Chp 15 Musculoskeletal Flashcards
bones, muscles, and joints in the body make up the ______ system.
musculoskeletal
structural support and protection of internal organs
bones
internal and external movement is dictated by _____.
muscles
where bones come together, the type is determined by need for flexibility
joints
bind muscles to bones
tendons
bone to bone connection
ligamentt
replacement of cartilage with bone
ossification
a cell that produces immature bony tissue that replaces cartilage
osteoblast
a cell that nourishes and maintains bone
osteocyte
a cell that reabsorbs or digests bone
osteoclast
proper bone formation of bone depends on (3 minerals)
- Calcium
- Phosphorus
- Vit D
what enzyme helps create hard bone?
Calcium phosphate enzyme
the skeleton is a source of ______. (mineral)
calcium
what two cells work together to deposit and tear down bone throughout life
osteoclasts and osteoblasts
calcium is necessary for ____ ______ to muscle, including heart muscle and muscles attached to bones.
nerve transmittal
Calcium level is maintained in the _____ by the ______ gland.
blood, parathyroid gland.
what gland secretes a hormone to release calcium from bone?
parathyroid gland
the diaphysis of the bone refers to the _____ (what area)
shaft
the epiphysis of the bone refers to the _____ (what area)
ends
cone like flared portion between the end and the shaft of the bone is called
metaphysis
growth plate where cartilage is replaced by bone for bone growth (in length)
epiphyseal line/plate
the ends of the bone are covered by ______ cartilage (what kind of cartilage)
articular cartilage
what kind of bone contains haversian systems for blood vessels, nerves, and yellow bone marrow
compact bone
what type of bone has spaces that contain red bone marrow with elements for blood formation
cancellous
what type of bone marrow is chiefly fat
yellow
what kind of bone marrow is rich with blood vessels and immature and mature blood cells in various stages of development
red
what is the production of all types of blood cells in the bone marrow
hematopoiesis
what serves as attachments for muscles, tendons, and ligaments
processes
what bone structure has openings or hollow regions to help join bones or serve as passageways for nerves or vessels
depressions
what is located in facial and cranial bone and lighten the skull and warm and moisten the air as it passes into the resp system
air cavities (sinuses)
26 bone segment from base of skull to tail bone, has five divisions and is separated by intervertebral discs
vertebrae
rounded depression in pelvis that joins the femur, forming the hip joint
acetabulum
outward extension of shoulder blade forming the point of the shoulder
acromion
dense, hard connective tissue composing the skeleton
bone
flexible, connective tissue
cartilage
dense connective tissue protein strands found in bone and other tissues
collagen
soft spot between the skull bones of an infant
fontanelle
opening of the occipital bone through which the spinal cord passes
foramen magnum
minute spaces filled with blood vessels, found in compact bone
haverisan canals
round process on both sides of the ankle joint
malleolus
upper portion of sternum
manubrium
round projection on temporal bone behind the ear
mastoid process
central hollowed out area in the shaft of a long bone
medullary cavity
large process on the proximal end of the ulna
olecranon
membrane surrounding bones, rich in blood vessels and nerve tissue
periosteum
area of confluence of the two pubic bones in pelviss
pubic symphysis
depression in sphenoid bone where pituitary gland is located
sella turcica
pole like process extending downward from temporal bone on each side of skull
styloid process
immovable joint between bones
suture
connection on either side of the head between temporal bone and mandibular bone
temporomandibular joint
supporting bundles of bony fibers in cancellous bone
trabeculae
lower, narrow portion of sternum
xiphoid process
what type of muscle is under voluntary control and moves all bones as well as facial and eye
striated
what type of muscle is involuntary and moves internal organs (not heart)
smooth
what type of muscle is not consciously controlled and found exclusively in the heart
cardiac
movement away from midline
abduction
movement toward midline
adduction
upper movement of foot
dorsiflexion
straightening of a flexed limb
extension
fibrous membrane separating and enveloping muscles
fascia
downward movement of the foot
flexion
connection of muscle to a bone that moves
insertion of a muscle
connection of muscle to stationary bone
origin of muscle
bending the sole of the foot downward toward the ground
plantar flexion
turning the palm down
pronation
circular movement around a central point
rotation
muscle connected to bone, voluntary or striated muscle
skeletal muscle
visceral muscle (which type of muscle)
smooth muscle
skeletal muscle (which type of muscle)
striated
turning palm up
supination
what is a malignant bone tumor arising in medullary tissue
ewing sarcoma
what type of sarcoma have symptoms such as pain, swelling of extremities, fever and leukocytosis?
ewing sarcoma
ewing sarcoma is more common in ____
males
when is the peak age for ewing sarcoma?
