Exam 3 Musculoskeletal Ch15 vocab only Flashcards
0
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Callogen
A
Bones primary protein is location where bones primary minerals calcium and phosphate are embedded
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Calcium and phosphate
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Bones primary minerals
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.
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.
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Bone forming cells
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Osteoblasts
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Osteoclasts
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Bone reAbsorbing cells
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Covers the spongy layers of bones
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Compact bone
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Spongy bone contains
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Bone marrow filled sacs - red colored marrow
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Name of the cavity at ends of long bones
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Medullary cavity
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From the growth plate the cartilage turned into bone which is a process called
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Ossification
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Damage to the growth plate before maturity tends to
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Prevent bone from reaching its mature length
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is a highly vascular layer of fi- brous connective tissue that covers the surface of bones. It contains cells that are capable of forming new bone tissue and serves as a site of attachment for tendons or muscles.
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The periosteum
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joints
A
articulating sites between bones.
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Various degrees of movement
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R.O.M.
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The shoulder (joint be- tween humerus and scapula)
A
is the most freely movable joint, but it is also the one most easily dislocated.
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Articulating bones are held together by dense strands of collagen that impart great strength
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ligaments
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the inner surface of the capsule is lined with
A
synovial membrane
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synovial membrane secretes __________ which lubricates the joints.
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synovial fluid
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Sacs of synovial fluid that are situated near some joints, such as the shoulder and knee, where they reduce friction during move- ment.
A
bursae
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Skeletal or voluntary muscle tissue
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found in muscles that are firmly attached to bones
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attach muscle tissue firmly to bones
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tendons
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stimulated by nerves at the myoneural junction,
A
muscle fibers contract
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shortening of the muscles
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moves the bones.
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an involuntary striated muscle
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Cardiac muscle
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X-rays, MRI, CT scans
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imaging Diagnostic Tests for Musculoskeletal Diseases
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Joint fluid
can be aspirated for microscopic and chemical analysis
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detects abnormalities of the spinal cord by visu- alizing the distribution of a radio opaque dye in- jected into the subarachnoid space. Can detect tumors and herniated discs.
Myelography
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measure electrical activity of muscles and reveals some abnormalities of muscle function. Biopsy can show muscle tis- sue abnormalities.
Electromyography
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atrophy
the decrease in size or function...in this case Bone
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is an inflammation of the bone, particularly of the bone marrow in the medullary cavity and the spaces of spongy bone.
Osteomyelitis kids:affects femur, tibia, humerus near ends of the growth plate adults:pelvis and vertebrae following trauma and surgery. -----bacterial infection that may have escaped treatment,
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Osteomyelitis is caused by bacteria, usually
Staphylococcus aureus and occasionally Strep- tococcus pyogenes, Pneumococcus, or Escher- ichia coli.
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chief risk factor for osteomyelitis includes
infec- tions, including open wounds of a compound fracture.
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In osteomyelitis, the infection develops into
an abscess in the bone, which compresses small blood vessels, reduces circulation, and causes bone necrosis. Infections may spread under the periosteum, lifting sections of it from bone sur- face, further reducing circulation to bone. In an attempt to heal, bone may be deposited around this area of necrosis.
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pain, redness, and heat. Systemic symptoms of chills, fever, and leukocytosis, tachycardia, nausea, and anorexia also occur.
Local symptoms of bone infection include
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Bones disease DX include
history and physical exam and can be confirmed with white blood cell count, an ele- vated erythrocyte sedimentation rate, blood cul- ture of causative microorganism, and magnetic resonance imaging or bone scans. An x-ray will not reveal early infections.
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an effective treat- ment and has reduced the incidence of ad- vanced serious cases
early antibiotic therapy
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Surgery may be required to remove necrotic
bone tissue
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Tuberculosis of bone is rare and is associated with
untreated pulmonary tuberculosis
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This infection occurs when bacteria spread to the bones from
the lungs........Commonly affected areas are the ends of long bones and knees.
