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Biomedicine > Lecture 2 , Pt 3 - Terminology, Landmarks & Skeletal System > Flashcards

Lecture 2 , Pt 3 - Terminology, Landmarks & Skeletal System Flashcards

1
Q

What is a fracture? How caused?

A

A break in a bone caused by low Vit D, low bone density, trauma

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2
Q

Impact of bone fracture?

A

Can damage blood vessels supplying bone and surrounding nerves

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3
Q

Type of fractures?

A

Complete - broken through completely

Incomplete - bone is fractured but not into fragments

Can be linear ie along the bone length or transverse ie dissect across the bone

Avulsion - where the bone comes away from the tendon or ligament

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4
Q

How does a fracture repair?

A

Haematoma (and inflammation) - blood vessels are broken at the site and blood leaks to the site. Causes local death of cells and some swelling

Fibrocartilginous callus formation - Phagocytes clean up the debris. Fibroblasts invade and lay down collagen forming a soft callus - 2-3 weeks

Bony callus formation - osteoblasts replace soft callus with new bone - up to 3 months

Bone remodelling - callus is mineralised and compact bone laid down. Osteoclasts reshape the new bone. Remodelling occurs over months to years

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5
Q

Fractures - Treatment?

A

Address the cause - ie any nutritional defic, check if osteoporosis is present, improve circulation and nutrients to the bone to aid repair

Creams and ointments can be effective - get absorbed to area

Herbs - comfrey, gotu kola

Nutrients - calcium, vit d, vit c

Homeopathic - arnica for bruising, ruta for injured nerves. Calc phos 4c should be given for 2 weeks to help fuse bones together

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6
Q

What is a Sprain?

A

A trauma that forces the joint beyond its normal range - over-straining / tearing ligaments

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7
Q

Treatment for sprains?

A

RICE - rest, ice, compression, elevation
Herbs - locally and internally - tissue repair eg comfrey, manual therapy and rehab
Nutrients - glucosamine, Vit C, zinc, Vit E
Homeopathy - eg arnica, ruta and acupuncture

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8
Q

What is subluxation?

A

Incomplete or partial dislocation

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9
Q

What is dislocation?

A

Full separation of two bone at a joint

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10
Q

Impact of dislocation?

A

Reduced strength in the area
Possible compromised joint
High risk of reoccurrence

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11
Q

Common areas of dislocation?

A

Shoulder and knee (patella).

May be accompanied by damage to soft tissues, nerves and blood vessels

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12
Q

When use X-ray?

A

To visualise skeletal system. teeth, heart and lungs

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13
Q

How X-rays work?

A

They pass though dens matter (air, fat, muscle and other tissue) but are absorbed and scattered by denser materials eg bone, tumours, lungs affected by severe pneumonia, appearing white

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14
Q

What else can be detected by X-ray?

A

Blood clots (thromboses can also be detected by X-ray, due to accumulation of RBCs (and hence iron)

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15
Q

What are the adverse effects of x-rays?

A

Cancer (induces DNA damage / genetic mutations)

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16
Q

What is a hyper-kyphotic spine? How caused?

A

Rounded forwarded eg rounded shoulders

Poor posture due to work, stress, body language, as a result of a disease eg osteoporotic spinal fractures

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17
Q

What are the likely effects of Kyphosis?

A

Muscular fatigue around the scapula, irritation of rib joints, may interfere with breathing

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18
Q

What is Lordosis?

A

An increased concavity in the spine

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19
Q

Cause of Lordosis?

A

Genetic / ethnic cause eg afro-caribbean women
Secondary to other muscoskeletal changes
More common in obese people
Is a normal adaption during pregnancy

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20
Q

Effect of Lordosis?

A

Muscular fatigue

Encourages vertebral joints to move closer together causing inflamation

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21
Q

What is Scoliosis?

A

A lateral S Shaped curve in spine

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22
Q

How does Scoliosis come about?

A

Can be born with it or develop it through out life often adolescent onset
Can develop as a result of everyday imbalances eg carrying a rucksack on one shoulder
Also common with leg length discrepancies

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23
Q

Impact of Scoliosis?

A

Can cause spinal nerve compression

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24
Q

What is osteoporosis?

A

Progressive thinning of bone

Due to decreased bone density leading to bone fragility

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25
Q

How is Osteoporosis diag?

