because of fractures, motor paralysis, or bone or joint inflammation.
  2. _____

clinical manifestations
-_____

A

activity level
regional
Postmenopausal
bone deformity

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14
Q

Evaluation Dual x-ray absorptiometry (DXA)
-Generally, osteoporosis is radiographically detected as increased _____ of _____. By the time abnormalities are detected by x-ray examination, as much as _____ to _____ of bone tissue may have been lost.

A

radiolucency
bone
25% to 30%

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15
Q

Postmenopausal osteoporosis
-Occurs in middle-aged and older women. It can occur because of _____ deficiency, as well as estrogen-independent, _____-related mechanisms (e.g., secondary causes such as hyperparathyroidism and decreased mechanical stimulation).

  • Recent studies indicate that increased _____ and increased intracellular _____ play significant roles in the development of age-related bone loss, as well as other age-related changes in the body.
  • _____ deficiency also can increase with stress, excessive exercise, and _____ body weight. Increased formation and longevity of _____ results in increased bone resorption and is associated with a cascade of _____.
A 
estrogen
age
oxidative stress
reactive oxygen species
Hormonal
low
osteoclasts
proinflammatory cytokines
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16
Q

peak bone mass and strength reached in women
-_____ continues at a pace faster than resorption until peak bone mass—or maximum bone density and strength—is reached at approximately _____ years of age, after which bone resorption slowly exceeds bone formation.

-_____ in women is associated with _____. Bone loss is most rapid in the first years after menopause but persists throughout the postmenopausal years

A

Bone formation
30
Bone loss
menopause

17
Q

Osteomalacia

  • Deficiency of_____ lowers the absorption of calcium from the intestines.
  • _____ is inadequate or delayed.
A

vitamin D

Mineralization

18
Q

Paget Disease

  • State of increased metabolic activity in bone
  • -Is abnormal, and _____ and _____ are excessive. Paget disease most often affects the _____ skeleton, especially the vertebrae, skull, sacrum, sternum, and pelvis
A

bone resorption
formation
axial

19
Q

Osteomyelitis

-_____, _____, _____, and _____ infections are all primary sources of bacteria in hematogenous bone infections.

A

Cutaneous
sinus
ear
dental

20
Q

Sequestration and involucrum
-Lifting of the _____ disrupts _____ that enter bone through the periosteum, which deprives the underlying bone of its blood supply.

-This deprivation leads to _____ and death of the area of infected bone, producing _____, an area of devitalized bone.

A

periosteum
blood vessels
necrosis
sequestrum

21
Q

Bone death as a result of osteomyelitis

-Vessel damage causes local _____ (blockage) of the small vessels, which leads to _____ (death) of bone.

A

thrombosis

ischemic necrosis

22
Q

Treatment of bone infection

  • Bone contains multiple microscopic channels that are _____ to the cells and _____ of the body’s natural defenses.
  • _____ of bone is highly vulnerable to damage and destruction by bacterial toxins, leading to _____ of bone.
  • Bone cells have a limited capacity to replace bone destroyed by _____.
A 
impermeable
biochemicals
Microcirculation
ischemic necrosis
infections
23
Q 
Bone Tumors (cont’d)
patterns of bone destruction
-\_\_\_\_\_: Areas of partially destroyed bone adjacent to completely lytic areas

-An _____ is a malignant bone-forming tumor. It is aggressive and most often found in _____; it has a _____ pattern of bone destruction

A

moth-eaten
osteosarcoma
bone marrow
moth-eaten

24
Q

bone tumors
myeologenic tunors
-Develop from various bone marrow cells
-_____ tumor

an overexpression of genes including _____

Giant cell tumors are typically located in the _____ in the femur, tibia, radius, and humerus.

They are _____-growing tumors that extend over the articular cartilage.

