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BRS Y2 > How to Treat MSK Conditions > Flashcards

How to Treat MSK Conditions Flashcards

1
Q

What is an osteogenic cell?

A

A bone stem cell

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2
Q

What is an osteoblast?

A

Bone forming cell

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3
Q

What do osteoblasts secrete?

A

Osteoid

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4
Q

What do osteoblasts catalyse the mineralisation of?

A

Osteoid

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5
Q

What are osteocytes?

A

Mature bone cells

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6
Q

What is the role of osteocytes?

A

Sense mechanical strain to direct osteoclast and osteoblast activity

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7
Q

How are osteocytes formed?

A

When osteoblasts become imbedded in secretion

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8
Q

What are osteoclasts?

A

Bone breaking cells

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9
Q

What do osteoclasts do?

A

Dissolve and resorb bone by phagocytosis

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10
Q

What are osteoclasts derived from?

A

Bone marrow

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11
Q

What structure does compact bone have?

A

Osteons

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12
Q

What are osteons?

A

Repeated structural units made of concentric ‘lamellae’ around a central ‘Haversian Canal’, they have few spaces

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13
Q

What is the role of osteons?

A

Provides protection, support and resists stresses produced by weight of movement

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14
Q

What does the haversian canal in an osteon contain?

A

Blood vessels
Nerves
Lymphatics

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15
Q

What are lacunae?

A

Small spaces containing osteocytes

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16
Q

What are Volkman’s canals?

A

Transverse perforating canals

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17
Q

Where is the epiphysis of long bones found?

A

Near the joint

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18
Q

What are the 3 pathologies of fracture?

A

Trauma
Stress
Pathological

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19
Q

How are stress fractures caused?

A

Abnormal stress on normal bone

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20
Q

How are pathological fractures caused?

A

Normal stress on abnormal bone

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21
Q

What are pathological causes of fractures?

A 
Osteoporosis
Malignancy
Vitamin D deficiency
Osteomyelitis
Osteogenesis imperfecta
Paget's disease
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22
Q

What are the 3 ways fractures are classified?

A

Soft tissue integrity: open or closed
Bony fragments: greenstick, simple or comminuted
Movement: displaced or undisplaced

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23
Q

What are clinical signs of a fracture?

A

Pain
Swelling
Crepitus
Deformity

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24
Q

How should you describe a fracture?

A

Location (what bone and what part of it)
Pieces (simple or multifragmentary)
Pattern (transverse, oblique spiral etc)
Displaced or undisplaced

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25
Q

What are 2 categories in fracture displacement?

A

Translation (lateral/medial/proximal/distal)

Angulation (internal or external rotation/varus or valgus/dorsal or volar)

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26
Q

What are the 4 principals of fracture management?

A

Reduce
Hold
Fix
Rehabilitate

27
Q

What do we mean by general fracture complications?

A

They affect the whole body or the part of the body where the fracture is from

28
Q

What are some common general fracture complications?

A 
Fat embolus
DVT
PE
Infection/sepsis
Prolonged immobility
29
Q

What are urgent local fracture complications?

A 
Local visceral injury
Vascular injury
Nerve injury
Compartment syndrome
Haemarthrosis
Infection
Gas gangrene
30
Q

What are causes of fractures at the neck of the femur?

A

Osteoporosis (common in older people)
Trauma (common in younger people)
Combination of above

31
Q

What are important points in the history of the head of femur fracture?

A

Age
Co morbidities (respiratory/cardiovascular/diabetes/cancer)
Pre injury mobility
Social history

32
Q

How are extracapsular neck of femur fractures treated?

A

Internal fixation

33
Q

How are intracapsular neck of femur fractures treated?

A

If displaced replace if they are above 65 years and reduce and fix if they are younger than 55
If undisplaced fix with screws

34
Q

Why can undisplaced neck of femur fractures be fixed with screws?