A

Conventionally by x-ray absorptiometry (a DXA Scan)

They check for T score and lowers than -2.5 indicates Osteo

26
Q

What are Osteoporosis risk factors?

A

Increasing age - over 30 - ability to retain calcium lowers
Poor diet -= is too high in acids eg sugars , proteins and low in minerals, malnourished, excess sodium, caffeine, fizzy drinks
Drugs - long term corticosteroid therapy - 6 months +
GIT diseases - liver issues, malabsorption syndromes, low stomach acidity etc

27
Q

Further risk factors?

A 
Genetics
Sedentary lifestyle
Low body weight
High alcohol consumption
Toxins (heavy metals)
Endocrine pathologies
28
Q

What are the signs and symptoms of Osteoporosis?

A

Is asymptomatic till bone has reached critical thinness whereby fractures occur spontaneously with minor trauma

Focal pain and kyphotic posture with loss of height

Pain aggravated with prolonger sitting, standing or bending

29
Q

What is the treatment of Osteoporosis?

A

Allopathic - medicines - Bisphosphonates - but can cause significant side effects - muscle and joint pain, HRT, gastritis, fractures etc

Natural - healthy alkaline diet, no caffeine, no alcohol, calcium, magnesium, inc Vit D3 and K2, weight bearing exercise, hers (hormone balancing, avoid toxins

30
Q

Osteomalacia & Rickets - what are they?

A

Inadequate mineralisation of the bone matrix in spongy and compact bone

Characterised by decalcification and hence softening of bone - seen in spine, pelvis and legs

Rickets - prior to Epiph plate closure ie under 18

Osteomalacia - seen in adolescent or adult

31
Q

Causes of Osteomalacia & Rickets?

A

Vit D defic poss due to :-

lack of sunlight
lack of dietary vit d
secondary defic ie malabsorption disorders
reduced receptor sites for vit D in tissues

32
Q

Signs & Symptoms - Osteomalacia & Rickets?

A

Deformed bones - bowed legs
Possible factures
Severe back pain / muscle weakness
With rickets - delayed closure of fontanelles and skull softening

33
Q

What is Osteomyelitis?

A

A bact infection of the bone marrow resulting n bone necrosis and hence bone weakness

34
Q

How does Osteomyelitis present?

A

Bac infection - staphylococcus aureus through blood or post fracture
Immunosuppression, diabetes, IV drug users

35
Q

Investigations for Osteomyelitis ?

A

Bloods - look for elevated inflammatory markers (ESR / CRP) and wbcs
X-ray - Mri

36
Q

What is Osteoarthritis?

A

Degenerative wear and tear of articular cartilage, typically effecting weight bearing joints and typically for 50+

37
Q

What are the signs and symptoms of Osteoarthritis?

A

Onset is gradual, pain increasing over months / years
Joint pain and stiffness
not assoc with systemic symptoms

38
Q

Causes of Osteoarthritis?

A

Primary - ageing - 80% of 65+ have radiological signs of OA

Secondary - assoc with eg trauma - fractures, surgery, obesity or is congenital ill development

39
Q

Diagnosis of Osteoarthritis?

A

X-ray - would reveal joint space narrowing, osteophyte (bone spur) formation, squared off of rounded joint surfaces

40
Q

Pathophysiology of Osteoarthritis?

A

Articular cartilage wears away - underlying bone is exposed
Subchondral bone becomes hard and glossy (eburnation)
Remodelling of underlying bone ie thickening occurs
Compensatory bone overgrowth in an attempt to stabilise joint - spurs

41
Q

Treatment of Osteoarthritis?

A

Allopathic - NSAIDS (pain relief drugs), joint replacements
Natural - Nutrition - glucosamine and chondroitin to improve cartilage and synovial fluid health / Vit C / MSM
Herbs - comfrey, tumeric, acupuncture, manual therapy eg chiropractic, weight loss

42
Q

What is Rheumatoid Arthritis?

A

An autoimmune inflammation of the synovium, potentially affecting all organs except the rain (systemic inflammation)

Affects 1% of people worldwide, higher in women
Peak occurrence between 30 -50

43
Q

What is the Aetiology? (Suspected cause)

A 
Genetic markers (HLA-DR4 and DR1)
Infectious agents eg EBV (Epstein-barr virus), rubella
Abnormal intestinal permeability, small intestinal bacterial overgrowth (SIBO) smoking
44
Q

Signs and Symptoms of Rheumatoid Arthritis?

