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PA-S: PATHOPHYSIOLOGY > chapter 45 > Flashcards

chapter 45 Flashcards

1
Q

fracture classifications

_________: break occurs at the site of a preexisting abnormality

_______: fatigue and insufficiency such as _______ and ______ activities that oc cur during athletics

A

pathologic
stress
strenuous, repetitive

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2
Q

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

A

reduction, immobilization
nonunion, delayed, malunion
malunion

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3
Q

______
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.

A

subluxation

dislocation

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4
Q

a 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.

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

A

epicondylitis
tennis elbow
sharp, localized

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8
Q

________

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 ______

A 
rhabdomyolysis
striated
trauma
cell
crush
compartment
intracellular
myoglobin
heroin
clofibrate
myoglobinuria
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9
Q

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

A

urine
crush syndrome
compartment syndrome

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10
Q 
rhabdomyolysis
classic triad
1
2
3               (from myoglobin
A

muscle pain
weakness
dark urine

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11
Q

osteoporosis

normal bone
-\_\_\_\_ mg/cm2
-\_\_\_\_\_\_\_\_ bone: decreased bone mass
\_\_\_\_\_ to \_\_\_\_\_\_ mg/cm2
-osteoporosis
-
A 
833
osteopenic
833, 648
648
activity level
radiolucency
25, 30
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12
Q

types of osteoporosis

  1. perimenopausal
  2. iatrogenic
  3. Regional-only classic regional osteoporosis is associated with disuse or immobilization of a limb because of _____, _______, or bone or joint ______
  4. __________

clinical manifestations
- pain, ________, fractures, kyphosis

A

fractures, motor paralysis, inflammation
postmenopausal
bone deformity

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13
Q

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 ________

A 
estrogen
hyperparathyroidism
stimulation
oxidative
reactive oxygen speciaes
stress, excessive, low
osteoclasts
cytokines
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14
Q

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

A

formation
resorption
30
menopause

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15
Q

deficiency of vitamin D lowers the absorption of _______ from the intestines
________ is inadequate or delayed

A

osteomalacia
calcium
mineralization

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16
Q

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

A

paget’s disease
excessive
axial

17
Q

osteomylelitis

_______, ______r, and ______infections are all primary sources of bacteria in hematogenous bone infections.

A

cutaneous, sinus, ear, dental

18
Q

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.

A 
lifting
blood supply
necrosis
death
sequestration
19
Q

bone death as a result of osteomyelitis

vessel damage causes local _______ (blockage) of small vessels which leads to ________ (death ) of bone

A

thrombosis

ischemic necrosis

20
Q

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 _____

A 
microscopic
biochemicals
toxins
ischemic necrosis
infections
21
Q

bone tumors
patterns of bone destruction

_______: areas of partially destroyed bones adjacent to completely lytic areas

A

moth-eaten

22
Q

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

A

bone marrow

moth eaten

23
Q

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 ________

A

osteoprotegerin ligand
femur, tibia, radius, and humerus
articular cartilage

24
Q

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.

A 
stromelysin
metalloproteinase
pain, stiffness
weight bearing
rest
25
Q 
classic inflammatory joint disease
systemic signs of inflammation
1
2
3
4
5
6
A

Fever, leukocytosis, malaise, anorexia, and hyperfibrinogenemia

26
Q

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 _____

A

weeks months

painful, tender, stiff

27
Q

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.

A 
ankylosing spondylitis
spine
fibrocartilage
inflammatory cells
CD8+T
28
Q

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 ____

A 
purine
uric acid
renal
crystillizes
connective
arthritis
29
Q

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

A

tophi
skin
renal failure
monosodium urate monohydrate

30
Q

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

A

fibromyalgia

31
Q

diseases of energy metabolism
________: myophosphorylase deficiency

_____________ deficiency

A

mcardle disease

myoadenylate deaminase deficiency

32
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 _____ muscle and is associated with ______ intolerance.

A

glycogen, lactic acid
skeletal
exercise

33
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 myositis

A

viral, bacterial, parasitic

34
Q

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.

A

polymyositis
dermatomyositis
autoimmune

35
Q

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

A

muscle
accumulations
endoplasmic reticular
wrist, finger

PA-S: PATHOPHYSIOLOGY (18 decks)

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