10-20
how do you treat ewing sarcoma (2)?
- surgery
- chemotherapy
bony growth arising from the surface of the bone
exostosis
what is the most common type of exostosis
bunion
where does swelling occur in a bunion?
metatarsophalangeal joint, near base of great toe
how does someone get bunions?
wearing improper shoes
Tx Exostosis (bunion)
bunionectomy
break in bone or bones
fracture
what type of fracture: no open wound
closed fx
what type of fracture: open wound
open fx
what type of fracture: distal radial fracture
Colles fx
what type of fracture: bone is in multiple pieces
comminuted fx
what type of fracture: bone collapses
compression fx
what type of fracture: bone is partially broken
Greenstick fx
what type of fracture: one fragmnet driven into another
impacted fx
what type of fracture: twisting injury, most common is the tibia
spiral fx
reduction of a fracture can either be ____ or ______.
open or closed
malignant tumor arising from the bone
osteogenic sarcoma (osteosarcoma)
what area of the long bones does osteosarcoma typically occur?
metaphyseal region of long bone
Symptoms of osteosarcoma (3)
- pain (with weight bearing)
- mass
- fracture (minor trauma)
where does osteosarcoma commonly metastasize?
lungs
what is the age distribution for osteosarcoma called (it affects adolescents and <65 y/o)
bimodal age distributtion
excess organic bone matrix secondary to defective or inadequate bone mineralization, known as rickets in children.
osteomalacia
osteomalacia usually affects the ____ population
older
what are the deficiencies in osteomalacia? (what minerals are hyper/hypo?)
- increased alkaline phosphatase
- low serum calcium
what are symptoms of osteomalacia? (3)
- bone pain
- tenderness
- muscle weakness
cause of osteomalacia vitamin D deficiency (how do people get Vit D deficiency) (3)
- decreased sunlight exposure
- poor nutrition
- drug induced - dilantin
acute or chronic infection of hte bone and its structures caused by bacteria
osteomyelitis
how can the osteomyelitis infection be acquired? (3)
- hematogenous
- contagious
- direct inoculation (trauma or surgery)
osteomyelitis infection is commonly seen in
older adults
signs and symptoms of osteomyelitis (5)
- abrupt onset of fever
- irritability
- restriction of movement in involved extremity
- local inflammation / joint destruction
- malaise
multifactorial skeletal disease characterized by severe bone loss
osteoporosis
where are the most common atraumatic fractures seen in osteoporosis pts (6)
- vertebral column
- upper femur
- distal radius
- proximal humerus
- pubic rami
- ribs
signs and symptoms in osteoporosis (4)
- back pain
- kyphosis
- scoliosis
- atraumatic fx
- loss of height
what are the risk factors for osteoporosis?
- malnourishment / malabsorption
- immobilization
- smoking
- caffeine
- excess thyroid hormone
osteoporosis is most common in
postmenopausal asian and caucasian women
congenital abnormality of the hind of foot, also known as club foot
talipes
in talipes the patient cannot stand with the __(part of foot)__ of the foot flat on the ground
sole
a chronic, progressive condition which inflammatory changes and new bone formation occurs at attachment of tendons and ligaments to bone is known as
Ankylosing Spondylitis
what joint involvement is the hallmark of ankylosing spondylitis?
sacroiliac joint
what are signs and symptoms of ankylosing spondylitis? (4)
- subgluteal / low back pain
- morning stiffness, awake at night from stiffness
- pleuritic chest pain
- loss of lumbar lordosis
when do S/S usually occur for ankylosing spondylitis?
early 20s, last >3 months
inflammatory reaction to urate crystal in joints, bones, and subcutaneous structures is known as
gout
what is the predominant age to get gout?
30-60 YO, males > females
Signs and Symptoms of Gout include (4)
- pain/swell/redness/warmth
- tenderness (extreme)
- Propensity for first MTP joint
- recurrent attacks last long/occur more frequently
what is the most common form of joint disease that involves progressive loss of articular cartilage and reactive changes at joint margins and in subchondral bone?
Osteoarthritis (OA)
what is the predominant age for OA, what age does this disease cause a disability most often?
> 40, 65
do males or females get OA more?
equal, haha trick question
signs and symptoms of OA? (5)
- slow developing joint pain, pain with use
- morning stiffness
- joint enlargement
- decreased ROM
- creptius = LATE sign, NO tenderness
what is joint enlargement symptoms known as in OA?
Heberben’s node of DIP
chronic systemis inflammatory disease of unknown etiology with a predilection for joint involvement is known as?
