chapter 45 Flashcards
fracture classifications
_________: break occurs at the site of a preexisting abnormality
_______: fatigue and insufficiency such as _______ and ______ activities that oc cur during athletics
pathologic
stress
strenuous, repetitive
the bone is not straight
improper _____ or _______ of a fractured bone may result in ______, ____ union or ______
_____ is the healing of a bone in a nonanatomic position that could result in the bone not being straight
reduction, immobilization
nonunion, delayed, malunion
malunion
______
contact 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.
subluxation
dislocation
a fibrous connective tissue that attaches skeletal muscle to bone
tendon
Tear or injury to a tendon (fibrous connective tissue that attaches skeletal muscle to bone)
strain
Tear or injury to a ligament (fibrous connective tissue that connects bones)
sprain
Is inflammation of a tendon where it attaches to a bone
______: Lateral epicondylitis-tissue degeneration or irritation of the extensor carpi radialis brevis tendon.
clinical manifestations
pain resulting from tendon and ligament injuries is usually described as ___ and _____, persisting over the distribution of the tendon or ligament.
epicondylitis
tennis elbow
sharp, localized
________
Release of myoglobin from damaged ____ muscle cells injuries!!
Life-threatening complication of severe muscle ___ with muscle __ loss
-_____ syndrome versus crush injuries
-________ syndromes
Rapid breakdown of muscle that causes the release of ______r contents
Protein pigment _____ into extracellular space and bloodstream
other causes:
Sedatives and narcotics, particularly street _____, _____(a hypolipidemic agent), and the antifibrinolytic aminocaproic acid often cause rhabdomyolysis and ______
rhabdomyolysis striated trauma cell crush compartment intracellular myoglobin heroin clofibrate myoglobinuria
rhabdomyolysis
Myoglobinuria is an excess of myoglobin (an intracellular muscle protein) in the __. Muscle cell damage releases the myoglobin.
The most severe form is often called ________. Less severe and more localized forms of muscle damage are called ________ syndromes
urine
crush syndrome
compartment syndrome
rhabdomyolysis classic triad 1 2 3 (from myoglobin
muscle pain
weakness
dark urine
osteoporosis
normal bone -\_\_\_\_ mg/cm2 -\_\_\_\_\_\_\_\_ bone: decreased bone mass \_\_\_\_\_ to \_\_\_\_\_\_ mg/cm2 -osteoporosis -
833 osteopenic 833, 648 648 activity level radiolucency 25, 30
types of osteoporosis
- perimenopausal
- iatrogenic
- Regional-only classic regional osteoporosis is associated with disuse or immobilization of a limb because of _____, _______, or bone or joint ______
- __________
clinical manifestations
- pain, ________, fractures, kyphosis
fractures, motor paralysis, inflammation
postmenopausal
bone deformity
postmenopausal osteoporosis
Occurs in middle-aged and older women. It can occur because of _____ deficiency, as well as estrogen-independent, age-related mechanisms (e.g., secondary causes such as ______ and decreased mechanical ________).
Recent studies indicate that increased ______ stress and increased intracellular ___ play significant roles in the development of age-related bone loss, as well as other age-related changes in the body.
Hormonal deficiency also can increase with ____, ______ exercise, and __ body weight. Increased formation and longevity of _____ results in increased bone resorption and is associated with a cascade of proinflammatory ________
estrogen hyperparathyroidism stimulation oxidative reactive oxygen speciaes stress, excessive, low osteoclasts cytokines
peak bone mass and strength reached in women
Bone ____ continues at a pace faster than ______ 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.
Bone loss in women is associated with ______. Bone loss is most rapid in the first years after menopause but persists throughout the postmenopausal years
formation
resorption
30
menopause
deficiency of vitamin D lowers the absorption of _______ from the intestines
________ is inadequate or delayed
osteomalacia
calcium
mineralization
state of increased metabolic activity in bone
Is abnormal, and bone resorption and formation are _______. Paget disease most often affects the ___ skeleton, especially the vertebrae, skull, sacrum, sternum, and pelvis
paget’s disease
excessive
axial
osteomylelitis
_______, ______r, and ______infections are all primary sources of bacteria in hematogenous bone infections.
cutaneous, sinus, ear, dental
Sequestration and involucrum
_____ of the periosteum disrupts blood vessels that enter bone through the periosteum, which deprives the underlying bone of its _______
This deprivation leads to ____ and ____ of the area of infected bone, producing _____ an area of devitalized bone.
lifting blood supply necrosis death sequestration
bone death as a result of osteomyelitis
vessel damage causes local _______ (blockage) of small vessels which leads to ________ (death ) of bone
thrombosis
ischemic necrosis
treatment of bone infection
Bone contains multiple ______ channels that are impermeable to the cells and ______ of the body’s natural defenses.
microcirculation of bone is highly vulnerable to damage and destruction by bacterial ____, leading to ______ of bone.
