Lecture 4 Flashcards

Question

Synovial joints

Answer 1

freely moveable

Answer 2

slightly moveable | found in the vertebral column

Answer 3

immoveable | found in the skull and pubic symphysis

Answer 4

a break in the rigid structure of the bone Most common traumatic musculoskeletal disorders

Answer 5

fracture—a single break with bone ends maintaining their alignment and position

Answer 6

sports injury | spin and twist

Answer 7

an incomplete break in which the bone is bent and only the outer curve of the bend is broken

Answer 8

complete break all the way across

Answer 9

different pieces from the fracture, multiple fracture lines and bone pieces gunshot wound, crushing

Answer 10

obvious deformities

Answer 11

partial breaks

Answer 12

skin is intact

Answer 13

bone is crushed or collapses into small pieces

Answer 14

mainly in the skull

Answer 15

fractures due to tumors

Answer 16

daredevils

Answer 17

deformity (e.g., angulation, shortening, and rotation), swelling and tenderness at the site, inability to move the affected limb, crepitus, pain, paresthesia(tingling in extremities), and muscle flaccidity progressing to spasms

Answer 18

history, physical examination, and X-rays

Answer 19

immediate immobilization (e.g., splints or traction, reduction (closed or open), surgery (may include pins, plates, rods, or screws), debridement, long-term immobilization (e.g., casts, splints, or traction), and physical therapy

Answer 20

Delayed union: aren't toughing yet, longer to heal malunion: bone grows along the side of another bone nonunion:

Answer 21

swelling around the fracture site, losing blood flow, swelling proximal or distal MEDICAL EMERGENCY limb threatening

Answer 22

stops the blood from flowing | ***biggest, most common complication from a fracture

Answer 23

bone inflammation

Answer 24

bone death

Answer 25

no vessels or blood supply, necrosis occurs

Answer 26

1. Hematoma formation 2. Necrosis of the broken bone ends 3. Fibroblasts invade the clot within a few days 4. Fibroblasts secrete collagen fibers, which form a mass of cells and fibers called a callus 5. Callus bridges the broken bone ends together inside and outside over 2–6 weeks 6. Osteoblasts invade the callus and slowly converts it to bone over 3 weeks to several months (usually 4–6 weeks)

Answer 27

separation of two bones at a joint

Answer 28

Visibly out-of-place, discolored, or deformed joint Limited movement Swelling or bruising Intense pain, especially with movement or weight bearing Paresthesia(tingling) near the injury

Answer 29

history, physical examination, X-rays, and magnetic resonance imaging(MRI)

Answer 30

***LIGAMENT Injury to a ligament that often involves stretching or tearing of the ligament or the capsule surrounding the joint. Heal more slowly

Answer 31

Rest, Ice, Compression, Elevation

Answer 32

Injury to a muscle or tendon that often involves stretching or tearing of the muscle or tendon ***TENDON possible surgery of severe tendon tears

Answer 33

Acute or chronic infection of the bone or marrow; difficult to treat Manifestations: fever, redness, swelling; bacteremia Treatment: Treat causative agent; Abx, possible surgery for I & D

Answer 34

Acute or chronic infection of the bone or marrow; difficult to treat Manifestations: fever, redness, swelling; bacteremia Treatment: Treat causative agent; Antibiotics, possible surgery for I & D(incision and drainage)

Answer 35

Avascular necrosis Caused by interruption in blood flow rather than infection Fractures, vessel injury (trauma), decompression sickness (SCUBA diving), sickle cell disease, radiation therapy, compartment syndrome. Can also be caused by corticosteroid therapy

Answer 36

Bone Tumors More frequently benign than malignant Both can develop from the cartilage (chondrogenic), bone (osteogenic), and supporting elements of bone (fibrinogenic) Location of the tumor provides important diagnostic information. ``` Manifestations: Pain, presence of a mass, impairment of function. Some tumors are found incidentally ```

Answer 37

adolescent boys (12-17): more in the legs Aggressive and highly malignant bone tumor Men > Women Unknown Causes (some link it to age and growing) Treatment: Surgery and Chemotherapy

Answer 38

Malignant tumors of cartilaginous lineage and sub-classified according to site of origin. CHONDRO: cartilage Commonly arise in the central portions of the skeleton, pelvis, shoulders, and ribs. Middle to later in life, slow growing often metastasize late and are often painless. Early dx is important because radical surgery excision tends to have better outcomes. Treatment: Radical surgery excision, combo chemotherapy. Typically does NOT respond to radiation.

