Misc. MSK info Flashcards
What happens in the first 6 hours of a joint being immobilized
Muscle fiber protein synthesis decreases
What happens in the first 24 hours of joint immobilization
Shortening of the muscle fibers
What happens within the first 48 hours of immobilization of a joint
Tissue surrounding the muscle fibers have increased collagen deposition
When is a goniometer used
Getting accurate joint measurements
What is the most common physical symptom associated with stress and anxiety
Stress induced muscle tension
What are tension heads caused by
muscle spasms in the neck
What is fibromyalgia
Diffuse pain without the structural changes that cause the discomfort
How does fibromyalgia present
Pain along fibromyalgia tender points
Decreased ability to inhibit pain
Increased perceived pain
Increased sensation of other stimuli
What are some causes of fibromyalgia
Genetic predisposition
Increased substance P in CSF
Serotonin / catecholamine signaling pathways
Decreased overall gray matter
Reduced pain improvement with positive emotion
What are the causes of viral myositis
A&B influenza
enterovirus
What does viral myositis lead to
muscle necrosis
in extremes can lead to rhabdo or compartment syndrome
What are the causes of bacterial myositis
Typically hematogenous spread of a pathogen
pyomyositis (abscess)
S. aureus
What area of the body is most commonly effects with bacterial myositis
Legs (pain cramping, discomfort)
What are the causes of parasitic myositis
Trichinosis
cysticercosis
Toxoplasmosis
* generally from travel
What is polymyositis and dermatomyositis
Immune mediated myopathy
What muscle groups are typically effected by polymyositis
Proximal with symmetrical muscle weakness
What are the skin presentations that occur with dermatomyositis
Gottron papules
heliotrope eruption
facial erythema
holster sign
What is inclusion body myositis
idiopathic inflammatory myopathy
Where is inclusion body myositis typically seen
Distal finger flexor with asymmetric weakness
What does rhabdomyolysis eventually lead to
myoglobinuria from the circulating intracellular contents
What does the shift of the intracellular products during rhabdomyolysis cause
Disruption of the NA+K+ATPase pumps and increased intracellular calcium
What are complications that can occur with rhabdo
Acute kidney injury
Compartment syndrome
DIC
How will rhabdo present
Myalgia
red/brown urine
Malaise
fever
tachycardia
What is the cause of osteomalacia
Vitamin D deficiency
malabsorption
hypophosphatemia
ETOH abuse
tumors
drugs
How does osteomalacia present
Bone and muscle pain
Increased fracture frequency
fatigue
What disease causes an insufficient mineralization of the growth plate
Rickets
What is the cause of rickets
Inadequate calcium and/or phosphate
In rickets, what will happen in abutting bones
osteoid accumulates
What is an osteoid
Unmineralized bone
What is calcipenic rickets associated with
Low vitamin D or inability to metabolize vitamin D into their active form
What is the most common cause of phosphopenic rickets
Renal phosphate wasting
In what disease does the osteoclastic activity outweigh the osteoblastic activity during remodeling
Osteoporosis / osteopenia
What is another name for osteitis deformans
Pagets disease
What is pagets disease
Idiopathic dysregulation of bone remodeling resulting in enlarged, deformed bones
What happens cellularly with pagets disease
Hyperactive osteoclastic activity followed by abnormal osteoblastic activity
What is the most common presentation of pagets disease
Hip pain
What can happen with vitamin D deficiency
Hypocalcemia
hypophosphatemia
Rickets
osteomalacia
What occurs with hypocalcemia
Decreased circulating calcium causes an increase in parathyroid function = more bone breakdown
If a patient has a femoral neck fracture that leads to AVN, what vessel was damaged
Circumflex (will experience groin pain from AVN)
What can cause a meniscal tear
Twisting with planted foot
squatting
What is the psoas sign and how do you test it
Stretch to test it
Can test for appendicitis
What can cause an anterior hip dislocation
Ski tip gets stuck and lead to external rotation and abduction of the leg
What ligament tears with a patellar dislocation
Retinaculum
What ligament do you tear with an ankle sprain
ATFL
what is a Liz franc fracture
Separating of metatarsal bones
- need wt bearing and non wt bearing films
What is the diabetic foot collapse known as
Charcots foot
Why is staph aureus so hard to treat
It has coagulase and created a biofilm
Also inhibits osteoblast activity
Why are uncontrolled diabetics considered immunocompromised
Glucose messes with PMNs
What can excessive alcohol cause
Leaky gut
What does CREST stand for
Calcinosis
Raynauds
esophageal
sclerodactyly
telangiectasia
Where is the neuromuscular bundle in the ribs found
In the costal groove
