HLTH 2501: bone, muscle, ligament and tendon disorders Flashcards

1
Q

osteoporosis

A

is a common metabolic bone disorder when there is a decrease in bone mass and density, combined with the loss of bone matrix and mineralization

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2
Q

who is osteoporosis more common in?

A

older women

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3
Q

what do most osteoporosis fractures involve?

A

the hip and the vertebrae

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4
Q

two forms of osteoporosis

A

primary or secondary

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5
Q

primary osteoporosis

A

is postmenopausal, senile, or idiopathic

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6
Q

secondary osteoporosis

A

follows a specific primary disorder such as cushing syndrome

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7
Q

how does osteoporosis develop?

A

during the bone remodeling process, bone resorption exceeds bone formation, leading to thin, fragile bones

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8
Q

what bones does osteoporosis affect more?

A

those with high proportions of cancellous bones, such as the vertebrae and femoral neck

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9
Q

osteopenia

A

occurs as the bone density slowly becomes lower and is considered a midpoint on the progression to osteoporosis

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10
Q

what factors contribute to osteoporosis?

A

genetic factors (ex. vitamin D receptors), nutrition, hormonal levels, aging, decreased mobility or sedentary lifestyle, cigarette smoking, excessive caffeine, and small, light bone structure

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11
Q

disuse osteoporosis

A

occurs when an area of the body is immobilized due to something like a fracture, developing osteoporosis as a result

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12
Q

what lack of nutrients is a risk for developing osteoporosis?

A

calcium, vitamin D and protein

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13
Q

why does aging lead to osteoporosis?

A

osteoblast activity declines with age, as well estrogen levels decline after menopause

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14
Q

what hormonal conditions are associated with osteoporosis?

A

hyperparathyroidism, cushing syndrome, or continued intake of catabolic glucocorticoids such as prednisone

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15
Q

who has light and small bone structure?

A

Asian and Caucasian people

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16
Q

signs of compression vertebrae fractures

A

back pain, loss of height, and abnormal curvature of the spine (leads to kyphosis, lordosis, and scoliosis)

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17
Q

kyphosis

A

excessive forward rounding of the upper back

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18
Q

lordosis

A

excessive natural curve of the lower spine

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19
Q

scoliosis

A

irregular curve of the spine

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20
Q

treatment for osteoporosis

A

dietary supplement of calcium, vitamin D, and flouride, calcitonin, bisphosphonates, injected human parathyroid hormone, regular weighlighting and walking, selective estrogen drugs, strontium ranelate, and surgery

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21
Q

how much calcium should premenopausal and postmenopausal women take?

A

1000 mg for pre and 1500 mg for most

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22
Q

why do fluoride supplements help?

A

they promote bone deposition

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23
Q

what is an example of bisphosphonates?

A

alendronate which inhibits osteoclast activity

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24
Q

selective estrogen drugs

A

ex. raloxifene or tamoxifen; these are better than estrogen therapy as there is less effect on uterine and breast tissue

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25
Q

strontium ranelate

A

new medication that appears to decrease bone resorption and increase bone formation, as well as antibody preparations that bind to osteoclasts, preventing bone resorption

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26
Q

what do rickets and osteomalacia result from?

A

vitamin D and phosphate deficines which are associated with dietary defects, malabsorption, prolonged intake of phenobarbital (for seizures), or lack of sun exposure

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27
Q

rickets

A

soft bone in children resulting from lack of calcification of the cartilage forming at the epiphyseal plate

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28
Q

why is vitamin D important for bones?

A

it is required for the absorption of calcium

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29
Q

osteomalacia

A

occurs in adults who have poor vitamin D absorption, causing soft bones and resulting compression fractures

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30
Q

renal rickets

A

is osteomalacia associated with severe renal disease

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31
Q

paget disease

A

is a progressive bone disease that occurs in 40+ adults; bone destruction occurs and is replacements by fibrous tissue and abnormal bone

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32
Q

causes of paget disease

A

has not been established however childhood infection with a virus or genetic factors may be the cause

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33
Q

another name for paget disease

A

osteitis deformans

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34
Q

signs of paget disease

A

structural abnormalities like thickening in the long bones, vertebrae, pelvis, and skill

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35
Q

risk of paget disease

A

pathologic fractures, if in the spine, can cause compression fractures and kyphosis; if in the skull, can cause increased pressure; and can increase risk for cardiovascular disease

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36
Q

osteomyelitis

A

is a bone infection caused by bacteria or fungi; microorganisms enter the blood and spread to the bones

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37
Q

signs of osteomyelitis

A

local inflammation and bone pain, fever, excessive sweating, chills, and general malaise

38
Q

treatment for osteomyelitis

A

antibiotics to eliminate the infection and sometimes surgery to repair the damaged tissue

39
Q

three types of curvature disorders

A

lordosis, kyphosis, and scoliosis

40
Q

function of the spine curves

A

help the spine to absorb stress of body movement and gravity

41
Q

another name for lordosis

A

swayback

42
Q

causes of lordosis

A

achondroplasia (genetic condition affecting protein), obesity, discitis, and slipping forward of the vertebrae

43
Q

kyphosis another name

A

hunchback or humpback

44
Q

causes of kyphosis

A

poor posture, spina bifida, congenital defects, spinal tumors or infections, and scheuermann disease

45
Q

causes of scoliosis

A

not really known but can be genetic, or the result of disease or trauma

46
Q

general treatment for spine disordesr

A

medication for pain and inflammation, weight loss, wearing a brace, physical therapy, and surgery

47
Q

what are most bone tumors?

