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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
How is Osteoporosis diag?
Conventionally by x-ray absorptiometry (a DXA Scan) | They check for T score and lowers than -2.5 indicates Osteo
26
What are Osteoporosis risk factors?
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
Further risk factors?
``` Genetics Sedentary lifestyle Low body weight High alcohol consumption Toxins (heavy metals) Endocrine pathologies ```
28
What are the signs and symptoms of Osteoporosis?
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
What is the treatment of Osteoporosis?
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
Osteomalacia & Rickets - what are they?
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
Causes of Osteomalacia & Rickets?
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
Signs & Symptoms - Osteomalacia & Rickets?
Deformed bones - bowed legs Possible factures Severe back pain / muscle weakness With rickets - delayed closure of fontanelles and skull softening
33
What is Osteomyelitis?
A bact infection of the bone marrow resulting n bone necrosis and hence bone weakness
34
How does Osteomyelitis present?
Bac infection - staphylococcus aureus through blood or post fracture Immunosuppression, diabetes, IV drug users
35
Investigations for Osteomyelitis ?
Bloods - look for elevated inflammatory markers (ESR / CRP) and wbcs X-ray - Mri
36
What is Osteoarthritis?
Degenerative wear and tear of articular cartilage, typically effecting weight bearing joints and typically for 50+
37
What are the signs and symptoms of Osteoarthritis?
Onset is gradual, pain increasing over months / years Joint pain and stiffness not assoc with systemic symptoms
38
Causes of Osteoarthritis?
Primary - ageing - 80% of 65+ have radiological signs of OA Secondary - assoc with eg trauma - fractures, surgery, obesity or is congenital ill development
39
Diagnosis of Osteoarthritis?
X-ray - would reveal joint space narrowing, osteophyte (bone spur) formation, squared off of rounded joint surfaces
40
Pathophysiology of Osteoarthritis?
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
Treatment of Osteoarthritis?
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
What is Rheumatoid Arthritis?
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
What is the Aetiology? (Suspected cause)
``` Genetic markers (HLA-DR4 and DR1) Infectious agents eg EBV (Epstein-barr virus), rubella Abnormal intestinal permeability, small intestinal bacterial overgrowth (SIBO) smoking ```
44
Signs and Symptoms of Rheumatoid Arthritis?
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
Treatment of RA?
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
What is Ankylosing Spondylitis (AS)?
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
Signs & Symptons Ankylosing Spondylitis?
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
Diagnosis of AS?
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
What is Gout?
A type of monoarthritis, characterised by uric acid crystal deposition in synovial joints
50
Who does gout effect?
Mainly men (10:1 women), over 40
51
How Gout happens?
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
What is hyperuricaemia?
elevated blood uric acid levels, due to overproduction or underexcretion Uric acid is derived from the breakdown of purines
53
Diagnosis for Gout?
Blood serum for uric acid (not definitive - fluctuates) but is a useful monitor Analysis of synovial fluid - needle aspiration
54
Signs and symptoms of Gout?
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
Treatment of Gout
``` 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
What is disc Herniation?
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
Treatment for Disc Herniation?
Manual therapy and exercise, homeopathy - arnica, anti-inflamatory nutrients and herbs eg devils claw, ginger and boswellia
58
What is Bursitis?
Inflammation of a bursa
59
Where do you commonly get bursitis?
Around shoulder - (sub acromial) and hip (trochanteric)
60
What causes bursitis?
Repetitive use eg overhead work - decorating | Sudden trauma, infection, wear and tear

Biomedicine (7 decks)

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