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Pott’s disease is
tuberculosis of the vertebrae....leading to deformity and paralysis.
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antibiotics, al- though strains of Mycobacterium tuberculosis have developed multiple-drug resistance. Surgery may be able to correct bone deformities.
tx of potts disease
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Calcium and phosphorus are required in ap- propriate quantities for
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proper bone formation and maintenance.
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dietary calcium cannot be absorbed from the digestive tract without
Vitamin D
-
Thus, mineral or vitamin D deficiencies may result in soft, malformed, or fragile bones.
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Rickets is a disease of
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a rare infancy or early child- hood in which the bones do not properly ossify, or harden.
"bowlegged"
flaccid muscles, delayed teething, and a characteristic potbelly
Each of these symptoms can be explained by calcium deficiency.
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Rickets can be prevented with
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vitamin D–for- tified milk and exposure to sunlight. Sunlight converts a substance (dehydrocholesterol) in the skin to vitamin D in the body
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Osteomalacia is the
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softening or decalcification of bones in adults
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Symptoms include
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muscle weakness, weight loss, bone pain. Bones of the verte- bral column, legs, and pelvis become susceptible to bending and fracturing with mild stress.
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Osteomalacia is caused by inadequate dietary
vitamin D
-
and dietary deficiency of calcium or phosphorus
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Both rickets and osteomalacia may be secondary to
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malabsorption syndrome because vitamin D is not absorbed from the intestine.
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Osteoporosis is a disease characterized by
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porous bone that is abnormally fragile and susceptible to fracture.
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the cause of the accelerated bone loss observed in osteoporo- sis
is unknown
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risk factors for osteoporosis have been identified as
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caucasian, being female, advanced age, and having a small frame
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Risk Factors for Osteoporosis
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Low bone mass
Low calcium intake Female
Vitamin D deficiency Small frame Sedentary lifestyle Family history Cigarette smoking Postmenopausal Excessive alcohol use Hysterectomy Caucasian or Asian Amenorrhea
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Unfortunately, osteoporosis can quietly
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become advanced because no symptoms accom- pany bone loss until bones weaken enough to fracture.
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Osteoporosis is diagnosed using
hx,
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bone density tests
-NO CURE
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prevention is strongly recommended. A lifelong diet in calcium and vitamin D ,
weight-bearing exercise
NOSmoking, alcohol, limited caffeine consumption
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TX of osteoperosis
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medications facilitate calcium uptake in bone and include estrogens,
calcitonin,
parathyroid hormone,
estro- gen-receptor modulators and bisphosphonates.
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**Paget’s** disease, or ***osteitis deformans**,*
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-men over 40.
overproduction of bone,
particularly in the skull,
vertebrae, and pelvis.
-20% to 30% of cases are genetically based.
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The excessive bony growth causes the skull to enlarge, which often
affects cranial nerves; thus, vision and hearing are affected. Abnormal bone development causes curvatures in the spinal column and deformities in legs.
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Another complication: osteogenic sarcoma
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Paget’s disease is diagnosed by
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examination, x-rays, bone scan, and bone biopsy
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Paget’s disease Treatment requires
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calcitonin and etidronate, which reduces bone resorption, and mithramycin, which decreases calcium.
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an abnormal lateral curvature of the spine that occurs to varying degrees of severity and is usually first identified during childhood
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Scoliosis
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Scoliosis may be caused by
abnormal development that results in fusion of the vertebrae
or abnormal muscle growth which pulles the spinal in certain directions like polio or spina bifida or cerebral palsy
\<20\* no correction needed
\>20\* correction
\>30\* surgery
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an exaggerated posterior curve of the thoracic spine, sometimes called hunch- back, occurs most commonly in adults and be- comes more noticeable in the elderly . It is most often caused by collapse of vertebrae affected by osteoporosis and by de- generative changes associated with arthritis of the vertebrae. Symptoms include mild back pain, back fatigue, perhaps tenderness, and, in severe cases, difficulty breathing because of compression of the thoracic cage. It can be diag- nosed with physical exam and x-rays. Treat- ment options are few and provide no cures.
