Mod. 11: Skeletal Disorders Flashcards by Alyssa Donley

what type of collagen is in bone, ligaments and tendons for tensile strength?

Type 1

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what type of collagen in hyaline cartilage?

Type 2q

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part of periosteum for growing the length of bones (long bones)

endochondral growth

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part of periosteum for growing the thickness of bones (flat bones)

intramembranous growth

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abnormal excessive thoracic curvature of spine

kyphosis

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structural kyphosis that is angular and sharp, usually d/t a compression fracture

Gibbus deformity

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excess curvature of lumbar spine in anterior pelvic tilt

Lordosis

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lateral spinal curvature that’s functional, degenerative, or neuromuscular

Scoliosis

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narrowing of lumbar vertebrae or IV foramina which causes degeneration & nerve impingement

Spinal stenosis

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s/s: pain w/ lumbar extension, relief w/ lumbar flexion; unilateral nerve root radiculopathy

spinal stenosis

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vitamin D (+calcium & phosphate) deficiency: in children (1) and adults (1)

children: rickets
adults: osteomalacia

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bone loses density & strength d/t estrogen reduction, prolonged corticosteroids, smoking etc

osteoporosis

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contraindications for osteoporosis (3)

resisted spinal flexion exercises
joint mobilization
traction

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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

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s/s: pain, stiffness, fatigue, bone deformities
w/ complications: nerve compression, secondary hyperparathyroidism, hypo/hypercalcemia, heart failure

Paget’s Disease

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bone infection as a complication of trauma; often d/t staph infection

osteomyelitis

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when TB spreads from other body organs to the spine

skeletal tuberculosis

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an infection with arthritis in the spine

Pott’s disease/
tubercolosis spondylitis

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when a disease weakens the bone and causes it to fracture; d/t cancer, osteoporosis

pathologic fracture

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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

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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

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fracture occurring from a fall on an outstretched hand: a transverse fx of distal radius (looks like bayonet deformity)

Colles’ fracture

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when physical stress causes rupture of fibrous annulus & nucleus pupulsus pushes outside of disk to impinge nerves

Herniated IV disc

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what type of exercise should be used for posteriorlateral herniated discs?
which lumbosacral joint is usually affected?

extension-based
L4/L5, L5/S1

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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