MSK Flashcards
in fx for kids, what is often affected
the physis aka growth plate
S A L T E R classification
S: straight across-->TYPE 1 A: above growth plate-->TYPE 2 L: lower than growth plate-->TYPE 3 T: through growth plate-->TYPE 4 E: Erasure of growth plate/crush injury-->TYPE 5 R: Reaction periosteal-->TYPE 6
MC salter fx
type 2— above growth plate
fracture healing
- requires?
- involves?
- typical time in adults
- bony fragments be in contact or in very close proximity
- involves: bridging structure–>CALLUS
**ADULTS: 6-8 weeks
what is a callus
- bridging structure made of fibrous tissue and cartilage
1. internal callus
2. external callus - fragile
- must be protected with immobilization of the limb
what happens if theres motion at the fracture site during healing
Bony bridges aka calluses will break— fx can take longer to heal or not heal at all
name the four stages of fracture healing
- hematoma formation
- fibrocartilaginous callus formation
- bony callus formation
- bone remodeling
fracture healing is also called
fracture consolidation
define ossification
bone formation via osteoblasts
define osteogenesis
bone formation via osteoblasts
define bone remodeling
replacement of old bone tissue with new bone tissue
Osteoblasts do?
osteroclasts do?
BLASTS– build aka form new tissue
CLASTS–cleave/absorb the old tissue
which vits (3), hormones (3) and minerals (3) are required for bone remodeling
Vitamins D, C, and A +
Ca, phosphorous, and magnesium
hormones: parathyroid, GH and calcitonin
up to ___ - ___ % of bone mass is recycled every week
5-7%
where is the largest ca store in body
bones
list the three hormones that regulate ca [ ]
PTH
calcitonin
Vit d
what raises ca levels
vit d and PTH
what lowers ca levels
calcitonin
how does PTH increase blood [ca]—3 ways
- stim osteoclasts to b/d bone
- increasing reabsorption of ca by kidneys
- increasing conversion of inactive vit D to active vit —–which then increases ca reabsorption from GI track
PTH causes elevated blood _____ and decreased ____
elev CA and decr Phosphate
Vit D _____ absorption of ____ and ____ from ____
increases abs calcium and phosphate from the gut
roles of vit d—3
- incrs abs of ca and phosphate in gut
- incrs bone resporption
- incrs phosphate reabs in kidneys
how does calcitonin decrease ca levels
using calcium to build bone–>decreasing renal reabsorption of ca.
scoliosis
- define
- assoc wit?
- MC in?
- MCC
*deviation of the spine from the vertical axis (cobb angle)
greater than 10 degrees aka cobb angle >10 degrees
*LATERAL curvature of the spine
*MC in females or ppl with fam hx
*MCC=idiopathic
*can be assoc with kyphosis (humpback) or lordosis (sway back)
screening for scoliosis
- when?
- whats test called
- instrument?
- abnormal findings
occurs during routine pediatric exam
- adams forward bend test*
- instrument=scoliometer
- abnormal finding= anything over 7 degree curve is considered abnormal
most sensitive test for scoliosis
adams forward bend test
most definitive diagnosis for scoliosis
-finding?
xray–over 10 degreees as measured on the AP and lateral xray
treatment of scoliosis depends on what 3 things
- how bad the angle is
- the progression of the curve
- skeletal maturity of patient
Lumbosacral sprain/strain aka?
lower back pain
MCC of lower back pain?
lumbrosacral sprain/ strain
define lumbosacral sprain/strain
-moa
acute strain or tear of paraspinal muscles—-esp after twisting or lifting injuries
s/s of lumbosacral sprain or strain
- back pain (lower)
- muscle spasms
- DOES NOT RADIATE to leg
- NO neuro s/s
Dx for lumbosacral sprain/srain
clinical dx
xrays are not needed unless s/s persistnet >1 MO or red flag s/s present
define auto immune dz
groups of diseases (that often include joint involvement) where body’s own immune system attacks healthy tissue, skin, organs, joints, etc
what drugs are usually tx for rheum dzs (2)
- systemic glucocoticoid steorids bc the s/s are from immune system rxn—- steroids tamper down immune system
- DMARDS–>disease modifying AntiRheumatoid Drugs–>attempt to slow down dz effects on body
what are the lab tests commonly used with autoimmune dz (6)
- Erythrocyte Sedimentation Rate (ESR)
- C-reactive protein (CRP)
- Complement tests (C3, C4)
- Antinuclear Antibody (ANA)
- Rheumatoid Factor (RF)
- Anti-citrullinated protein antibody (ACPA)
what is ESR
- is it specific?
- what does high ESR mean
measures how quickly RBCs settle at bottom of test tube
- –settle faster=inflammation
- **it is non-specific and is elevated in many diff conditions
what is CRP
- used for?
- sensitive, specific?
- used to detect or monitor significant inflammation in acute conditions—infections
- used in monitoring chronic inflamm conditions to detect flare ups and det if tx is effective–EX: RA, Lupus, vasculitis)
- sensitive but not specific
What is Complement tests
-when does it go up? go down?
C3 and C4
- immune system proteins that normally rise dramatically just after an infection and injury
- BUT in LUPUS—– where the immune system is constantly activated, the levels go down bc they stop responding as dramatically since there is chronic dz state