Clinical Conditions

Question 1

Compartment syndrome

Answer 1

Bleeding into compartment raises pressure
Nerve compression -> intense pain
Blood vessel compression -> ischaemia and potential oncosis
Treatment - fasciotomy (cut fascia to relieve pressure)

Question 2

Hypotonia

Answer 2

Loss of muscle tone
Primary degeneration of muscle (myopathies - DMD)
Lesion of sensory afferents in skeletal muscle
Cerebral/spinal neural shock
Lesions of the cerebellum
Lesions of lower motor neurones (polyneuritis)

Question 3

Tetanus

Answer 3

Infection of wound by clostridium tetanii
Toxin released
Permanent state of contraction due to temporal summation
Treat with antibiotics

Question 4

Amelia

Answer 4

Complete lack of limb due to congenital defect

Question 5

Meromelia

Answer 5

Lack of particular part of limb

Phocomelia - hands and feet attached to abbreviated arms and legs; result of thalidomide’s teratogenic effects

Question 6

Syndactyly

Answer 6

Lack of apoptosis between two or more digits -> webbed feet or hands

Question 7

Polydactyly

Answer 7

More than a normal number of digits

Question 8

Slipped disc

Answer 8

Nucleus polposus herniates and leaks out from centre of intervertebral disc in poster-lateral or posterior direction
Postero-lateral - pain (due to nerve root compression and local inflammatory mediator response)
Posterior - compress spinal cord, can cause paralysis

Question 9

Kyphosis

Answer 9

Abnormal posterior convexity of thoracic spine (>60 degrees)
Causes hunch back and back pain
Correct with brace if young

Question 10

Lordosis

Answer 10

Abnormal posterior concavity of lumbar or cervical spine
Causes saddle back
Back pain, stiffness etc.
Correct with brace if young

Question 11

Scoliosis

Answer 11

Abnormal 3D abnormality of spine, some lateral deviation, potentially a degree of twisting
Issues with posture, rarely causes pain
Treat with brace

Question 12

Spina bifida

Answer 12

Hole in vertebral column (unknown cause)
Lack of folic acid during and just before pregnancy strong risk factor)
Spinal cord exposed - nerve damage and infection likely
Closed with surgery at birth, rare for no damage to have occurred though

Question 13

Whiplash

Answer 13

Sudden jerking movement of the head
Damages ligaments and muscles, can dislocate vertebrae
Rapid jerk causes cervical spine to adopt sigmoid shaper
Forces C5 and C6 to hyperextend - vulnerable to dislocation
Pain and partial paralysis can occur if spinal cord damaged (foramen of cervical vertebrae very large, some degree of movement before spinal cord impacted)

Question 14

Rheumatoid arthritis

Answer 14

Inflammation of synovial membrane, pain when moving joint
Progresses to fibrosis of affected joints, affecting mobility and causing them to seize eventually
Not age related
Progress slowed with steroids but physiotherapy and lifestyle changes usually necessary
Surgery - joint replacement, resurfacing or fusion

Question 15

Osteoarthritis

Answer 15

Persistent movement stripping articular surface from joints
Bone grinds against bone -> joints seize -> pain
Associated with age
Physiotherapy and lifestyle changes can help
Surgery - joint replacement, resurfacing or fusion

Question 16

Sarcopenia

Answer 16

Loss of muscle mass with ageing 
0.5 - 1% per year after 50 
Some consider normal part of ageing
Contributes to increased risk of death following a fall
Known as frailty syndrome