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System Screening > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

What are the most common sites involved in Paget’s Disease

A

Cranium and long bones of LE

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2
Q

Mechanism of action of Polysynaptic Inhibitors

A

Decrease polysynaptic reflex activity, which causes a decrease in alpha motor neuron excitability

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3
Q

Bacteria spread from preexisting infections from other body sites by the blood

A

Hematogenous osteomyelitis

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4
Q

Best therapy for chronic osteomyelitis

A

Minimal response to antibiotics; aggressive surgery

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5
Q

What happens to the Soleus in humans during the chronic stage (>3 yrs) of a SCI?

A

80% drop in torque

Complete change to FT muscle fibers, no longer fatigue resistant

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6
Q

Life threatening complications of Rhabdomyolysis

A

Myoglobinuric acute renal failure, hyperkalemia, cardiac arrest, compartment syndromes

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7
Q

Segmental fracture

A

Complete fracture resulting, fracture with 2 or more pieces in a single bone that don’t interconnect.

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8
Q

What is the structure and function of bone?

A

Calcified CT: Ca added to collagen/CT matrix

Homeostatic storage of Ca and P for blood

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9
Q

Spasms involves what kind of injury

A

Increased tenson of skeletal muscle after musculoskeltal injuries/inflammation. Involves nerve impingement, muscle strain/overuse, chemical or mechanical stimuli in PNS

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10
Q

Solutions for drugs and rehab

A

Schedule PT when sedative effects are minimal, discuss weakness implications with MD, for spasticity use PT to promote normal physiological motor control, for spasms use PT to improve strength/posture/flexibility/proper body mechanics

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11
Q

Adverse reactions for drugs in rehab

A

Muscle weakness, decreased muscle tone, sedation, dizziness, ataxia

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12
Q

Treatment of osteosarcoma

A

Chemo (30% can be completely cured), resection of tumor

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13
Q

A genetic defect that results in a mutation of gene for Type I collagen which results in defective bone or osteoid formation

A

Osteogenesis imperfecta

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14
Q

Common fracture sites of the elderly

A

Proximal femur, proximal humerus, vertebrae, pelvis

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15
Q

Myositis

A

Inflammatory muscular conditions caused by injury or an infectious pathogen

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16
Q

Gabapentin (Neurontin) mechanism of action

A

Decrease spasticity by raising level of inhibition in spinal cord, decreasing excitation of alpha motor neuron

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17
Q

-sarcoma

A

Malignant cancers; metastasize to other tissues

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18
Q

Steps in growth of the epiphyseal plates:

A

A region of cartilage grows and lengthens the bone–>cartilage cells die–>BVs, bone marrow, and bone cells invade empty space depositing collagen and minerals–>epiphyseal plates close 18-20 y/o

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19
Q

Most common malignant tumors are derived from:

A

Metastasized tumors from other organs

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20
Q

Late complications of Rhabdomyolysis

A

Compartment syndromes, ischemia, systemic disorders, death

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21
Q

Dowager’s Hump

A

compression fracture of the vertebrae resulting in back pain/kyphosis; also seen in postmenopausal women

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22
Q

Osteomyelitis cast care

A

Cover rough edges, monitor pt sensation/circulation/drainage, Increased temp, redness, localized heat, and swelling need to be reported

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23
Q

Risk factors Rhabdomyolysis

A

Trauma, untrained individuals in extreme exercise, Meds (Statins, AZT), alcohol abuse, etc.

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24
Q

2 factors that contribute to degree of immobilization-induced atrophy:

A

Degree: number of joints muscle crosses

Normal use and % slow twitch muscle fibers

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25
Q

Clinical features of Osteoarthritis

A

Pain relieved by rest, joint stiffness 15-20 minutes after sitting/sleeping, reduced ROM, crepitus, deformities (varus/valgus), muscle spasm, contractures, atrophy

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26
Q

Features of Myotonic dystrophy

A

Weakness/atrophy of face, slurred speech/ptosis, well-preserved posterior cervical muscles, limited muscle involvement in limbs, frontal baldness

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27
Q

Symptoms in the hands and feet for Osteoarthritis

A

“DOH”
Heberden’s Nodes at DIPs
Hallux valgus and bunion at 1st MTP

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28
Q

Fibrous union

A

Bony fracture defect is replaced with a fibrous scar instead of mineralized bone
Too much stress: disrupt BF

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29
Q

Malignant bone tumor of young people. More in men. (10-25)

A

Osteosarcoma

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30
Q

What is the fiber size of the spinal ST soleus fibers?