A

There is minimal risk to blood supply and AVN

35
Q

What are the 3 types of joints?

A

Fibrous
Cartilaginous
Synovial

36
Q

How are synovial joints stabilised?

A

Depending on how much bony congruity they have, this relies on the proportion of muscles/tendons to ligament to congruity

37
Q

What is cartilage composed of?

A

Specialised cells=chondrocytes

Extracellular matrix

38
Q

What specialised cells are present in cartilage?

A

Chondrocytes

39
Q

What is present in ECM of cartilage?

A

Water
Collagen
Proteoglycans (mainly aggrecan)

40
Q

What is blood supply to cartilage like?

A

Cartilage is avascular

41
Q

What is aggrecan?

A

A proteoglycan that possesses many chondroitin sulfate and keratin sulfate chains

42
Q

What does aggrecan interact with?

A

Hyaluronan (HA) to form large proteoglycan aggregates

43
Q

What are the 2 main types of arthritis?

A

Osteoarthritis (degenerative)

Inflammatory (mainly rheumatoid)

44
Q

How do radiographs of rheumatoid and osteoarthritis differ?

A

There is no subchondral sclerosis or osetophytes in rheumatoid but there is in oseto
There is no osteopenia or bony erosions in osteo but there is in rheumatoid

45
Q

What is arthritis?

A

A degenerative disease of chondral cartilage

46
Q

When does inflammation occur in arthritis?

A

Late

47
Q

What are the main risk factors for developing arthritis?

A 
Age 
Excess weight
Mechanical stress (sports, profession etc)
Hereditary
Females (inc menopause)
Metabolic syndrome
48
Q

What should you ask about in osteoarthritis history?

A

Pain (exertional/rest/night)
Disability (walking/stairs/do their legs give way/)
Deformity
Previous history (of trauma/infection etc)
Treatments given
If other joints are affected

49
Q

How should you assess for osteoarthritis?

A

Look, feel, move

50
Q

What does conservative management of osteoarthritis include?

A 
Analgesics
Physiotherapy
Walking aids
Avoidance of exacerbating activity
Injections (steroid/viscosupplementation)
51
Q

What does operative management of osteoarthritis include?

A 
Replace (knee/hip)
Realign (knee/big toe)
Excise (toe)
Fuse (big toe)
Synovectomy (Rheumatoid)
Denervate (wrist)
52
Q

What is infection of the bone called?

A

Osteomyelitis

53
Q

What are systemic signs of osteomyelitis?

A

Fevers
Weight loss
Sweats

54
Q

What are the classifications of osteomyelitis?

A

Acute or chronic

Primary or secondary

55
Q

What is infection of a joint called?

A

Septic arthritis

56
Q

How does septic arthritis manifest?

A

Pain
Joint swelling
Stiffness

57
Q

What is septic arthritis caused by?

A

Bacterial infection of a joint (usually caused by spread from the blood)

58
Q

What are risk factors for septic arthritis?

A

Immunosuppressed
Pre-existing joint damage
Intravenous drug use (IVDU)

59
Q

How urgent is septic arthritis? Why?

A

It is a medical emergency, if left untreated it can destroy a joint

60
Q

When should you consider a diagnosis of septic arthritis?

A

In any patient with an acute painful, red, hot, swelling of a joint, especially if there is fever

61
Q

What test diagnoses septic arthritis?

A

Joint aspiration

62
Q

What is septic arthritis called if it affects one joint and if it affects multiple?

A

One=monoarthritis

Multiple= polyarthritis

63
Q

How is septic arthritis treated?

A

Surgical wash-out (‘lavage’) and intravenous antibiotics

The joint is immobilised in the acute phase then physiotherapy when the acute phase is over

64
Q

How is osteomyelitis treated?

A

IV antibiotics
Surgical drainage
If chronic antibiotic suppression or dressings can be used
Amputation may be required

BRS Y2 (85 decks)

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