Mod. 11: Skeletal Disorders Flashcards
what type of collagen is in bone, ligaments and tendons for tensile strength?
Type 1
what type of collagen in hyaline cartilage?
Type 2q
part of periosteum for growing the length of bones (long bones)
endochondral growth
part of periosteum for growing the thickness of bones (flat bones)
intramembranous growth
abnormal excessive thoracic curvature of spine
kyphosis
structural kyphosis that is angular and sharp, usually d/t a compression fracture
Gibbus deformity
excess curvature of lumbar spine in anterior pelvic tilt
Lordosis
lateral spinal curvature that’s functional, degenerative, or neuromuscular
Scoliosis
narrowing of lumbar vertebrae or IV foramina which causes degeneration & nerve impingement
Spinal stenosis
s/s: pain w/ lumbar extension, relief w/ lumbar flexion; unilateral nerve root radiculopathy
spinal stenosis
vitamin D (+calcium & phosphate) deficiency: in children (1) and adults (1)
children: rickets
adults: osteomalacia
bone loses density & strength d/t estrogen reduction, prolonged corticosteroids, smoking etc
osteoporosis
contraindications for osteoporosis (3)
resisted spinal flexion exercises
joint mobilization
traction
chronic metabolic disease when overgrowth of new bone occurs more quickly than breakdown of old bone; bone is replaced with a solid structure
Paget’s Disease
s/s: pain, stiffness, fatigue, bone deformities
w/ complications: nerve compression, secondary hyperparathyroidism, hypo/hypercalcemia, heart failure
Paget’s Disease
bone infection as a complication of trauma; often d/t staph infection
osteomyelitis
when TB spreads from other body organs to the spine
skeletal tuberculosis
an infection with arthritis in the spine
Pott’s disease/
tubercolosis spondylitis
when a disease weakens the bone and causes it to fracture; d/t cancer, osteoporosis
pathologic fracture
Complete fractures: (5)
-runs at right angle to bone axis
-runs in diagonal direction
-when bone has been twisted
-runs entire length of bone
-splintered or crushed bone
transverse fracture
oblique
spiral
longitudinal
commuinuted
Other types of fractures: (5)
-when one side is broken and the other side bent
-when bone fragments are out of position
-bone is “impacted”/mashed down
-bone separates from cortex where tendon/lig attached
-forms star-like pattern from radiating fissures at point of injury
greenstick fracture
displaced
compression/impacted
avulsion
stellate
fracture occurring from a fall on an outstretched hand: a transverse fx of distal radius (looks like bayonet deformity)
Colles’ fracture
when physical stress causes rupture of fibrous annulus & nucleus pupulsus pushes outside of disk to impinge nerves
Herniated IV disc
what type of exercise should be used for posteriorlateral herniated discs?
which lumbosacral joint is usually affected?
extension-based
L4/L5, L5/S1
increased pressure in mm compartment/fascial space
-lack of expansion leads to nerve/mm damage & blood flow issues
Compartment Syndrome
benign bone tumor that develops in cortex of long bones
Osteoid Ostoma
benign bone tumor occurring in spine, sacrum, or flat bones (can become malignant)
osteoblastoma
malignant bone tumor that grows rapidly in long bones of youth
osteosarcoma
malignancy that develops in bone marrow & appears in femur diaphysis
Ewing’s sarcoma
malignant cartilaginous cells in long bones, pelvis, scapula
chondrosarcoma
malignancy in fibrous CT- deep soft tissue of extremities, neck & trunk
fibrosarcoma
malignant bone marrow. that arises from B-lymphocyte plasma cells
multiple myeloma
inflammatory, systemic CT & autoimmune disease w/ bil, symmetrical arthritis
rheumatoid arthritis
nonarticular s/s of RA: (5)
- causes splenomegaly & leukopenia
-fibrous necrotic tissues & chronic inflammatory cells
-leads to dec. vision & blindness
-dry mucous membranes
-vasospasms of hands/ft, cold sensitivity
Felty’s syndrome
skin nodules
slceritis
Sjogren’s syndrome
Raynaud’s phenomenon
RA joint deformities: (4)
- hyperext. of DIP jt, flex of PIP jt & hyperext of MCP jt
- flex of DIP jt, hyperext of PIP jt
- fingers drift towards ulnar side of hand
- snapping motion d/t finger flexor tenosynovitis
Boutonniere’s deformity
Swan-neck deformity
ulnar drift
trigger finger
Contraindications for RA (5)
cervical traction
joint mob
spinal flexion (if osteoporosis too)
forced stretching
pillows under knees (prevent contractures)
unilateral, nonsystemic degenerative joint disease d/t wear&tear
osteoarthritis
OA s/s: (3)
- cartilage absorbs water, cracks develop & cartilage breaks off
- smooth/shiny bone appearance d/t bone on bone rubbing
-bone spurs that cause pain & limit ROM
fibrillation
eburnation
osteophytes
OA deformities:
- hip: weak ___ & ____
- knee: ___
- hands: tender cartilage/bone nodes on PIPs ____ & DIPs ____
- feet: ____
weak hip extensors & abductors
genu valgus
Bouchard’s nodes; Heberden’s nodes
hallux valgus
degenerative disease of IV discs; “spinal arthritis” w/ radiculopathy
-clinical s/s absent or point tender pain
spondylosis
defect of pars articularis of lumbar vertebrae
-clinical s/s absent or point tender pain
spondylolysis
after lumbar pars fracture, vertebrae slips anteriorly
-avoid which exercise?