A

2700 um2

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31
Q

-oma, -blastoma

A

Benign cancers; can’t metastasize

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32
Q

Myelogenic tumors

A

Originate from bone marrow cells

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33
Q

Arthrodesis

A

Surgical immobilization or fusion of jt causing artificial ankylsos

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34
Q

Avascular necrosis of the vertebrae; seen as kyphoscoliosis in adolescents

A

Scheuermann’s Disease

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35
Q

Gouty Arthritis

A

Metabolic disease characterized by disturbance in purine metabolism resulting in Na urate crystals

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36
Q

Adverse effects of Polysynaptic inhibitors

A

Drowsiness, nausea, vertigo, dependence, death

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37
Q

Clinical features of benign bone tumors

A

Appear as bumps on outer bone or nodules inside bone

Pain if tumor is expansive, removed is cause pain

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38
Q

How is pus created in infection?

A

Neutrophils die b/c of bacteria and acid pH

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39
Q

Clinical features Osteoporosis

A

back pain/kyphosis, 15cm of height lost, long bone fractures, Ca/P/alkaline P levels normal, 30-50% reduction via X-ray

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40
Q

Arthroplasty

A

Reshaping the joint and implanting an artificial joint surface or prosthesis

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41
Q

Softening of bone w/o loss of bony matrix, but loss in mineralization of bone by Ca and/or P

A

Osteomalacia

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42
Q

Death of bone not caused by bacteria:

A

Aseptic necrosis

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43
Q

Characteristics of Chondrosarcomas

A

Large malignant tumor that infiltrates trabeculae in spongy bone. Occurs most in metaphysis or diaphysis of long bones

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44
Q

Mild form of Osteogenesis imperfecta

A

Later in life that can increase susceptibility to bony fractures

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45
Q

What is spasticity

A

Injury to the CNS. Involves Increase tonic stretch reflex, tone, muscle weakness, discrease visco-elastic properties

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46
Q

Treatment giant cell tumors

A

Cryosurgery and resection, bone grafts, amputation

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47
Q

Mechanism of action for Diazapam (Valium)

A

Increase central inhibitory effects of GABA. Has sedative effects in the brain

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48
Q

Compression Fracture

A

Fracture is wedged or squeezed together on 1 side of bone

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49
Q

Special concerns for Botox in Rehab patients

A

Complement rehab, allow for aggressive PT to prevent reinjury, PTs need to identify pts who don’t need meds anymore

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50
Q

Remodeling of bone is done in response to:

A

Structural needs: support

Biochemical roles: Ca and P metabolism

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51
Q

Rhabdomyolysis effects on the kidneys

A

Heme casts causes obstruction, tubular necrosis, renal ischemia, electrolyte abnormalities

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52
Q

Causes of Secondary Osteoarthritis

A

Joint trauma, long-term stress, instability, neurologic disorders (Charcot, diabetic neuropathy), Hemophilia, HyperPTH (chronic bleeding in jts)

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53
Q

Symptoms of Ewing’s Sarcoma

A

Pain/swelling progressive, flulike symptoms (low-grade fever)

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54
Q

Clinical features Rheumatoid Arthritis

A

“Flare” consists of increased pain, swelling, decreased function/ROM, low grade fever, loss of appetite, fatigue, anemia

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55
Q

Later symptoms of myotonic dystrophy

A

proximal limb weakness, myotonic symptoms, slow steady progression of disease associated with organ system abnormalities

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56
Q

Clinical manifestations of Osteomyelitis

A

Fever, pain, guarding, over metaphysis of bone

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57
Q

What other bodily abnormalities will result in Osteogenesis Imperfecta (reduction Type I collagen)

A

Thin skin, thin dental enamel, floppy mitral valve, bluish hue to normally white sclera of eye

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58
Q

Treatment for Osteomyelitis

A

Antibiotics
Surgery
Duration of treatment: 3-6 wks
Parenteral-oral antibiotics

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59
Q

Compartment syndrome

A

Edema around fracture applies pressure to regional BVs causing loss of blood supply to muscle and muscle death

