HLTH muscle and joints Flashcards
significance of unique markings on bones
provide attachment for tendons and passageways for blood vessels and nerves
what does the periosteum contain?
osteoblasts, vessels, nerves, and lymphatics
what is the medullary cavity lined with?
endosteum which contains osteoblasts
where is adult red bone marrow found?
cranium, vertebrae, ribs, sternum, and ilia
motor unit meaning
is the motor neuron and all the muscle fibres it stimulates
myofibrils
found in each muscle cell and contain smaller myofilaments containing actin and myosin
what is stored in muscle cells?
glycogen
aerobic respiration
is used to produce ATP as long as O2 is available
anaerobic respiration
is when O2 is not available and glucose is used as the primary energy source for muscles; produces smaller amounts of ATP and lactic acid
during strenuous exercise, is the body more acidic or basic?
acidic
adverse effects of anabolic steroids
liver damage, cardiovascular damage, personality changes, irritability, and sterility
synarthroses
immovable joints
amphiarthroses
slightly moveable joints in which the bones are connected by hyaline or fibrocartilage
diarthroses
freely moveable joints aka synovial joints
articular capsule
is composed of the synovial membrane and the fibrous capsule which is the outer covering
menisci role
stabilize the joint
bursae
are fluid filled sacs composed on synovial membrane and are located between tendons or joints; these offer extra cushioning in the joints
electromyograms
measure the electrical change associated with muscle contraction and are helpful for differentiating muscle disorders from neurological damage
mature bone cells and location
are osteocytes and found in lacunae
osteoprogenitor cells
are derived from embryonic mesenchymal cells and develop into osteoblasts
where are osteoclasts derived from?
macrophage progenitor cells
what skeletal muscles are not voluntary?
breathing, blinking, posture, and shivering
acetylcholinesterase
is an enzyme that inactivates AcH after contraction
why do increased respirations occur during exercise?
to compensate for metabolic acidosis during anaerobic exercise
what is a muscle cramp a result from and why does pain occur?
strong muscle contractions or spasms and the release of metabolic wastes; these reduce blood flow, causing ischemic pain
how do muscles change with aerobic exercise?
they do not hypertrophy but instead increase the blood flow and mitochondria to increase O2 supply
segmental fracture
is when a several large bone fragments separate from the main body of a fractured bone
where are compression fractures common?
the vertebrae
where are stress fractures common?
the tibia, fibula, and 2/3 metatarsal
colles fracture
is a break in the distal radius of the wrist; commonly when falling and attempting to break the fall
pott fracture
fracture of the lower tibia due to excessive stress often from forceful stepping down
what is the of the blood clot forming in the medullary canal during healing of a fracture
hematoma
purpose of the hematoma for fracture healing
serves as a basis for the fibrin network in which granulation tissue grows
procallus
aka fibrocartilaginous callus and serves as the preliminary bridge between the broken ends during healing
what is the procallus replaced by?
the bony callus
5 stages of bone healing
hematoma, granulation tissue, procallus, bony callus, and remodelling
systemic problems delaying bone healing?
anemia, diabetes, circulatory problems, and nutritional defects
what causes ischemia during healing?
edema in a cast
compartment syndrome
occurs when there is more extensive inflammation, causing the increased pressure within the fluid of the fascia, which compresses nerves and causes pain; common in a cast
fat emboli
occurs when yellow bone marrow travels into the circulation and to the lungs, causing behavioural changes, confusion, disorientation, respiratory distress, and hypoxia
from which bones does fat emboli often occur?
pelvis or long bones like the femur
closed reduction
is done using traction or using pressure to move the bones closer together
open reduction
requires surgery and devices like pins, plates, and rods to move bones closer together
subluxation
is partial dislocation
sprain vs strain
sprain is a tear in a ligament and strain is a tear in a tendon
avulsion
is when ligaments or tendons are completely separated from the bone
how does healings of strains and sprains occur?