Kyphosis
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another name for
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Lordosis,
"swayback"
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Lordosis
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an inward curvature of the lumbar vertebrae. Some degree of curva- ture is normal and most cases are benign
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Bone Cancer
Malignant Bone Tumors
are rare
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Most bone cancer is
secondary and results from metastasis from a tumor located elsewhere in the body
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osteogenic sarcoma, arises in the bony tissue itself and frequently affects the ends of long bones, frequently at the knee, where enlargement of the bone is observed
osteogenic sarcoma
Signs and symptoms include dull localized bone pain that intensifies at night. Masses may be noted and fractures accompany sarcomas. Bone cancer is diagnosed with biopsy. X-rays and CT scans are used to locate and measure tumors. Treatment may involve chemotherapy to reduce tumor size followed by surgical removal
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Trauma, however, is also a common cause of bone fractures. Exces- sive force, twisting, or compression can lead to
bone fractures. The chief signs and symptoms of a fracture include
Visibly out-of-place or misshapen limb or joint
Swelling, bruising, or bleeding
Intense pain
Numbness and tingling
Broken skin with bone protruding
Limited mobility or inability to move a limb
bone fractures- Exces-sive force, twisting, or compression can lead to bone fractures.
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compound fractures, require
surgery, pins, and plates to promote healing.
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Joints that bear weight
the lower verte- brae, hips, and knees—
receive a great deal of stress and are especially susceptible to the dis- eases and disorders
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Arthritis means
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“inflammation of a joint.”
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Symptoms of arthritis include
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persistent joint pain and stiffness. swelling, loss of mobility , deformity to the point of losing function.
Commonly affected joints include the lower vertebrae, hips, fingers, and knees.
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A chronic and debilitating autoimmune disease, a systemic inflammatory disease that affects several joints and the surrounding muscles, ten- dons, and ligaments.
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Rheumatoid Arthritis
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antiglobulin antibod- ies, combine with immunoglobulin in the syn- ovial fluid to form antibody complexes. Neu- trophils are attracted to the joint space and cause destruction. The condition is aggravated by stress, and there is a genetic predisposition
[page11image27752] [page11image27912]
toward development of the disease.
Rheumatoid factors
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joint pain and stiffness,
particularly on waking. The joints are swollen, red, and warm. The same joints are often af- fected on both sides of the body. As the disease is systemic, the patient experiences fatigue, weakness, and weight loss.
RA symptoms
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When this scar tissue turns to bone, the ends of the bones fuse, a con- dition called
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ankylosis.
The fusion immobilizes and deforms the joint.
swan neck defor- mity and ulnar deviation characteristic of ad- vanced rheumatoid arthritis in the hands. Rheumatoid nodules may form under the skin, usually near the joints, but they sometimes de- velop on the white of the eye, too.
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Diagnosis is based on
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physical exam, x-rays showing joint changes, a rheumatoid factor test, and synovial fluid analysis
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tx
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Other nonsteroidal anti- inflammatory medications commonly used in- clude indomethacin, fenoprofen, and ibuprofen. Immunosuppressants such as corticosteroids and methotrexate are now administered in early stages of the disease. COX-2 inhibitors like Celebrex have also been used. A balance between exercise and rest should be achieved.
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most com- mon form of arthritis
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Osteoarthritis
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Primary osteoarthritis occurs with
normal aging
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Secondary osteoarthritis is associated with
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joint injury, trauma, or obesity. Other than injury, risk factors and causes are not well understood.
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Unlike rheumatoid arthritis, osteoarthritis may affect only
one joint
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Signs and symptoms include pain and
stiffness of the joint
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Arthritis in the lower
back may pinch a
spinal nerve
such as the sciatic nerve, in which case pain radiates down the back and leg.