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60
Q

Treatment of Ewing’s Sarcoma

A

Surgery, radiation, chemo

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61
Q

Tumor of adult women (20-40). Some are malignant and some are benign

A

Giant Cell tumors

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62
Q

Adverse effects of statins and Rhabdomyolysis reduced by:

A

Cautious use of statins w/ impaired renal function, use lowest ED, careful monitoring, discontinue statins w/ muscle toxicity

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63
Q

S/S compartment syndrome

A

Decrease motor function, diminish reflexes, pain, burning, paresthesias

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64
Q

Mechanism of Action for Baclofen

A

Binds to GABA-B (G-protein mediated) inhibiting transmission w/in spinal cord

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65
Q

Steps of muscle fiber repair

A

Damaged cellular components digested–>Satellite cells proliferate–>Satellite cells form myotubes and muscle fibers regaining cell function

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66
Q

What does local swelling and redness mean?

A

Infection has spread out of the metaphysis into subperiostal space

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67
Q

Pathophysiology Paget’s Disease

3 phases:

A 
Destructive phase (Inc. osteoclast)
Mixed phase (destructive phase = new bone)
Osteosclerotic phase (thickened trabeculae, abnormal compact bone)
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68
Q

Signs of Rheumatoid Arthritis

A

“PBR”
Bouchard’s Nodes at PIPs
Deformity and dislocation at MCP jts, ulnar deviation of fingers w/ anterior slippage of PIPs

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69
Q

How are chondrosarcomas rated?

A

Grade I-III based on maturity and level of cartilage cell differentiation.
Grade III is the worse.

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70
Q

Neurovascular injury

A

damage to arteries and nerves around the injury site

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71
Q

S/S fat embolism

A

w/in 1 week post surgery. Subtle behavior and orientation changes, Dyspnea, chest pain, diaphoresis, pallor, cyanosis, rash

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72
Q

Botox mechanism of action

A

Bind to ACh containing vesicles at NMJ, block release of ACh

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73
Q

Treatment Gouty Arthritis

A

Meds for control of inflammation and uric acid, rest, elevation, ice or moist heat (uric acid more likely to precipitate out with ice)

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74
Q

How are growth plate injuries classified?

A

I-V depending on tissue involvement

I and II are best possible diagnosis

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75
Q

Botox and its use for local spastic disorders

A

CVA

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76
Q

Adverse effects of Dantrolene

A

Muscle weakness, hepatotoxicity, fatal hepatitis, drownsiness/dizziness/nausea
Not an effective drug

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77
Q

Primary Osteoporosis

A

Idiopathic (young w/ normal gonad fxn)
Postmenopausal
Senile

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78
Q

How does the Soleus muscle become faster after transection?

A

Sarcoplasmic reticulum changed increased Ca transport ability

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79
Q

What are the 3 stages of muscle fiber repair

A

I. Inflammation: macrophages digest
II. Proliferation of Satellite cells (3-4 days)
III. Synthesis of new myofibrillar proteins (~6 mos)

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80
Q

Symptoms of Osteoarthritis

A

Pain in buttocks/upper anterior/medial thigh, “+” Patrick’s test
Pain crepitus, effusion during WB
Affects facet joints, radicular pain

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81
Q

Complications of intrathecal baclofen

A

Pump malfunction leading to OD, catheter obstruction, tolerance with long-term

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82
Q

Transverse fracture

A

Complete fracture resulting in smooth or serrated surfaces perpendicular to the long axis of bone. Caused by direct or indirect forces. Usually bending

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83
Q

Factors effecting fracture healing

A

Age (children faster), general health (diabetes, PVD), Nutrition smoking, local infection

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84
Q

Factors that disrupt healing of fractured bone

A

Appropriate immobilization, too much immobilization: reduces mineralization
Too little immobilization: reduce BF

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85
Q

Eburnation

A

Abnormal pressure produces sclerosis of bone underneath the cartilage

86
Q

Joint destruction causes inflammation

A

Non-inflammatory disease

87
Q

Mechanism of Action for Dantrolene

A

Only muscle relaxant that directly exerts its effect on skeletal muscle cells, impairs release of Ca from SR during excitation

88
Q

Benefits of Polysynaptic inhibitors

A

Improve S/S of spasms, decrease pain/tenderness, increase ROM, less restrictions in ADLs

89
Q

Most common cause of aseptic necrosis of bone

A

Avascular necrosis

90
Q

Autosomal-dominant pattern that is the most common and serious of the myotonic disorder

A

Myotonic myopathies

91
Q

Cautions for Polysynaptic inhibitors

A

Hyperthyroidism, glaucoma, urinary retention, enhances effect of alcohol/barbiturates/CNS depressants

92
Q

Atrophy results from a decrease in what 2 components of muscle?