Rheumatoid Arthritis (RA)
are women or men more affected by RA?
women
signs and symptoms of RA? (5)
- swelling
- joint deformities
- joint destruction occurs earlier
- pain with ROM
- morning stiffness
what joints are most oftenly involved in RA? (5)
- wrist
- knee
- elbow
- shoulder
- ankle
the most common cause of peripheral nerve compression is known as?
Carpal Tunnel Syndrome (CTS)
what nerve is compressed as it traverses the carpal tunnel in the wrist/hand in CTS
median nerve
what is the “tunnel” comprised of in the carpal tunnel?
carpal bones dorsally, transverse carpal ligament ventrally (contains flexor tendons and median nerve)
what hand do symptoms affect most?
dominant
what are signs and symptoms of CTS?
- tingling sensation in fingers
- burning pain (relieved by hand movement)
- tinel’s sign positive
- phalens sign positive
displacement of bone from its joint is known as
dislocation
common locations for a dislocation are (3)
- acromioclavicular
- shoulder
- hip
restoration of bones to normal positions is known as
reduction
partial or incomplete dislocation is known as
subluxation
fluid filled cyst arising from the joint capsule or tendon is known as
ganglion
where are ganglions most common?
wrist
do we know where ganglions come from?
no, unknown etiology
abnormal protrusion of a fibrocartilagenous intervertebral disc into the neural canal or spinal canal is known as
herniation of intervertebral disc
most common herniation of intervertebral disc is known as
posterolateral herniation
mutli-system infection caused by spirochete Borrelia burgdorferi is known as
Lyme disease
how is lymes disease most commonly transmitted?
lxoid ticks
stage 1 of Lyme’s disease shows as (2 signs/ymptoms)
- erythema migrans rash (bullseye)
- flu-like symptoms
stage 2 lymes disease shows as (1 sign/symptom)
- one or more organ system not working to fullest capability (ex. neuro 15%, cardiac 8%)
stage 3 lymes disease shows with
- chronic arthritis
- neurologic symptoms
risk factors to lymes disease includes
exposure to tick infected area from May-September
an injury to the ligaments around a joint is known as
sprain
multi-system, autoimmune inflammatory condition characterized by a fluctuating chronic course is known as
Systemic Lupus Erthematosus (SLE)
signs and symptoms SLE (a literal gazillion)
- arthritis
- fever
- anorexia
- malaise
- weight loss
- skin lesion
- oral ulcers
- eye pain
- chest pain/SOB
- pallor
- Malar Rash
- Photosensitivity
inherited progressive diseases of muscle with wide ranges of clinical expression is known as
muscular dystrophy
signs and symptoms of muscular dystropy? (3)
- motor dysfunction
- muscle weakness
- muscle atrophy
what is the most common type of muscular dystrophy?
Duchene muscular dystrophy
systemic connective tissue disease characterized by inflammatory and degenerative changes in proximal muscles sometime accompanied by a characteristic skin rash is known as
polymyositis
signs and symptoms of polymyositis (6)
- symmetrical proximal muscle weakness (difficult when sitting/standing)
- difficulty with movement
- joint pain
- swelling
- dysphagia
- respiratory impairment
what is it called when a needle is inserted into a joint in order to remove fluid
arthrocentesis
what is the purpose of a arthrocentesis?
removal of fluid to decrease symptoms of pain and improve mobility in joint.
also to diagnose
the radiographic exam of a joint after injecting dye-like contrast material and/or air to outline the soft tissue and joint structures on the images is known as
arthrography
the operation for construction of a new moveable joint is known as
arthroplasty
what are the the three types of arthroplasty
- excision arthroplasty
- half-joint replacement arthroplasty
- total replacement arthroplasty
the visual exam of the interior of the joints with special surgical instruments is known as
arthroscopy
dual energy absorptiometry used to measure bone density is known as
DEXA, bone densitometry scan
why are DEXA scans preferred?
precision, low radiation exposure
Bone density scans are reported with two types of scores, what are they?
T and Z scores
what score is known as number of standard deviations for patient compared to normal
T score
what score is defined as number of SDs fro pt compared to normal
Z score
what type of scan is a nuclear scanning test that identifies new areas of bone growth or breakdown
bone scan
bone scans can detect problems _____ to _____ earlier than X ray
days to months
a test that assesses the health of the muscles and nerves controlling the muscles. Electrode is inserted into muscle
electromyography (EMG)
what type of diseases do muscle biopsies identify?
neuromuscular disease
used to image tendons, muscle, joints and often used with joint injections to visualize proper site for injection and or aspiration is known as
musculoskeletal US
