Lecture 19 Musculoskeletal system Flashcards
What are the axial areas?
Skull, ribs and vertebral comumn
Is not axial what are bones?
Appendicular
What are the parts of a long bone?
Epiphysis, diaphysis, Epiphysis.
What is the outside of a bone called?
Periosteum
What is the pathology of osteroporotic bone?
Thin weak compact(outside) bone and thin broken spongy(inside) bone
What is a bone healing pathway?
After fracture ->haematoma-> fills fracture gap/ provides fibrin meshwork-> granulation tissue-> Inflam cells release cytokines to activate oseob&c -> callous (1 week)
How long until repair tissue reaches maximum girth?
2-3 weeks
What is osteoporosis?
Decrease in bone mass and density -> #. Very common. 3 million ppl in UK
What decreases bone mass and density?
^ in bone resorption and decrease in bone production
What causes osteoporosis?
Hormone influences (lack of oestrogen), Ca2+ metabolism and Vit D deficiency
What is used to treat osteoporosis?
Alendronic acid - bisphosphonate that prevents osteoclast activity
Where does osteoarthritis occur?
usually weight bearing joints
Risk factors for osteoarthritis?
Age, female, menopause, obesitiy, preexisting joint deformity, excess mechanical stress, genetic, hypermobility.
Osteoarthritis pathogenesis?
Wear and tear. Breakdown of articular cartilage -> underlying bone exposed -> cartilage fragements can fall into joint -> Osterophytes
Pathogenesis of rheumatoid arthritis?
Inflam in synovium, membranes thicken, chronic inflam->cartilage and joint destruction.
What is the HLA (human leukocyte antigen) linked to?
Rheumatoid arthritis
What are the features of rheumatoid arthritis?
Small joints hands and feet, pain, swelling, fever, fatigue, stiff without prior activity.
To be diagnosed with RA need to have 4 from below…
Morning stiness >1hour. Arthritis in 3 or more joints, in hand joints, symmetric arthritis, rheumatoid nodules, serum rheumatoid factor, radiographic changes
What are crystal arthropathies? And the two types?
Intra-articular crystal formation. Gout and pseudogout
What causes gout?
Raised uric acid from purine bases break down.
What is gout?
Urate deposited as crystals in the joints
Risk factors of gout?
Aspirin, diuretics, alcohol, renal disease, hypothyroidism, dehydration. (affect kidney)
What are the features of gout?
sudden onset excruciating burning joint pain (big toe). Redness, warmth, tenderness, stiffness, subsequent attacks less severe.
What is pseudogout?
Precipitation of ca2+ pyrophosphate crystals in connective tissues. Usually in knees and ankles
What is “crystal shedding”
When crystals in cartilage enlarge and rupture into joint cavity or soft tissues
What causes pseudogout?
Hereditary, associated with osteoarthritis, trauma, surgery or inceasing age.
What is septic arthritis?
Inflam of joint caused by infection. (Knee).
Symptoms of septic arthritis?
Severe pain, swlling, redness, heat. Develop over a few hours or days. Sometimes high temp.
Treatments for septic arthritis?
IV antibiotics, washout of joint, may cause sepsis!
What is osteomyelitis?
bone infection caused by bacteria. Trauma, surgery and presence of foreign bodies. Spread by haematogenous and diabetes ^ risk
What is the commonest bone tumour?
Metastatic disease from distant cancer (prostate, kidney, breast).
What is striated muscle?
Skeletal muscle, voluntary movement
What is smooth muscle?
Involuntary actions, ANS controlled.
Define leiomyomas
Benign smooth muscles neoplasm. Most common in uterus, small bowel and esophagus.