spondylolisthesis
extension-based exercise
joint infected by virus or bacteria; common in old, young, immunosuppressed, or drug users
infective/septic arthritis
when hemophilic patient has hemarthrosis & causes necrosis of bone ends & cyst formation in joint
Hemophilic Arthritis
crystal-like formation within joint from metabolic inability to process uric acid
Gout
s/s: inflammation (often MTP jt), pain, fever, fatigue, tophi nodules, uric acid in blood; chronic- renal failure
Gout
inflammatory disease causing vertebrae to fuse w/ LBP & dec. spinal ROM, eye inflammation, jt swelling, etc
Ankylosing Spondylitis
blood supply to bone epiphysis experiences necrosis & degeneration in youth; often to femoral head;
bone marrow & osteocytes die
Osteonecrosis/
Avascular necrosis
avascular necrosis of proximal femoral epiphysis in pediatrics
Legg-Calve Perthes Disease
s/s: severe HA, pain aggravated by chewing, clicking sound, dec. ability to open mouth, stiff jaw mm in morning, trigger points in pterygoid mm, mandibular midline deviation
TMJ Syndrome
hallux valgus deformity & joint misalignment d/t poor fitting shoes, excess pronation, trauma, genetics etc
Bunions
inflammation of bursae d/t repetitive movements & excess pressure upon any bursa
Bursitis
inflammation & microtearing of fibers in extensor tendons of forearm (ext. carpi radialis brevis)
lateral epicondylitis
mononeuropathy w/ sensory disturbances & weakness in nerve distribution d/t compression of median nerve
Carpal Tunnel syndrome
compression of tibial nerve that causes motor/sensory disturbances
Tarsal Tunnel syndrome
separation of bone from normal position vs.
partial separation of bone from normal position
dislocation vs. subluxation
femoral head slides at epiphysis often from torsional injury
slipped capital femoral epiphysis
mm fibers don’t function properly d/t injury, infection or autoimmune disease
myopathy
inflamed artery near temporal lobe (giant cell arteritis)
polymyalgia rheumatica
s/s: bilateral proximal aching, stiffness, bursitis, joint synovitis, bicipital tenosynovitis; Dx from elevated ESR
polymyalgia rheumatica
inflammation within endomysial layer of skeletal mm
polymyositis
syndrome where pain is localized w/ presence of trigger points & may refer pain elsewhere
myofascial pain syndrome
chronic pain syndrome w/ multiple areas of jt/mm pain at 18 specific trigger points
fibromyalgia
s/s: ANS problems, neuroendrocine problems, stressors, genetic factors, depression, anxiety, sleep disruption, high levels of substance P in S.C.
fibromyalgia
rapid breakdown of skeletal mm tissue causing large release of creatinine enzymes
-mm tissue fills w/ fluid upon damage & calcium leads to tetanic mm contraction & ATP depletion
rhabdomyolysis
s/s: pain, urine color changes, shock, hyperkalemia (cause fatal dysrythmia), skeletal mm necrosis, acute renal failure, imbalanced electrolytes
Rhabdomyolysis
trauma injury to a ligament with inflammatory s/s
sprain
trauma injury by overstretching of mm or tendon
strain
inflammation of tendon d/t repetitive motion vs.
degeneration of tendon at cellular level
tendonitis
tendonosis
trauma injury when valgus twisting of knee occurs in flexed position w/ foot planted
-which side of the tear heals better?
Meniscal tear
outer 1/3 heals best (inner 2/3 is avascular)
one-sided jt replacement vs.
replacement of both articulating jt surfaces
hemiarthroplasty
total arthroplasty
ortho surgery: fusion of joint to prevent motion
arthrodesis
ortho surgery: cut made in bone to realign bones
osteotomy
ortho surgery: removal of joint
resection arthroplasty
Precautions for THA Posterolateral approach
no hip flex > 90*
no hip adduction
no IR
Precautions for THA anteroloateral approach
no hip extension
no ER
Precautions for TSA
no IR/ER past 35-40* during first 2-3 wks post-op