A

Myofibril protein

Cross-sectional area

93
Q

Tumor of the very young. More in men. (5-20)

A

Ewing’s sarcoma

94
Q

Vitamin D Deficiency for Osteomalacia caused by:

A

Inadequate intake/exposure to sunlight (synthesis Vit. D), abnormal intestinal absorption that effect fat absorption, Kidney tubular defects

95
Q

Risk factors Osteonecrosis

A

Corticosteroid use, Lupus, Cushing’s disease, cancer therapies, obesity, etc…

96
Q

Treatment of Chondrosarcomas

A

Surgical excision of tumor or complete amputation

97
Q

Primary Osteoarthritis

A

Neither cause nor risk factors known

98
Q

Symptoms of Osteosarcoma

A

Intermittent pain/swelling increasing in severity and duration, Pain worse at night, pathological fractures

99
Q

What happens to neural activity of muscles during immobilization

A

Neural activity of muscles remains the same during the entire period of immobilization

100
Q

Clinical features of Gouty arthritis

A

Initial acute attack usually occurs in single jt – most common 1st MTP JT

101
Q

Results in flattening of the femoral head caused by ischemic necrosis

A

Legg-Calve-Perthes Disease

AKA: coxa plana

102
Q

What are the forms of Dichlorodifluoromethane?

A

Vapocoolant spray: topical use only

103
Q

Pathophysiology of Rheumatoid Arthritis

A

Inflamed synovial membrane–>cells into joint cavity/synovial fluid–>:tissue repair (proliferation) via new synovial cells/new BVs–>Joint pannus–>secretion of lytic enzymes–>destroys synovial tissue/hyaline cartilage/underlying bone–>jt becomes immobile–>jt space obliterated w/ JP creating ankyloses (collagen scar)

104
Q

Death of bone caused by bacteria:

A

Septic necrosis

105
Q

Myelogenic tumors includes 2 types of tumors:

A

Giant cell tumors

Myelomas

106
Q

Secondary Osteoarthritis

A

Caused by chronic, excessive, or abnormal forces that damage joint surfaces, underlying bone, and leads to jt instability

107
Q

What are the stages of bone healing?

A

I. Hematoma (2-3 days)
II. Fibrous lattice
III. Cell proliferation: osteoblasts from soft callus (4 wks)
IV. Stage of clinical healing: hard callus from soft callus (4-12 wks)
V. Stage of radiologic healing: Callus completely reabsorbed- looks like normal bone

108
Q

What is the fiber size of the Soleus muscle?

109
Q

Purpose of skeletal muscle relaxants

A

Treat conditions associated with hyperexcitable skeletal muscle

110
Q

Incidence of Osteomyelitis

A

More common in:

children, long bones, immunocompromised

111
Q

Tumors are intraosseous cysts usually located in epiphysis of femur, tibia, radius, humerus. May extend into local soft tissue

A

Giant cell tumors

112
Q

Pseudoarthrosis

A

Movement occurring between 2 bony fragments attached through fibrous nonunion
Too much stress

113
Q

Who is hematogenous osteomyelitis more common in?

114
Q

Avascular necrosis of the navicular bone

A

Kohler’s disease

115
Q

Most common site of avascular necrosis of bone

A

femoral head in hip jt

116
Q

Proliferation of immune cells. Tumors can cause cortical and medullary bone damage and spread to the bone marrow

117
Q

Symptoms of Chondrosarcomas

A

Insidious onset of local swelling/pain; Pain intermittent at 1st than becomes more intense/constant. Awakens individual at night.l

118
Q

Symptoms of myeloma

A

Weakness, fatigue, weight loss, anorexia, bone pain which increases.
Can be treated incorrectly for discogenic back pain or arthritis

119
Q

How to use Dichlorodifluoromethane

A

Spray from origin to insertion, sweep the target and referral zone

120
Q

Special considerations for Gabapentin (Neurontin)