granulation tissue forms, collagen is placed down, and fibrous tissue forms
tennis elbow
is inflammation between the humerus and the forearm muscle
what do muscle tears result in?
hematoma and scar tissue formation
result of repeated injuries
scar tissue, loss of strength and ROM, permanent joint damage, and OA
repetitive strain injury
refers to disorders affecting muscle, tendons, and nerves that develop over a period of time, and often is associated with forceful and repetitive motions; this is because circulation to the tissue is reduced and tissues are damaged
primary vs secondary osteoporosis
primary is postmenopausal or idiopathic whereas secondary follows another condition like cushing syndrome
what bones are affected more by osteoporosis?
those with higher proportions of cancellous bone like the vertebrae and femoral neck
osteopenia
is the decline of bone density and is considered a midpoint to osteoporosis
why is osteoporosis common in postmenopausal women?
due to a decline in estrogen and osteoblastic activity also decreases with age
factors contributing to osteoporosis
aging, immobility, excessive glucocorticoids, hyperparathyroidism, small bone structure, cigarette smoking, caffeine intake, and vitamin deficiencies (D and C)
rickets/osteomalacia and causes
is a deficit of vitamin D and phosphates, resulting in soft bones and compression fractures; often is a result of malnutrition, lack of sun exposure, and prolonged intake of phenobarbital (for seizures)
rickets vs osteomalacia
rickets is in children and osteomalacia is in adults
renal rickets
refers to osteomalacia as a result of severe renal disease
pagets disease
is a progressive bone disorder in 40+ adults is which excessive bone destruction occurs and is replaced with fibrous tissue
complications of pagets disease
thickening of bones, compression/pathological fractures, increased intracranial pressure and kyphosis
causes of pagets disease
a viral infection as a child and genetic factors
osteomyelitis
is a bone infection from a bacteria or fungi then spread through the bloodstream to bones
signs of osteomyelitis
local inflammation, bone pain, fever, excessive sweating, chills, and malaise
lordosis
curve of the lower back
lordosis causes
obesity, achondroplasia, discitis, and slipping forward of the vertebrae
kyphosis
hunchback
kyphosis causes
poor posture, spina bifida, spinal tumors, or scheuermann disease
common locations of bone tumors
spine and pelvis
where do bone tumors usually come from?
breast, lung, or prostate
osteosarcoma
primary malignant tumor that commonly develops in the metaphysis of the femur, tibia, or fibula
ewing sarcoma
is a primary malignant tumor in the diaphysis of long bones
where do primary bone malignant tumors often spread to?
the lungs
signs of bone cancer
steady, severe pain at rest
chondrosarcomas
arise from cartilage cells and often form at the pelvis or shoulder girdle at points of attachment
duchenne MD
most common MD and is inherited as an X-linked recessive gene
pathophysiology of all MDs
a deficit of dystrophin causes skeletal muscle to gradually be replaced with fibrous tissue, causing muscle function to be lost
facioscapulohumeral
is a type of MD that has an onset before age 20 and is an autosomal dominant gene affecting the shoulder, neck, and face
myotonic
is a type of MD with a slow development until age 50 and is an autosomal dominant inheritance on chromosome 19; it affects the face and hands
limb girdle
is an MD whose progression varies but affects the shoulder and pelvis and is an autosomal recessive gene
duchenne’s MD signs
around age 2-3, difficulty climbing stairs, waddling gait, and gower’s maneuver develop
what is the cause of death in MD
respiratory or cardiac failure
primary fibromyalgia
is a group of syndromes characterized by pain and stiffness affecting muscles, tendons, and surrounding soft tissues
cause of primary fibromyalgia
not fully understood but central nervous system transmission is altered, resulting in increased soft tissue sensitivity to substance P, a neurotransmitter involved in pain
signs of primary fibromyalgia
muscle aching, fatigue, sleep disturbances, depression, and IBS; men also have jaw pain and headaches
myositis
refers to inflammation and damage of the muscles caused by secondary conditions
types of myositis
polymyositis, dermatomyositis, juvenile myositis (these are autoimmune diseases), inclusion body myositis, and toxic myositis
primary vs secondary OA
primary is associated with aging and obesity and secondary with abuse or injury
how does OA develop?