A

Symmetrical / bilateral arith of small joints (hands and feet mostly)
gradual spread through proximal structures
Progressive morning stiffness
Deformity of joints eg swan neck
General malaise and fatigue
Subcutaneous nodules around fingers and elbows
C1 /C2 subluxation and compression of spinal cord leading to paralysis and neurological complications
Kidney probs

45
Q

Treatment of RA?

A

Allopathic:-
Anti-inflamatories and immunosuppressants
Surgery

Natural:-
Nutrition - anti-inflamatory and reducing intestinal permeability, mediterranean diet, inc omega 3, vit d
Herbs - for pain and inflamation and immune modulation - tumeric, boswellia and devils claw
Homeopathy - eg rhus tox and acupuncture

46
Q

What is Ankylosing Spondylitis (AS)?

A

A systemic autoimmune disease assoc with chronic inflammation of the spine and sacroiliac joints, often leading to spine fusion (ankylosis) and stiffness

Age of onset is 15-30 more common in men
Strong genetic assoc with HLA-B27 (present in 95% of AS patients

Links with inflammatory bowel diseases and leaky gut as ell as urogenital issues eg salmonella and shigella, cross reacting with HLA-B27

47
Q

Signs & Symptons Ankylosing Spondylitis?

A

Typically begins at sacroiliac and lower lumbar spine, worsening stiffness in the am

Lower back symptoms improve with activity

Lumbar lordosis flattens and patients can become kyphotic

Hip and heel (achilles) pain common

20% suffer actue iritis - HLA-B27 diseases

Systemic symtpons - fever, fatigue and malaise

48
Q

Diagnosis of AS?

A

Elevated blood inflammatory markers (ESR.CRP), HLA-B27 positive
X-ray / MRI identifies characteristic bamboo spine

Treatment - Allopathic - surgery for later stages, anti-inflamatory’s or Natural - nutrition - remove pathogenic organisms / elimation diet / increase Vit ds and antioxidants and herbs, homeopathy, acupuncture

49
Q

What is Gout?

A

A type of monoarthritis, characterised by uric acid crystal deposition in synovial joints

50
Q

Who does gout effect?

A

Mainly men (10:1 women), over 40

51
Q

How Gout happens?

A

Excess uric acid forms solid crystals on cartil surfaces

This causes wbcs to infiltrate activating an acute inflammatory response

Increased intake of purine-rich foods (red meat, organ meat, shellfish)

Dehydration, kidney disease, meds, obesity, excessive alcohol, hypertension, type 2 diab

52
Q

What is hyperuricaemia?

A

elevated blood uric acid levels, due to overproduction or underexcretion

Uric acid is derived from the breakdown of purines

53
Q

Diagnosis for Gout?

A

Blood serum for uric acid (not definitive - fluctuates) but is a useful monitor
Analysis of synovial fluid - needle aspiration

54
Q

Signs and symptoms of Gout?

A

Typically effect big toe, can affect mid-feet, ankles, knees, elbows and hands

Usually monoarticular - one joint
Sudden onset of intensively painful red hot and swollen joints, often lasting 12-24 hours

Urate crystals deposit under the skin and produce tophi

55
Q

Treatment of Gout

A 
Allopath - allopurinol to prevent episodes
Corticosteroid injections (adverse effects - indigestion, rapid heartbeat, nausea, insomnia, mood changes, diabetes, glaucoma, osteoporosis

Natural - nutrition - anti inflammatory . alkaline, folate inhibit the production of uric acid, weight loss, inc water intake, natural diabetics, herbs for inflammation, homeopathy, acupuncture

56
Q

What is disc Herniation?

A

The nucleus pulpous of the intervertabral disc leaks out through the annulus fibrosus

Typically happens with discs with highest fluid content - lumbar spione L5 - S1 then cervical spine

Age 30-40
A herniated disc can compress spinal nerves

57
Q

Treatment for Disc Herniation?

A

Manual therapy and exercise, homeopathy - arnica, anti-inflamatory nutrients and herbs eg devils claw, ginger and boswellia

58
Q

What is Bursitis?

A

Inflammation of a bursa

59
Q

Where do you commonly get bursitis?

A

Around shoulder - (sub acromial) and hip (trochanteric)

60
Q

What causes bursitis?

A

Repetitive use eg overhead work - decorating

Sudden trauma, infection, wear and tear

Biomedicine (7 decks)

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