A

Effective when used with other antispasticity drugs, also for chronic pain

121
Q

General rule of thumb for ST and FT muscle fibers

A

Slow get fast

Fast stay fast

122
Q

Pathophysiology of Rhabdomyolysis with normal sarcolemma function

A

Protects hypertonic intracellular muscle fluid (cytosol) from massive ECF flooding into muscles, Na/K ATP pumps maintain cation gradients and normal IC electronegativity

123
Q

Clinical features Paget’s disease

A

Asymptomatic or minor skeletal pain, compression of cranial nerves, Tib/Fib bow-leg, Osteosarcoma can develop

124
Q

Inflammatory process causes jt destruction

A

Inflammatory disease

125
Q

Tizanidine (Zanaflex) mechanism of action

A

Alpha 2 adrenergic agonist in CNS. Relieve spasticity after a neurological injury.

126
Q

Preventative role for PT and Osteomyelitis

A

Strict aseptic routine for wound care, monitoring/protection of wounds, avoid skin around pins/wires, avoid massage/mechanical stimulation

127
Q

Pathophysiology Fat embolism

A

fat globules are emboli from either subcutaneous tissue or bone marrow that settle in lung tissue and can block pulmonary vessels

128
Q

Adverse reactions of Tizanidine

A

Sedation, dizziness, dry mouth, hypotension, less weakness than baclofen/diazepam

129
Q

Surgical treatment for Legg-Calve-Perthes Disease

A

Usually cast for 6-8 wks after surgery, return to normal activity in 3-4 mos

130
Q

Legg-Calve-Perthes disease and PT

A

Maintain full ROM

131
Q

Avascular necrosis of the lunate bone

A

Kienbock’s disease

132
Q

Skeletal muscle response to injury

A

Damaged cell parts removed (inflammation/degeneration)–>damaged cell replaced with new tissue (tissue healing/regeneration)

133
Q

Most common sites of metastases for Osteosarcoma

A

Long bone metaphysis, knee joint, mandible, lungs via the blood

134
Q

Treatment of Rhabdomyolysis

A

Refer to MD, Systemic fluid control, acid/base control, restore electrolytes (Ca, K, Na)

135
Q

Common primary malignant bone tumors for men

A

Osteosarcoma, chondrosarcoma, ewing’s sarcoma

136
Q

Uses of Dichlorodifluoromethane

A

Manage pain and muscle spams and myofascial pain

137
Q

What disorders is spasticity involved with?

A

CP, MS, SCI, CVA

138
Q

What is the hierarchy of muscles susceptible to atrophy with immobilization? (Most to least)

A

Soleus > Plantaris > Vastus intermedius/vastus lateralis > Gastroc > Tib ant/RF

139
Q

Malignant primary bone tumor composed of undifferentiated small cells. Arises from stem cells in medullary cavity of bone and be found in shaft or diaphysis of bone.

A

Ewing’s Sarcoma

140
Q

Best therapy for Acute osteomyelitis

A

Good response to antibiotics; limited surgery

141
Q

Oblique fracture

A

Complete fracture resulting in fracture line at 45 degrees. Caused by bending force with some axial compression

142
Q

Osteomyelitis Implications for PT

A

Drainage, pain w/ movement, low-grade fever, swelling/redness, control WB

143
Q

Osteomalacia of long bones

144
Q

Conservative treatment for Rheumatoid Arthritis

A

Anti-inflammatory drugs, rest, gentle/regular AROM exercises (reduce ankylosis), moist heat or ice, splinting

145
Q

Bone tumor incidence from Lowest to Highest

A

<15–>30-35–>after 35–>16-21

146
Q

Pathophysiology of Osteomyelitis

A

Bacterial seeding–>inflammation–>pus (dead neutrophils) and swelling–>BF block–>Sequestra and Involucrum–>predisposition of fractures or sinus tract escapes pus

147
Q

What is the most common bacteria that causes Osteomyelitis

148
Q

Describe Type I and Type II growth plate injuries

A

Type I: Separation of growth plates

Type II: Involvement of cortex of the bone

149
Q

Treatment of Myeloma

A

Palliative care, spinal cord decompression, radiation, chemo

150
Q

How drugs interfere with rehab

A

Motor control problems, functional decline for daily activities, decreased alertness, weakness, tolerance and dependence