damage of the articular cartilage becomes rough due to breakdown, causing the release of enzymes which accelerate this degeneration; cysts and osteophytes develop and may narrow the cavity and break off
how does RA first appear?
symmetrical involvement of the small joints
how does RA develop?
due to an abnormal immune response (autoimmune), often viral, causing synovitis which results in the production of antibody rheumatoid factor which defends against immunoglobulin G
exacerbations of RA
inflammation of the synovium reoccurs and granulation tissue called pannus forms over the articular cartilage, releasing destructive enzymes; cartilage erodes and nutritional supply is limited; in time, the granulation tissue will be replaced by fibrous tissue, and ankylosis may develop
ankylosis
refers to joint fixation
changes around the joint in RA
muscles atrophy, tendons and ligaments stretch, spasms may occur, alignment of the joint shifts, and contractures and subluxation develop
systemic effects of RA
nodules on the extensor surfaces, pleura, heart, or eyes may form; fatigue, malaise, fever, anorexia, and iron-deficiency anemia (doesn’t respond to treatment) may also develop
criteria for diagnosis of RA
swelling of 3 joints for a minimum of six weeks
celecoxib
inhibits prostaglandin production during inflammation and is used to treat RA; however is associated with increased risk of MIs and strokes
JRA vs RA
JRA is more acute, with more systemic effects, and affects larger joints; RF and nodules are absent; antinuclear antibodies may be present as well
systemic signs of JRA
rash, fever, lymphadenopathy, uveitis, and hepatomegaly
infectious arthritis
aka septic arthritis; is caused by a bacterium and usually develops in a single joint, causing redness, swelling, pain, decreased ROM, and purulent exudate
causative organism for infectious arthritis
gonococcus or staphylococcus
psoriatic arthritis
is an autoimmune disorder that is accompanied by psoriasis; can appear in many different forms, ex. symmetric or asymmetric
signs of psoriatic arthritis
swollen tender joints, painful muscles and tendons, scaly skin patches and scalp, nail pitting, and eye pain
gout
results from deposits of uric acid and urate crystals in the joint cavity that cause an acute inflammatory response; usually affects a single joint and causes pain, redness, and swelling
tophus
is a large, hard nodule of urate crystals in soft tissue or bone, causing a local inflammatory response
common locations for tophus
burase, extensor surfaces of the forearm, and the ear
ankylosing spondylitis
is a progressive autoimmune inflammatory disorder affecting the sacroiliac joints, intervertebral spaces, and costovertebral joints of the axial skeleton, characterized by remissions and exacerbations
cause of ankylosing spondylitis
is an autoimmune disorder with a genetic basis and the HLA-B27 antigen
pathophysiology of ankylosing spondylitis
inflammation of the joints leads to fibrosis and calcification, resulting in fixation of the joint that begins at the sacroiliac joints and progresses up the spine; kyphosis and osteoporosis develop, as well as impaired lung expansion
signs of ankylosing spondylitis
lower back pain and stiffness that is similar to sciatic pain; as calcification develops, the spine becomes more rigid; systemic signs and uveitis also may develop
bursitis
inflammation of the bursae often a result of repetitive motions like throwing a baseball
tendonitis
inflammation of the tendon characterized by dull, aching pain at the site of tendon attachment and is often the result of repetitive motions
what often cause soft tissue damage?
strains, sprains, and dislocations
creatine kinase
plays a role in energy storage and is released by damaged muscles
still disease
is present in JRA and includes systemic effects like rash, fever, lymphadenopathy, and hepatomegaly
