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Clin Med II > MSK Gen > Flashcards

MSK Gen Flashcards

1
Q

What is bone composed of?

A

Highly vascularized, metabolically active connective tissue

Made mainly of collagen type I and hydroxyapatite crystal Ca10(PO4)6(OH)2

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2
Q

What happens to calcium in bone at lower pH

A

increase in the amt of Ca2+ leaving the bone at lower pH

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3
Q

Bone fns

A

structure

protection

locomotion

reservoir- for Ca2+, PO4- and fat

hematopoietic and immune cell prod

endocrine- GF, cytokines, FGF23 and osteocalcin

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4
Q

What does osteocalcin do?

A

↑ insulin sensitivity

↑ glucose uptake in
muscle and bones

↑ insulin secretion

↑ beta cell proliferation

↑ Testosterone and bone formation

↑ exercise capacity

osteocytes release FGF23 which ↑ phosphate excretion from kidney

kidney releases erythropoietin and ↑ RBC prod

↓ anxiety and depression

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5
Q

What are the 4 design features of bone?

A

compact (strength) vs porous (low weight and more space)

rigidity vs flexibility

durability (lamellar bone) vs speed (woven bone)

balance in bone formation and reabsorption

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6
Q

Describe trabecular (cancellous) bone

A

interior is porous to ↑ space and ↓ weight

and ↑ surface area to help Ca2+ that is leaching for homeostasis

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7
Q

Describe medullary cavity

A

holds marrow, nerves, vessels

↑ space and ↓ weight

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8
Q

Describe cortical bone

A

compact outer layer that is heavily mineralized (strong) but thin (↓ weight)

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9
Q

What fills the porous bone space

A

red bone marrow- hematopoietic cells

yellow marrow- fat (as we get older)

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10
Q

What bone type are vertebra mainly composed of?

A

trabecular bone

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11
Q

What bone type are long bones mainly composed of?

A

cortical bone

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12
Q

What bone type is the hip mainly composed of?

A

cortical bone

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13
Q

Where is red marrow mainly found?

A

in flat bones such as hip, skull, breast, ribs, vertebra, shoulder blades and cancellous bones at ends of long bones

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14
Q

Where is yellow marrow mainly found?

A

mainly in medullary cavity of long bones

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15
Q

Why are trabecular bones more preferentially affected by pathological conditions that disturb bone remodeling?

A

they are remodeled more each year than cortical bone due to being more porous to provide Ca2+ for homeostasis

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16
Q

Describe the structure of hydroxyapatite crystal Ca10(PO4)6(OH)2

A

strong and resists compression but is weak to tensile strength and shears

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17
Q

Describe the structure of collagen fiber type I

A

weak but flexible to absorb bending and shear strain, resists tensile strain but is weak to compression

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18
Q

What happens to hydroxyapatite crystal size in osteopetrotic individuals?

A

increase in size

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19
Q

What happens to hydroxyapatite crystal size in diabetes and Paget’s disease individuals?

A

decrease in size

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20
Q

What determines bone strength?

A 
density
size and geometry
composition (cortical v trabecular)
matrix material property
microsctruture (lamellar vs woven)
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21
Q

MC cause of bone tumors

A

Mets from lung, breast, prostate, kidney, thyroid

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22
Q

Oligoarthritis

A

arthritis affecting two to four joints during the first six months of disease

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23
Q

Polyarthritis

A

any type of arthritis that involves 5 or more joints simultaneously usually associated with autoimmune conditions

24
Q

ankylosis

A

abnormal stiffening and immobility of a joint due to fusion of the bones

25
Q

osteophytes

A

a bony outgrowth associated with the degeneration of cartilage at joints

26
Q

If 1 joint is painful and swollen what must you rule out?

A

septic arthritis

27
Q

Closed Fracture (aka Simple Fracture)

A

Skin over the fracture is intact

28
Q

Open Fracture (aka Compound Fracture)

A

Overlying skin is disrupted; “open wound”

29
Q

Fn of Labrum in hip

A

Increases depth of acetabular cavity creating increased surface and strength of joint

30
Q

What is the MC inj structure of the knee?

A

MCL

31
Q

Angulated fx

A

Fracture fragments are malaligned at an angle

32
Q

Segmental fx

A

Fx with at least two fracture lines that together isolate a segment of bone

33
Q

Comminuted fx

A

Fx that results in two or more fragments

34
Q

Transverse fx

A

Fx line forms a right angle with longitudinal axis

35
Q

Rhabdomyolysis

A

Rapid death of striated muscle cells often with myoglobinuria or acute renal failure

36
Q

ca that mets to bone

“BLT w/ pickles and ketchup”

A 
breast
lung
thyroid
prostate
kidney
37
Q

Intra Articular fx

A

Involving the joint space

38
Q

Extra Articular fx

A

No involvement of joint space

39
Q

Impacted fx

A

Fx in which one of the fragments is driven into another fragment

40
Q

Compression Fracture

A

Vertebral collapse

41
Q

Greenstick fx

A

One side broken; opposing side bent

42
Q

Occult Fracture

A

Fx that does not appear on x-ray

look for hypodense area (fat pads)

43
Q

Avulsion fx

A

Release of small portion of bone at location of tendon insertion

(tendon pulls bone and fxs it)

44
Q

Stable fx

A

A fracture that tends to remain in alignment after reduction

45
Q

Unstable fx

A

A fracture that tends to displace after reduction

46
Q

McCarthy Test

A

Patient is in supine position.

Flex both hips and then extend the affected hip + a catch a labral tear is presen

47
Q

FABER Test

A

Patient is in a supine position.

Put affected leg and on the opposite straight leg in a position of Flexion Abduction External Rotation.

Apply pressure to anterior aspect of the knee lowering the test leg into further abduction.

+ If the leg can not be lowered parallel to the opposite leg or pain

48
Q

Fn of Labrum in hip

A

Increases depth of acetabular cavity thus, increasing surface and strength of joint

49
Q

What is the MC inj structure of the knee?

A

MCL

50
Q

Myalgia

A

Symptom of muscle-discomfort: muscle aches, soreness, tenderness, cramps with a normal CK

51
Q

Myopathy

A

Muscle weakness (not due to pain), with or without an elevated CK

52
Q

Myositis

A

Muscle inflammation

53
Q

Myonecrosis

A

Elevated CK due to death of striated muscle cells

54
Q

Rhabdomyolysis

A

Rapid death of striated muscle cells often with myoglobinuria or acute renal failure

55
Q

ca that mets to bone

“BLT w/ pickles and ketchup”

A 
breast
lung
thyroid
prostate
kidney
56
Q

Why do most herniated lumbar discs occur posteriorly and off to one side?

A

Posterior longitudinal ligament is strongest in the midline and the posterior-lateral annulus may bear a large share of the axial load.

Clin Med II (19 decks)

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