Answer 39

A member of the family of tumors that include primitive neuroectodermal tumor (PNET) usually seen in children Densely packed, regularly shaped, small cells with round or oval nuclei, reciprocation of chromosome 11 and 31. Primarily seen in children, and usually located in the femur and pelvis, but can be found in other bones. Treatment: Multiagent chemo for shrinking of tumor, surgery, and radiation therapy.

Answer 40

“brittle bone disease” Autosomal recessive trait that causes deficiencies in the synthesis of type I collagen Extreme skeletal fragility No definitive treatment for correction

Answer 41

“Bowlegs” | Bowing of the knees greater than 1inch when the medial malleoli of the ankles are touching.

Answer 42

“Knock knees” | Deformity in which there is decreased space between the knees

Answer 43

“congenital dislocation of the hip” Can lead to unstable, malformed, subluxed, or dislocated hip in severe cases. Newborn screening includes Barlow test. Confirmation of dysplasia is obtained with Ortolani “click”

Answer 44

Idiopathic osteonecrotic disease of the proximal femoral epiphysis. Avascular necrosis of the bone and marrow involving the epiphyseal growth center. Main symptoms are pain in the hip and groin area Unknown cause Typically treated with surgery to reduce deformity and preserve femoral head.

Answer 45

Micro fractures in the area where the patellar tendon inserts to the tibial tubercle. Pain in the front of the knee associated with inflammation and thickening of the patellar tendon. Treatment is rest, activity restriction, and occasional knee immobilization

Answer 46

“coxa vera” disorder of the growth plate that occurs near the age of skeletal maturity. Three dimensional displacement of the epiphysis (posteriorly, medially, and inferiorly) Pain usually in the knee area with fatigue and difficulty walking. Diagnosis is made by x-ray and treatment is determined by severity of slippage.

Answer 47

Curvature of the spine in the upright position | Congenital, neuromuscular, and idiopathic

Answer 48

Curvature of the spine in the upright position Congenital, neuromuscular, and idiopathic Complications: pulmonary compromise, chronic pain, degenerative arthritis of the spine, intervertebral disk disease, and sciatica Manifestations vary depending on the degree of curvature and are exaggerated when an affected person bends over Include: asymmetrical hip and shoulder alignment, asymmetrical thoracic cage, asymmetrical gait, back pain or discomfort, fatigue, and indications of respiratory compromise

Answer 49

Lateral deviation of the spine that may affect the thoracic or lumbar area or both May also include a rotation of the vertebrae

Answer 50

Increase in the curvature of the thoracic spine outward

Answer 51

Exaggerated concave of the lumbar spine | in children

Answer 52

Metabolic condition characterized by a progressive loss of bone calcium that leaves the bones brittle Complications: pathological fractures (typically in the wrist, hip, and spine) Manifestations Often asymptomatic in early stages Includes: osteopenia, bone pain or tenderness, fractures with little or no trauma, low back and neck pain, kyphosis, and height reduction (as much as 6 inches) over time Diagnosis Conducted screening periodically on those persons at risk Include: history, physical examinations, bone density scans, X-rays, and spinal computed tomography Advances in diagnostic methods of bone mass density have made early detection possible

Answer 53

Rickets (pediatric form)– soft, weak bones in children, usually because of an extreme and prolonged vitamin D, calcium, or phosphate deficiency Osteomalacia – adult form Manifestations Becomes apparent in children as the soft bones cannot support the growing child Skeletal deformities (e.g., bowed legs, asymmetrical skull, scoliosis, kyphosis, pelvic deformities, sternum projection) Delayed growth in height or limbs Dental problems Bone pain Muscle cramps or weakness

Answer 54

Progressive metabolic condition characterized by excessive bone destruction that occurs along with the replacement of bone by fibrous tissue and abnormal bone The new bone is bigger but weakened and filled with new blood vessels ``` manifestations: Vary depending on the area affected Often insidious in onset and may be asymptomatic early Bone pain Skeletal deformities (e.g., bowing of the legs, asymmetrical skull, and enlarged head) Fractures Headache Hearing and vision loss Joint pain or stiffness Neck pain Reduced height Warmth over the affected bone Paresthesia or radiating pain in the affected region Hypercalcemia ```