151
Q

Inflammation of the bone caused by an infectious organism

A

Osteomyelitis

152
Q

Spiral fracture

A

Complete fracture resulting in fracture line encircling bone like a spiral staircase. Caused by twisting force with the distal part fixed

153
Q

Skeletal muscle relaxants for muscle spasms

A

Diazapam (valium), Polysynaptic inhibitors (Cyclobenzaprine, Metaxalone, Carisoprodol, Orphenadrine, more), Dichlorodifluoromethane

154
Q

Inherited autosomal trait that is a genetic defect of endochondric ossification of the epiphyseal plates

A

Secondary Achondroplastic Dwarfism

155
Q

Surgical treatment for Rheumatoid Arthritis

A

Synovectomy, Soft-tissue release (d/t valgus deformity), Arthroplasty, Arthrodesis

156
Q

Adverse reactions of Diazapam (Valium)

A

Hypotension, rash, muscle weakness, ataxia, incoordination, euphoria, respiratory depression, dependence, withdrawal, death

157
Q

What is the fiber size of spinal + exercised soleus ST fibers?

158
Q

Pathological traits of Primary and Secondary Osteoarthritis

A

Joint narrowing, thinning/softening cartilage, erosion, eburnation, fluid filled bone cysts, osteophytes, joint swelling and inflammation

159
Q

Where is myeloma most located at?

A

Low back, upper spine, pelvis, ribs, sternum

160
Q

What is intrathecal Baclofen

A

Pts with severe, intractable spasticity, into subarachnoid matter, small amount to elicit effects, less side effects, implanted surgically through catheter

161
Q

Risk factors Osteomyelitis

A

Trauma/infection, drug addicts, sickle cell anemia, Screws and external fixators

162
Q

Open physis (growth plate fx)

A

Growth abnormality with premature partial or complete closure of physis
Can stop bone growth resulting in short leg or arm

163
Q

Secondary Osteoporosis

A 
Endocrine (HyperPTH, T2D, Cushings)
Malabsorption (GI, hepatic disease)
Renal failure
RA
Respiratory disease
Neoplasms
Chemical dependency
Amenorrhea
164
Q

Delayed union of fracture

A

Fracture takes longer to heal in bony regions with low blood supply
Distal tibia and navicular or scaphoid

165
Q

Clinical features Osteomalacia

A

Nonspecific bone pain, muscle weakness, rickets, Varus tibia

166
Q

More severe form of Osteogenesis imperfecta

A

Infant born with many fractures in utero

167
Q

Diagnosis of Osteomalacia based on

A

Symptoms, Lab findings of low Ca and/or P, elevated PTH

168
Q

Osteophytes

A

Formation of bone spurs

169
Q

Uses of Dantrolene

A

Severe Spasticity, traumatic cord lesions, advanced MS/CP/CVA, Malignant hyperthermia

170
Q

What is the classic myotonic response to mechanical stimulus

A

Reflex hammer to Thenar eminence causing sustained muscle contraction

171
Q

Common fracture sites of the young

A

Tibia, clavicle, distal humerus

172
Q

Common primary malignant bone tumors for women

A

Giant Cell tumor

173
Q

Symptoms Gouty Arthritis

A

Severe pain caused by exercise, physical/emotional stress, swelling/heat/pain on palpation, redness at 1st MTP jt, systemic symptoms

174
Q

Comminuted fracture

A

Complete fracture resulting in at least 3 bone fragments that interconnect. Caused by high energy trauma

175
Q

What is the mechanism of action for Spasticity?

A

Loss of supraspinal inhibition of alpha/gamma motor neurons leading to excitability of alpha motor neurons below site of injury

176
Q

Cautions of Dichlorodifluromethane

A

Allergic rxns, vascular insuffiencies, avoid inhaling/contact with eyes, store away from high frequency ultrasound equipment

177
Q

Adverse effects of Gabapentin (Neurontin)

A

Dizziness, sedation, fatigue, ataxia

178
Q

Agents used for spasticity

A

Baclofen (lioresal), Dantrolene (Dantrium), Diazepam (Valium), Gabapentin (Neurontin), Tizanidine (Zanaflex)

179
Q

Symptoms Giant Cell tumors

A

Pain, local swelling, limitation of movement

180
Q

Pharmacology for Spasms

A

Depressants of spinal polysynaptic reflex arc

181
Q

Sequestrum

A

dead bone and pus

182
Q

Loss of estrogen at menopause results in how much bone loss per year?