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Degeneration occurs at the
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articular cartilage of the joint
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The bone ends thicken and develop sharp irregular bony sur- face structures called spicules and
spurs
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Diagnosis of osteoarthritis is made principally by
x-rays that show the joint damage and a history of the symptoms. There is no cure for osteoarthritis, but treatment can greatly relieve the pain.
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osteoarthritis tx
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A combination of rest and mild exer- cise to maintain range of motions, medication, and heat applications is generally prescribed. Nonsteroidal anti-inflammatory medications commonly used include aspirin, indomethacin, fenoprofen, and ibuprofen. Steroids such as cortisone are sometimes injected into the joint capsule to relieve pain.
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, \_\_\_\_\_affects the joints of the feet, particularly those of the big toe, and sometimes of the hand, fingers, wrist, or knee.
gout
--Also called gouty arthritis
-unknown cause
-
It sometimes follows a minor injury or excessive eating or drinking, and there may be no explanation for its occur- rence, but heredity seems to play a role.
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Gout attacks are related to
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excess uric acid in blood, which results either from a defect in metabolism of purines
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The high uric acid level leads to deposits of uric acid crystals in the joints. Uric acid crystals also deposit in the kidneys, stimulating kidney stone formation and irritating the kidney.
deposits of uric acid crystals in the joints. Uric acid crystals also deposit in the kidneys, stimulating kidney stone formation and irritating the kidney.
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The affected joints exhibit typical signs of
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pain, heat, swelling, and redness . Signs and symptoms may last from days to many weeks.
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A chronic form of gout also occurs in which a person experiences
per- sistent arthritis.
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Gout can be diagnosed by
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microscopic exam- ination of aspirated joint fluid, which reveals needle-like urate crystals. High serum level of uric acid is consistent with gout. X-rays of af-
fected joints may initially appear normal until repeated attacks of chronic gout damage the bone and cartilage at joints.
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Acute gout attacks can be treated with
rest, application of hot or cold compresses, anal- gesics, colchicine, and corticosteroids.
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Chronic gout may be treated with
colchicine, which pre- vents acute attacks, and uricosuric agents such as probenecid that promote excretion of uric acid.
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If diagnosed early and treated properly, the development of chronic gout can be
prevented.
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Septic Arthritis
is considered
a medical emergency
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It develops as a result of bacterial infection of a joint.
bacterial infection of a joint.
-Cartilage and bone destruction may lead to ankylosis and life threatening septicemia (blood-borne bacterial infec- tion).
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Streptococci and staphylococci cause sep- tic arthritis by
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invading a joint following trauma or surgery.
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Neisseria gonorrhea, the cause of gon- orrhea, may
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spread to joints via blood from a primary infection site. Antibiotics are required to control the joint infection and to prevent sep- ticemia.
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Bursitis
Bursae are
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fluid-filled sacs located near the joints that cushion and reduce friction on movement.
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Bursitis is an
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inflammation of these bursae, and it is a very painful condition.
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bursae of the shoulder joint are
the most fre- quently affected, although bursitis can develop at any joint.
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for bursitis tx
Steroids are some- times injected into the joint to reduce the in- flammatory response.
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A dislocation is a displacement of
bones from their normal position in a joint.
- most common in the shoulder and finger joints
- The bone must be reset and immobilized to allow healing of torn ligaments and tendons
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Sprains result from
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the wrenching or twisting of a joint such as an ankle that injures the ligaments. Blood vessels and surrounding tissues, muscles, tendons, and nerves may also be damaged. Swelling and discoloration due to hemor- rhaging from the ruptured blood vessels occur. A sprain is very painful
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Strains, also called pulled muscles, result from a tearing of a muscle and/or its tendon from excessive use or stretching.
a tearing of a muscle and/or its tendon from excessive use or stretching.