Answer 55

Degenerative joint disease characterized by local deterioration of articulating cartilage and its underlying bone as well as bony overgrowth Bone rubbing on bone Results in joint space narrowing, joint instability, stiffness, and pain Manifestations Gradual onset, usually beginning after the age of 40 Joint pain that worsens during or after movement or weight bearing Joint tenderness with light pressure Enlarged, hard joints Limited joint range of motion Hard nodules around the affected joint (bone spur)

Answer 56

Systemic, autoimmune condition involving multiple joints The exact cause is unknown, but it is thought to be caused a genetic vulnerability that permits a virus or bacteria to trigger the disease Risk factors: being female, family history, advancing age (however, there is a juvenile form), and smoking ``` manifestations: Usually insidious onset Progressively worsen Fatigue Anorexia Low-grade fever Lymphadenopathy Malaise Muscle spasms Morning stiffness lasting more than 1 hour Warmth, tenderness, and stiffness in the joints when not used Bilateral joint pain Swollen and boggy- joints Limited joint range of motion Contractures and joint deformity (e.g., boutonniere deformity and swan neck deformity) Unsteady gait Depression Anemia ```

Answer 57

Osteoarthritis is usually just one joint Rheumatoid happens in all of them equally

Answer 58

Inflammatory disease resulting from deposits of uric acid crystals in tissues and fluids

Answer 59

1. Asymptomatic Uric levels climb in the bloodstream and crystals deposit in the tissue Crystals accumulate, damaging tissue

Answer 60

2. Acute flares or attack Tissue damage triggers an acute inflammation Characterized by pain, burning, redness, swelling, and warmth at the affected joint lasting days to weeks Most initial attacks occur in the lower extremities (most often the big toe)

Answer 61

3. Intercritical period After the attack subsides and the disease is clinically inactive until the next flare Hyperuricemia and crystal accumulation continues These periods in between attacks become shorter as the disease progresses Reoccurring attacks are often precipitated by sudden increases in serum uric acid

Answer 62

4. Chronic gouty arthritis Characterized by joint soreness and aching present most of the time May also develop tophi that can drain or renal calculi

Answer 63

Vary depending on the phase Intense pain at the affected joint that frequently starts during the night and is often described as throbbing, crushing, burning, or excruciating Joint warmth, redness, swelling, and tenderness (even to light touch) Fever Joint deformities Limited joint mobility

Answer 64

Progressive inflammatory disorder affecting the sacroiliac joints, intervertebral spaces, and costovertebral joints hips and spine

Answer 65

Intermittent lower back pain (early) Pain and stiffness that typically worsens with inactivity and improves after activity Lower back pain that evolves to include the entire back Pain in other joints (especially the shoulders, hips, or lower extremities) Muscle spasms Fatigue Low-grade fever Weight loss Kyphosis

Answer 66

Group of inherited disorders characterized by degeneration of skeletal muscle Most types are inherited, but some occur because of a genetic mutation (often spontaneously) Some types cause tremendous disability and rapidly decline whereas others have minimal symptoms and hardly noticeable progression males more than females

Answer 67

Diagnosis: history, physical examination, muscle biopsy, electromyelography, electrocardiogram, serum creatine kinase levels, serum presence of defective dystrophin, genetic testing, and fetal chorionic villus testing (as early as 12 weeks’ gestation)

Answer 68

All of the muscles may be affected or only a selected group Mental retardation (in some types) Muscle weakness and spasms that progresses Delayed development of muscle motor skills Difficulty using one or more muscle groups Poor coordination Drooling Ptosis: drooping of the eyelids Frequent falls Progressive loss of joint mobility and contractures (e.g., clubfoot and foot drop) Unilateral calf hypertrophy Scoliosis or lordosis

Answer 69

No cure for MD Gene therapy may potentially be the answer Goal is to maintain motor function and prevent deformities as long as possible Includes: physical therapy, muscle relaxants, immunosuppressant agents, assistive devices (e.g., walker, braces, and splints), surgical contracture release, coping strategies, and support

Answer 70

Syndrome predominately characterized by widespread muscular pains and fatigue Affects muscles, tendons, and surrounding tissue, but it does not affect the joints

Answer 71

Vary depending on the weather, stress, fatigue, physical activity, and time of day Widespread pain, typically described as a constant, dull muscle ache with trigger points Fatigue, sleep disturbances, depression, irritable bowel syndrome, headaches, and memory problems