183
Q

Causes of Rhabdomyolysis

A

Diseases, trauma, medication side fx, toxins

184
Q

Osteomalacia

A

Inadequate mineralization of the organic bony matrix; wide seams of osteoid in bone that weakens or softens bony matrix

185
Q

Chronic systemic inflammatory disease with features of chronic inflammation of synovial joints

A

Rheumatoid Arthritis

186
Q

What happens to the Soleus in humans during the acute stage (<5 wks) of an SCI?

A

10% drop in torque

Still fatigue resistant

187
Q

Signs of Rhabdomyolysis in the blood

A

HyperK, HypoCa, HyperP, LDH, Carbonic anahydrase III

188
Q

Describe Type IV and V Growth plate injuries

A

IV: Goes up into joint and into metaphysis
V: Compressive force

189
Q

Treatment for Legg-Calve-Perthes disease

A

Initial 1-2 wks bed rest followed by gradual WB. Conservative RX may continue for 2-4 yrs

190
Q

Botox and its local use for generalized spastic disorders

191
Q

What happens to the ST muscle fibers after transection?

A

Become similar to FT muscle fibers

Soleus time to peak isometric tension decreased 50%

192
Q

Surgery indications for Osteomyelitis treatment

A

Prolonged fever, erythema, pain/swelling, persistent bacteremia; abscess; sinus tract

193
Q

Exogenous osteomyelitis

A

Invasion of bone by infectious organism from outside the body

194
Q

Diagnosis S/S of Rhabdomyolysis

A

Muscle pain, 5x normal CPK, dark urine (myoglobinuria)

195
Q

What else is affected as Myotonic dystrophy progresses?

A

Cardiac/respiratory involvement/failure, GI dysfunction, testicular atrophy, cataracts, mental disability,

196
Q

Malignant tumor of adults. More in men. (35-60)

A

Chondrosarcomas

197
Q

Pharmacology for Spasticity

A

Modify stretch reflex arc, interfere with skeletal muscle contraction

198
Q

Paget’s disease

A

Associated with osteomalacia, increase in remodel rate of bony tissue resulting in disorganized and excessive amount of bony tissue

199
Q

Cellular mechanism for atrophy

A

Protein synthesis rates decrease and protein degradation increase–>(2 wks) degradation decreases to less than control–>New state of homeostasis (~30 days)

200
Q

Fracture problems common with Post traumatic arthritis

A

Intracapsular fracture

201
Q

Etiology of Osteonecrosis

A

D/t bony tissue ischemia

202
Q

Summary of changes in muscle properties after SCI

A

Muscle weaker–>ST to FT conversion–>Muscle fatigues faster–>WB can hypertrophy muscle fibers in leg

203
Q

What is the denervation response of muscle?

A

Increased ACh sensitivity, spontaneous EMG at rest, muscle fib, no response to currents delivered at >20Hz

204
Q

Adverse effects of Baclofen

A

Less sedation, drowsiness, confusion/hallucinations, fatigue, weakness, withdrawal

205
Q

Age-related changes in metabolism results in how much loss of total bone mass per year?

A

.5%

After 30, bone resorption exceeds bone formation

206
Q

How is bony ischemia caused:

A

Injury disrupting the arterial supply or thrombus disrupting the microcirculation to the bone

207
Q

S/S Legg-Calve-Perthes disease

A

Usually unilateral, in 4-8 y/o, limping w/ hip pain in grown region or along entire length of thigh to the knee, reduced ROM, pain relieved by rest.

208
Q

Rhabdomyolysis

A

A clinical and biochemical condition resulting from disruption or damage to the integrity of the sarcolemma of skeletal muscle

209
Q

Inherited autosomal trait that is a genetic defect of endochondral ossification in the long bones.

A

Primary Achondroplastic dwarfism

210
Q

Greenstick Fracture

A

Incomplete fracture resulting in break in only 1 cortex of bone. Caused by minor direct or indirect force

211
Q

Reduction of total bone mass/bony matrix, or demineralization of bone

A

Osteoporosis

212
Q

Clinical features of Achondroplastic Dwarfism

A

Short arms and legs on normal torso. Tor

System Screening (2 decks)

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