A

malignant and secondary tumors

48
Q

where do bone tumors commonly develop?

A

the spine and pelvis

49
Q

what are bone tumors often secondary to?

A

breast, lung, or prostate tumors

50
Q

osteosarcoma

A

is a primary malignant neoplasm that usually develops in the metaphysis of the femur, tibia, or fibula of children or young adults, mostly males

51
Q

ewing sacroma

A

is another malignant neoplasm common in adolescents that occurs in the diaphysis of long bones

52
Q

where do ewing sarcoma and osteosarcoma tend to spread to?

A

the lungs

53
Q

signs of bone cancer

A

usually bone pain that increases in severity, especially at night

54
Q

treatment for bone cancer

A

surgical amputation or excision of the tumor, followed by chemo

55
Q

chondrosarcomas

A

arise from cartilage cells and are more common in 30+ adults

56
Q

where does chondrosarcoma tend to develop?

A

the pelvic bone or shoulder girdle at the points of muscle attachment; they often spread to the lungs

57
Q

prognosis for bone cancer

A

about 70% survive, and about 30% if the tumor has spread

58
Q

muscular dystrophy

A

is a group of inherited disorders characterized by degeneration of skeletal muscle; the groups differ in their inheritance, area affected, age at onset, and rate of progression

59
Q

most common type of muscle dystrophy

A

duchenne

60
Q

duchenne MD

A

inherited by X-linked recessive (in males), age of onset if 2-3 years, distribution is hips, legs, ascending shoulder girdle, and progresses rapidly

61
Q

facioscapulohumeral MD

A

inherited by autosomal dominant, age is before 20, distribution is shoulder, neck, and face, and it progressed slow to moderate

62
Q

myotonic MD

A

inherited by autosomal dominant, specifically chromosomes 19, age is birth to 50 years, occurs in the face and hands, and progresses slow

63
Q

limb girdle MD

A

inherited by autosomal recessive gene, age of onset is all ages, distributed in the shoulder and pelvis, and progression varies

64
Q

what in blood is elevated in duchenne MD?

A

creatine kinase

65
Q

how does muscle dystrophy occur?

A

a metabolic defect leads to degeneration and necrosis of the cell, causing skeletal muscle fibres to be replaced by fat and fibrous CT, leading to hypertrophy appearance of the muscle, but function is gradually lost

66
Q

common risk for MD

A

cardiomyopathy and mental retardation

67
Q

duchenne MD signs

A

around age 3, motor weakness and regression become apparent (difficulty walking stairs, waddling gait, gower maneuver)

68
Q

gower maneuver

A

when the child pushes up in an erect position by using the hands to climb up the legs

69
Q

risks for those with duchenne MD

A

vertebral deformities such as kyphoscoliosis, respiratory insufficiency, and infections

70
Q

tests for MD

A

genetic abnormalities, elevated CK levels, EMG, and muscle biopsy

71
Q

treatment for MD

A

to support motor function with moderate exercise and the use of supportive appliances, OTs, and somes ventilators

72
Q

primary fibromyalgia syndrome

A

is a group of disorders characterized by pain and stiffness affecting muscles, tendons, and surrounding soft tissues (not joints)

73
Q

causes of primary fibromyalgia syndrome

A

not known but is related to altered central neurotransmission, resulting in increased sensitivity to substance P

74
Q

substance P

A

a neurotransmitter involved in pain sensation

75
Q

risk population for primary fibromyalgia syndrome

A

women 20-50, a prior history of trauma or OA, and sleep deprivation, stres, or fatigue

76
Q

diagnosis for primary fibromyalgia syndrome

A

18 specific tender or trigger points are used to diagnosed this; they are tendons and ligaments in the neck, shoulder area, trunk, and limbs

77
Q

signs of primary fibromyalgia syndrome

A

muscle aching pain, marked fatigue, sleep disruptions, depression, and IBS or urinary symptoms caused by interstitial cystitis

78
Q

treatment for primary fibromyalgia syndrome

A

stress reduction, regular early morning exercise, massage therapy, resting, heat or massage, antidepressants, and NSAIDs

79
Q

antidepressant drugs for primary fibromyalgia syndrome

A

low doses of tricyclic antidepressants or selective serotonin-norepinephrine reuptake inhibitors

80
Q

drug for fibromyalgia

A

lyrica which mediates the pain pathway

81
Q

myositis

A

is a general term referring to severe inflammation and subsequent damage of the muscles

82
Q

diseases in the myositis group

A

autoimmune diseases like polymyositis, dermatomyositis, and juvenile myositis, as well as medication ones like boy myositis and toxic myositis

83
Q

signs of myositis

A

difficulty climbing stairs or lifting arms, tired after standing and walking, trouble swallowing and breathing, muscle pain and soreness, and elevations in muscle enzymes in the blood (creatine phosphokinase or aldolase)

84
Q

tests for myositis

A

blood tests, MRI, EMG, and muscle biopsy

85
Q

treatment for myositis

A

drugs that suppress the immune system like prednisone, azathioprine, and methotrexate

86
Q

recommended vitamin D intake

A

400-800 IU daily

87
Q

bone disorders associated with vitamin D and phosphate deficiencies

A

rickets (children) and osteomalacia (adults)

88
Q

risk factors for rickets and osteomalacia

A

lack of sun exposure or prolonged intake of phenobarbital (for seizures)

89
Q

another name for paget’s disease

A

osteo deformans

90
Q

where does osteosarcoma develop and where does ewing sarcoma develop?

A

osteosarcoma in the metaphysis (femur, tibia, or fibula) and ewing sarcoma in the diaphysis (long bones)