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CTS carpal tunnel syndrome
* larger class of problems known as repetitive strain injuries (RSIs)
* Many women report the symptoms during preg- nancy, which is attributed to accumulation of fluid within the tissues.
*
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Risk factors for CTS in- clude the performance of repetitive manual tasks such as
## Footnote
knitting, driving, typing, comput- ing, and piano playing
-begins with numbnes or tigling in the hand can radiate to arm and sholder
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The (CTS)diagnosis is confirmed by an
electromyogram. The test measures the velocity of sensory and motor nerve conduction. If electrical impulses are slowed as they travel through the carpal tunnel, compression of the nerve is indicated
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Skeletal muscle function is intimately...
associated with nervous system function. Muscles cannot function unless they are stimulated by nerves.
113
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Another cause of muscle failure is the improper...
transmission of the impulse for contrac- tion at the myoneural junction, the site at which a nerve ending sends its signal to a muscle cell.
114
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ncludes sev- eral forms of the disease, all of which are hered- itary. The various forms are transmitted differ- ently and affect different muscles, but all forms result in muscle degeneration, which totally dis- ables the individual.
MUSCULAR DYSTROPHY (MD)
115
most common form of MD is a serious type which is caused by a sex linked gene
Duchenne's muscular dystrophy
116
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In Duchenne’s muscular dystrophy, a cytoskeletal protein called ________ is missing. As a result of this defect, muscle fibers die and are replaced by ________ and connective tissue.
dystrophin, fat
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A severe form can progress rapidly and affect the muscle of the heart, causing \_\_\_\_\_\_; other forms progress slowly. In the most severe form of muscular dystrophy, the \_\_\_muscles enlarge as a result of \_\_\_\_\_deposition. The shoulder muscles are weak, which causes the _____ to hang limply.
death, calf, fat, shoulders
118
kids with this issue do not usually live live to adulthood and are normally...
very weak and thin
119
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a disorder of the myoneural junction in which the nerves fail to transmit an impulse for contraction to the muscles.
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Myasthenia gravis (MG)
120
in MG(an autoimmune disorder)
when the musles are not used it can
## Footnote
atrophy and muscle weakness.
121
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Antibodies attach near the myoneural junction and destroy _______ or its receptors. Myasthenia gravis is a ___________ disease. it is probably\_\_\_\_\_\_\_in origin
acetylcholine, rare, genetic
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The principal symptoms of this disease are ________ and the inability to use the muscles. The voluntary muscles of the body are affected, including the muscles of \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_ren- dering the person’s face expressionless. ________ control is lost, and simple actions such as chewing and talking become difficult.
fatigue, facial expression, eyelid
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The greatest danger in MG is _______ \_\_\_\_\_\_\_\_ because the muscles required for respiratory ventilation are unable to \_\_\_\_\_\_\_\_\_.
respiratory failure, contract
124
MG Tx
## Footnote
drugs that increase acetylcholine levels at the myoneural junction
-removal of thymus gland sometimes will help(remission, not a cure)
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Muscle tumors are rare, but when they occur, they are usually highly \_\_\_\_\_\_\_\_\_
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malignant
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A malignant tumor of skeletal muscle is a \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. The tumor requires _____ \_\_\_\_\_\_\_\_, and the prognosis is\_\_\_\_\_. It metastasizes early and is usually an advanced malignancy when it is diagnosed. Muscle malignancy is rare because muscle cells do not con- tinually divide like ____ or _____ cells.
rhabdomyosarcoma, surgical removal, poor, blood, skin
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At menopause, bone loss accelerates, making women more susceptible to ____________ and its effects.
osteoperosis
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Joint mobility decreases with ____ because cartilage in movable joints becomes stiffer, ligaments lose flexibility and elasticity, and synovial membranes become \_\_\_\_\_and stiff and produce less _______ fluid.
age, fibrous, synovial
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Muscles become less sensitive to stimulation with age, meaning that they take longer to con- tract when \_\_\_\_\_\_\_\_\_.
stimulated
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