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Pathophysiology test 3 > Muscular skeletal exam 4 > Flashcards

Muscular skeletal exam 4 Flashcards

1
Q

What are the 2 types of skeletal systems?

A

Axial and appendicular

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2
Q

What makes up the axial skeleton?

A

Central parts of the skeleton, skull, vertebral column and rib cage.

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3
Q

What makes up the appendicular skeleton?

A

Includes peripheral parts of the skeletal system, bones of the arms, legs, pelvic and pectoral girdles

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4
Q

What are the 3 parts to a long bone?

A

Diaphysis
Epiphysis
Metaphysics

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5
Q

What is the main long part of the long bone?

A

Diaphysis

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6
Q

What is called the tip or end of the long bone?

A

Epiphysis

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7
Q

What is the growing part of the long bone until it fuses with epiphysis once the growth plate becomes solid?

A

Metaphysis.

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8
Q

What area of the long bone do we worry about with kids and fractures?

A

Metaphysis due to the growth plate. We don’t want the growth plate to be damaged or they could have bone problems.

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9
Q

What are osteoblasts?

A

The cells that form bone; bone germinates.

Think of blast making it bigger!!

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10
Q

What are osteoclasts?

A

Cells that break bone down and resorption of bone tissue.

Think clasts as crushing bone.

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11
Q

Osteocytes are made from what?

A

Osteoblasts

Like an egg yolk surrounded by the white

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12
Q

Which cells in the bone communicate with other cells and instruct osteoblasts and osteoclasts about when ans where to form and resort bone, concentrate nutrients in the matrix, regulate bone mass ans minerals, and secrete other proteins that influence mineral metabolism?

A

Oseteocytes

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13
Q

What does the receptor activator of nuclear factor kappa B ligand (RANKL) do?

A

Induces osteoclasts activation and bone resorption

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14
Q

With osteoporosis medication, what area does it work on the most?

A

Receptor activator of nuclear factor kappa B ligand (RANKL).

Helps to prevent the breakdown of bone.

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15
Q

How do we maintain bone integrity and how long does it take?

A 
Remodeling of bone: activation of remodeling cycle, resorption, formation of new bone(secondary bone)
And it takes 3-4 months
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16
Q

What is the joint capsule made out of?

A

Fibrous and synovial fluid that surrounds the joint

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17
Q

What is the joint cavity filled with?

A

Synovial fluid

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18
Q

What is synovial fluid formed from and what does it do?

A

Formed by synovial membrane and it provides lubrication to joint movement

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19
Q

What is the bursa?

A

Synovial fluid sac that helps to reduce the friction bone and muscle or bone and tendon.

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20
Q

What is the meniscus?

A

Fibrous cartilage that reduces the friction in a joint and distributes weight evenly across the joint cavity.

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21
Q

What is the largest organ in the body and made out of millions of fibers?

A

Skeletal muscle

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22
Q

What are myoblasts?

A

Primary cell responsible for muscle growth and regeneration.

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23
Q

What are the 3 things that compose skeletal muscle?

A

75% water
20% protein
5% organic and inorganic compounds

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24
Q

How many muscles are there?

A

350, most are paired

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25
Q

How long are skeletal muscles?

A

2 to 6 cm

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26
Q

What are skeletal muscles controlled by?

A

CNS- voluntary

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27
Q

What is striated skeletal muscle?

A

Organization of muscle fibers into contractile units called sarcomeres.

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28
Q

What is essential for the contraction of muscles?

A

Calcium

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29
Q

What neurotransmitter helps to make our muscles move?

A

Acetylcholine

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30
Q

What is innervation ratio?

A

Motor units per muscle

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31
Q

What happens if you have greater innervation ratio?

A

You will have greater endurance, prevents fatigue

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32
Q

What happens when you have lower innervation ratio?

A

Facilitates precision movement

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33
Q

What are the phases of muscle contraction?

A

Excitation
Coupling
Contraction-cross bridge theory
Relaxation

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34
Q

Skeletal and cardiac muscles interact with what to contract?

A

Troponin and calcium

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35
Q

What does muscle contraction require a constant supply of?

A

ATP and phosphocreatinine

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36
Q

Why would you see an elevation of troponin in a trauma?

A

Troponin is needed for muscle contraction and with a trauma you can see a leak of troponin in blood stream.

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37
Q

What is rhabdomyolysis?

A

Rapid break down of muscle that causes the release of intracellukar contents

38
Q

What is found in the blood stream with rhabdo?

A

Protein pigment myoglobin

39
Q

What is the classic triad of rhabdo?

A

Muscle pain, weakness, and dark urine(from myoglobin).

40
Q

How do you measure rhabdomyolysis?

A

By a CK, we are worried about kidney function. It can cause kidney failure.

41
Q

How do we treat rhabdo?

A

IV fluids to flush myoglobin out of system

42
Q

What happens in osteoporosis?

A

Increase in osteoclasts activity and a decrease in osteoblasts activity.

43
Q

What are some causes of osteoporosis?

A

Decreased hormones
Decreased activity
Inadequate levels of vitamin D, calcium or magnesium

44
Q

What hormone decrease causes osteoporosis?

A

Estrogen.

45
Q

What medication can cause osteoporosis?

A

Depomedrol

46
Q

What is osteomyelitis and what bacteria is it usually causes from?

A

Caused by a staph infection and it is infection of the bone

47
Q

What are the two types of osteomyelitis?