Bone cells have a limited capacity to replace bone destroyed by _____
microscopic biochemicals toxins ischemic necrosis infections
bone tumors
patterns of bone destruction
_______: areas of partially destroyed bones adjacent to completely lytic areas
moth-eaten
bone tumors
An osteosarcoma is a malignant bone-forming tumor. It is aggressive and most often found in ______; it has a ____ pattern of bone destruction
bone marrow
moth eaten
Giant cell tumor
an overexpression of genes including _______ (OPGL)
Giant cell tumors are typically located in the ____ in the ____, ____, ____ and ____
They are slow-growing tumors that extend over the ________
osteoprotegerin ligand
femur, tibia, radius, and humerus
articular cartilage
osteoarthritis
_____ and acid ________ break down articular cartilage.
local areas of damage and loss of articular cartilage
clinical manifestations
__ and _____ in one or more joints, usually _________ or load-bearing joints, are the first symptoms of osteoarthritis.
Use-related joint pain relieved by ____ is a key feature.
stromelysin metalloproteinase pain, stiffness weight bearing rest
classic inflammatory joint disease systemic signs of inflammation 1 2 3 4 5 6
Fever, leukocytosis, malaise, anorexia, and hyperfibrinogenemia
rheumatoid arthritis
Rheumatoid arthritis begins with general systemic manifestations of inflammation, including fever, fatigue, weakness, anorexia, weight loss, and generalized aching and stiffness.
Local manifestations also gradually appear over _____ or _____.
Typically, the joints become _____, _____, and _____
weeks months
painful, tender, stiff
Chronic inflammatory joint disease of the ___ or sacroiliac joints, causing stiffening and fusion of the joints
Begins with inflammation of the ______, particularly in the vertebrae and sacroiliac joint.
_______ infiltrate and erode the fibrocartilage.
Cartilage antigens are proposed as the targets for the immune response and the presentation of such antigens to ____ cells.
ankylosing spondylitis spine fibrocartilage inflammatory cells CD8+T
gout
causes
_____ synthesis or breakdown is accelerated
Poor ______ secretion in the kidneys
_____ stones are 1000 times more prevalent in individuals with primary gout than they are in the general population.
When the uric acid reaches a certain concentration in fluids, it ______, forming insoluble precipitates that are deposited in ______ tissues throughout the body. Crystallization in synovial fluid causes acute, painful inflammation of the joint, a condition known as gouty ____
purine uric acid renal crystillizes connective arthritis
Tophaceous 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 ___
Crystal aggregates deposited in the kidneys can form urate renal stones and lead to _______
clinical manifestations
Deposits of ___________ (tophi) in and around the joints
tophi
skin
renal failure
monosodium urate monohydrate
Chronic widespread joint and muscle pain, fatigue, and tender points
fibromyalgia
diseases of energy metabolism
________: myophosphorylase deficiency
_____________ deficiency
mcardle disease
myoadenylate deaminase deficiency
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 _____ muscle and is associated with ______ intolerance.
glycogen, lactic acid
skeletal
exercise
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 myositis
viral, bacterial, parasitic
Polymyositis
Inflammation of connective tissue and muscle fibers that presumably causes the destruction of muscle fibers characterize ______ and ________
The agent that causes the muscle inflammation has not been identified, but recent findings strongly suggest an ________ connection.
polymyositis
dermatomyositis
autoimmune
Inclusion body myositis
Degenerative changes of _____
______ of multiple proteins within muscle fibers
Evidence of ___________ stress with misfolding of proteins
Weakness of the ___ and ___ flexors, as well as asymmetric atrophy and quadriceps weakness
muscle
accumulations
endoplasmic reticular
wrist, finger