A

Giant cell
osteoprotegerin ligand (OPGL)
epiphysis
slow

25
Q

Osteoarthritis

  • Stromelysin and acid metalloproteinase break down _____.
  • Local areas of damage and loss of _____, new bone formation of joint margins, and thickening of joint capsule

clinical manifestations
-_____ and _____ in one or more joints, usually weight-bearing or load-bearing joints, are the first symptoms of osteoarthritis.
Use-related joint pain relieved by rest is a key feature.

A

articular cartilage
articular cartilage
Pain
stiffness

26
Q

Classic Inflammatory Joint Disease
Systemic signs of inflammation
-_____, _____, malaise, _____, and _____

A

Fever
leukocytosis
anorexia
hyperfibrinogenemia

27
Q

Rheumatoid Arthritis Clinical Manifestations
-Rheumatoid arthritis begins with general systemic manifestations of inflammation, including _____, _____, _____, _____, weight loss, and generalized aching and stiffness.
Local manifestations also gradually appear over weeks or months.

Typically, the _____ become painful, tender, and stiff

A 
fever
fatigue
weakness
anorexia
joints
28
Q

Ankylosing Spondylitis

  • Chronic inflammatory joint disease of the _____ or _____ joints, causing stiffening and fusion of the joints
  • Begins with inflammation of the _____, particularly in the vertebrae and sacroiliac joint.
  • _____ cells infiltrate and erode the fibrocartilage.
  • _____ antigens are proposed as the targets for the immune response and the presentation of such antigens to _____.
A 
spine
sacroiliac
fibrocartilage
Inflammatory
Cartilage
CD8+ T cells
29
Q

gout
Causes
-_____ synthesis or breakdown is accelerated
-Poor _____ secretion in the kidneys
-_____ are 1000 times more prevalent in individuals with primary gout than they are in the general population.

A

Purine
uric acid
Renal stones

30
Q

Mechanisms for crystal deposition
-When the uric acid reaches a certain concentration in fluids, it crystallizes, forming _____ that are deposited in connective tissues throughout the body. Crystallization in synovial fluid causes acute, painful inflammation of the _____, a condition known as _____.

A

insoluble precipitates
joint
gouty arthritis

31
Q

_____ gout/calcium crystals that are associated with chronic gout
-With time, crystal deposition in subcutaneous tissues causes the formation of small white nodules, or _____, that are visible through the skin.

-Crystal aggregates deposited in the kidneys can form _____ and lead to renal failure.

clinical manifestations
-Deposits of _____ (tophi) in and around the joints

A

Tophaceous
tophi
urate renal stones
monosodium urate monohydrate

32
Q

Chronic widespread joint and muscle pain, fatigue, and tender points

A

fibromyalgia

33
Q

Diseases of Energy Metabolism

  • _____: Myophosphorylase deficiency
  • _____ deficiency
A

McArdle disease

Myoadenylate deaminase

34
Q

McArdle disease: Myophosphorylase deficiency
-The individual with McArdle disease is not able to break down _____ or produce _____

-Myoadenylate deaminase deficiency
is an enzyme deficiency that produces changes in _____ and is associated with _____ intolerance.

A

glycogen
lactic acid.
skeletal muscle
exercise

35
Q

Inflammatory MuscleDiseases: Myositis
-_____, _____, and _____ infections of varying severity are known to produce inflammatory changes in skeletal muscle, a group of conditions collectively described by the term _____

A

Viral
bacterial
parasitic
myositis

36
Q

Polymyositis
-Inflammation of _____ and _____ that presumably causes the destruction of muscle fibers characterize polymyositis and dermatomyositis.
The agent that causes the muscle inflammation has not been identified, but recent findings strongly suggest an _____ connection.

A

connective tissue
muscle fibers
autoimmune

37
Q

Inclusion body myositis

  • Degenerative changes of _____
  • Accumulation of multiple _____ within muscle fibers
  • Evidence of _____ stress with misfolding of proteins
  • Weakness of the _____ and _____, as well as asymmetric atrophy and quadriceps weakness
A 
muscle
proteins
endoplasmic reticular
wrist
finger flexors

PAS- PATHOPHYSIOLOGY (17 decks)

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