A

Exogenous- enters from outside the body

Endogenous- enters through blood stream

48
Q

How do you treat osteomyelitis?

A

Iv antibiotic, debridement, hyperbaric chambers

49
Q

In adults where does osteomyelitis affect the bone?

A

Cortex

50
Q

What is sequestra?

A

Secretions of dead bone from separation

51
Q

What is invollucom?

A

New bone

52
Q

How does infection spread in osteomyelitis?

A

Under the peristenum and along the bone shaft or into bone marrow.

53
Q

What is osteoarthritis?

A

Age related disorder of synovial joints, inflammatory joint disease

54
Q

What is a key symptom with OA?

A

Pain becomes worse as the day goes on, they have nodes in their finger joints.

55
Q

Where can you find OA?

A

Hands, feet, back, hips, shoulders

56
Q

What is RA?

A

Inflammatory joint disease, systemic autoimmune destruction to synovial membrane and joints.

57
Q

What factor is present in RA?

A

Rheumatoid factor

58
Q

What antibodies are affected in RA?

A

IgG and IgM

59
Q

What is a cardinal sign of RA?

A

Morning joint stiffness lasting at least 1 hour.

60
Q

What is gout?

A

A metabolic disorder that disrupts the body’s control of Uric acid

61
Q

What are symptoms of gout?

A

Red, inflammed area that is very painful to touch

62
Q

What is gout treated with?

A

NSAIDS, endomethycin

63
Q

Why are some ways to help patients with gout?

A

Medications and avoidance of foods that increase Uric acid.

64
Q

What is FM?

A

A chronic widespread joint and muscle fatigue, pain. More sensitive due to increase innervation.

65
Q

What are some tests you can do to diagnose rotator cuff injury?

A

MRi

Ask them if they reach above their head, brush their hair, put in a shirt, hook their bra, pain in deltoid area

66
Q

How can a me is always tear happen?

A

Twisting injury, chronic degenerative tears occur in older patients

67
Q

What happens if a me is always tear is left untreated?

A

A large complex tear can impair smooth motion of the knee

68
Q

What are some symptoms of a meniscal tear?

A

Clicking or popping of knee, locking of knee, catching of the cartilage

69
Q

What is a anterior cruiciate ligament injury?

A

Devastating injury as it is the stabilizing ligament of the knee.

70
Q

What are the 3 classic signs of ACL injury?

A

Felt or heard “pop”, rapid effusion develop, pain was so bad they thought about calling 911.

71
Q

What types of movement will you not be able to do with a ACL injury?

A

Squatting, pivoting, stepping laterally, walking DOWN stairs

72
Q

what is knee OA?

A

Most common form, happen in people over 50, degenerate wear and tear, bone on bone, X-rays are best for dx

73
Q

If a younger person is complaining of back pain that radiates down their leg, what could that be?

A

Disc herniation

74
Q

If a older person complains of back pain with radiation down the leg, what could this be?

A

Spinal stenosis

75
Q

What happens with a disc herniation or spondylosis?

A

Nerve root compression

76
Q

Where do most disc herniation happen?

A

L5 and S1 radiculopathies

77
Q

Where do most spinal stenosis occur in older patients?

A

L2/L3/L4

78
Q

What can help you determine where there might be stenosis or herniation?

A

Dermatones

79
Q

What is the common complaint for DDD?

A

Mechanical back pain or axial column back pain, generally in the low back alone with no radiation.

80
Q

What is DDD causes from?

A

Wear and tear, unfortunately disk don’t regenerate.

81
Q

What is spinal stenosis?

A

Narrowing of the central canal, lateral recess and foremen.

82
Q

What is caude equine syndrome?

A

Medical emergency, caused by an intraspinal lesion caudal to the conus that injured 2 or more of the 18 nerve roots constituting the cauda equina within the lumbar spinal cord.

83
Q

What 2 things can cauda equina involve?

A

Bladder and bowel, it is marked as a neurological disorder

84
Q

What is snapping hip?

A

Patients hear a “snap” with movement

85
Q

What is trochanteric bursitis?

A

Patients complain of pain when lying on that hip

86
Q

What is an acetabular labrum injury?

A

Labrum seals the central portion of the hip from the periphery keeping synovial fluid central compartment.

Tears can be from acute trauma or from repetitive micro trauma.

87
Q

What is leg Calvin perthes?

A

It is found in children, brought in limping,complaining of knee pain, spams with inward rotation.
it’s pulled away from blood supply at femoral head and tries to remodel itself and causes it to not move as well.

88
Q

What are manifestations of scoliosis?

A

Nonstructual- mild spinal curvature with prominence of one hip or rounded shoulders

Structural- asymmetry of hip height, shoulder height, shoulder and scapula prominence and rib prominence.

89
Q

What is the treatment for scoliosis?

A

Braces, PT, fusion of spine

90
Q

What are the 2 tests we use to determine congenital defects in babies for musculoskeletal?

A

Barlow test and Ortolani test

91
Q

What are manifestations of dysplasia of the hip in kids?

A

Asymmetry of gluteal thigh folds
Limb length discrepancy: galeazzi sign
Limitation of hip abduction
Positive Ortolani sign: hip dislocated but reducible
Positive Barlow: hip reduced but dislocatable
Positive trendelnburg gait: waddling
Pain: late sign

Pathophysiology test 3 (6 decks)

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