EXAM 3-Ch 15 Musculoskeletal

Question 1

Primary Minerals of Bones

Answer 1

-calcium -phosphate *minerals embedded in collagen (bones main protein) *minerals make bones hard and rigid and collagen impairs flexibility

Question 2

-mature bone cells

Answer 2

Osteocytes

Question 3

-bone-forming cells

Answer 3

Osteoblasts “B”-> birth

Question 4

-bone-reabsorbing cells

Answer 4

Osteoclasts “C”->consume

Question 5

Bones is built by __________ and broken down by __________, and is constantly in a state of remodeling, based on use and pressure.

Answer 5

osetoblasts; osteoclasts

Question 6

Diagnostic Tests (6)

Answer 6

-x-ray -MRI -CT -joint fluid aspiration and microscopic/chemical analysis -electromyography -biopsy

Question 7

Hormones affecting bone (3)

Answer 7

-parathyroid hormone (increase blood calcium) -calcitonin (decrease blood calcium) -vitamin D (increases blood calcium)

Question 8

Dietary calcium cannot be absorbed from the digestive tract without _________.

Answer 8

vitamin D

Question 9

Osteoporosis (“pores”) -definition -malfunction -most susceptible bones

Answer 9

-definition: a metabolic bone disease where bone density is reduced (porous bone that is abnormally fragile and easy to fracture) -malfunction: osteoblasts are not keeping up with bone breakdown -most susceptible: weight-bearing bones (hips, vertebrae)

Question 10

Osteoporosis (7) -risk factors

Answer 10

-females after menopause (amenorrhea-absense of menstrual cycle); decreased estrogen; 30-35 years old -males (older males); decrease in testosterone -low bone mass & calcium intake -Vitamin D deficiency -small frame -smoking & alcohol -diet & exercise

Question 11

Osteoporosis -symptoms (3) -diagnosis (2) -treatment (4)

Answer 11

-symptoms are mild: height loss, ease of fracture, Kyphosis (dowager’s hump) -dx: pt history, bone density testing -tx: meds to enhance calcium uptake by bones, bisphosphonates, estrogen calcitonin, parathyroid hormone (bone forming)

Question 12

Osteomalacia -definition -causes -higher occurrence in what population -manifestations -diagnosis -treatment

Answer 12

-definition: softening of the bones due to inadequate mineralization in adults -causes: low calcium absorption or low vitamin D -occurrences: high in elderly pt’s, in colder regions, and in person on long term anticonvulsants -manifestations: bone pain, tenderness, fractures (pathologic: fractures not caused by injuries) -dx: x-ray, bone scan, bone biopsy -tx: nutritional supplementation and correction of the primary cause

Question 13

Bone trauma: fractures

• greenstick
• compound
• spiral
• depressed
• closed
• open
• impacted
• comminuted

Answer 13

.

Question 14

Paget’s Disease

• definition
• most affected population
• diagnosis
• treatment

Answer 14

• definition: overproduction of bone, particulary in the skull, bertebrae, and pelvis
• affects mostly men over 40 in the US
• dx: physical exam, x-ray, bone scan and biopsy
• tx: calcitonin and drugs to reduce bone reabsorption and reduce calcium

Question 15

Paget’s Disease

-signs and symptoms (pathophsyiology)

Answer 15

• bone softening, followed by overgrowth of weak bone- osteoblasts are in overdrive
• possibly genetic link, or viral cause
• fracture easily
• skull overgrowth affects cranial nerves, so vision and hearing are affected
• curvature of the spine and legs

Question 16

Bone Healing

-bone stages

Answer 16

1. Hematma (1-2 days) brings clotting factors
2. Formation of granulation tissue/soft tissue callus (pink healthy tissue)
3. Ossification- deposit of mineral salts
4. Remodeling- resorption of excess bony callus

Question 17

Osetomyelitis

• definition
• bones primarily affeted
• cause

Answer 17

• defintion: chronic or acute infection of the bone and marrow
• primarily affected: long bones (especially in children and adolescents)
• casue: by bacteria that are carried by blood to the bone from other sites in the body (ex. staphylococci)

Question 18

Arthritis

• definition
• two main types and their defintiion

Answer 18

• disease of the joints causing pain and limiting mobility
• 2 main types: osteoarthritis (“wear and tear” brough on by age) and rheumatoid arthritis (autoimmune disorder that affects joints and the entire body; exacerbations and remissions)

Question 19

Muscular Dystrophy (MD)

-definition

diagnosis

Answer 19

• defintion: genetic disorder with a defect in the dystrophin protein that links sacromeres to the muscle membrane; results in muscle degenerstion leading to disability
• dx: genetic testing, biopsy muscle fibers, and seeing how well the muscles contract