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Patho Exam 2 > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

1
Q

how many bones are there in the human body

A

206

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2
Q

what are the functions of bones

A
  1. structural support
  2. storage of minerals
  3. production of blood cells
  4. protection of body organs
  5. provision of leverage and movement
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3
Q

what are the types of bone cells

A
  1. osteoblast
  2. osteoclast
  3. osteoprogenitor cells
  4. osteocyte
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4
Q

what is the job of modeling within the bones?

A

osteoblast cells build/grow the skeleton through osteoblastic activity
= modeling

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5
Q

what is the job of remodeling within the bones?

A

once the bone reaches maturity, osteoclasts breakdown and renew it

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6
Q

osteoblast and osteoclast activity functioning together is known as what?

A

basic multicellular unit (BMU)

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7
Q

how many BMU are active at one time in adults?

A

about 1 million BMU

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8
Q

when is peak bone mass achieved?

A

early adulthood (30-35)

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9
Q

around age 30, what happens to the bone activity?

A

the amount of bone resorbed by osteoclasts exceeds the bone formed by osteoblasts
= there will be a steady decrease in bone mass as we age

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10
Q

what influences bone mass?

A
  1. nutrition
  2. physical activity age
  3. age
  4. hormonal status
  5. vitamin D
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11
Q

what does locomotion require of our skeleton?

A

locomotion requires our skeleton to have moveable joints and muscles acting on the bones

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12
Q

what are the 3 types of muscles

A
  1. skeletal muscles
  2. smooth muscles
  3. cardiac muscles
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13
Q

describe skeletal muscles

A

muscles that connect to the bone

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14
Q

describe smooth muscles

A

lines the walls of hallow organs and tubes

- involuntary

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15
Q

describe cardiac muscles

A

make up the heart

- involuntary

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16
Q

what attaches muscle to bone?

A

tendons

- tough cords or bands of dense connective tissue

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17
Q

what is the function of tendons

A

attaches muscles to bones and transmit load from muscles to bones = joint motion

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18
Q

what is the function of ligaments

A

attach bone to bone, helps in the mechanical stability of the joint

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19
Q

describe how tendon injuries occur

A

tendons can be subjected to injuries particularly overuse
= tendinopathy, a result of inflammation, degeneration and weakening of the tendons

= TENDON RUPTURE

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20
Q

describe how ligament injuries occur

A

ligaments can rupture too, most common is the knee

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21
Q

what is the healing process like for a ligament

A

similar to scar formation, the healed ligament is weaker in providing joint stability and prone to re-injury

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22
Q

what is a traumatic musculoskeletal injury

A

fracture - a break in the continuity of the bone

23
Q

what are the most common causes to a fracture

A
  1. primary:
    - falls
    - MVA
    - sports-related injury
  2. secondary from conditions that weaken the bone
    - osteoporosis
    - Paget’s disease
    - bone cancer
24
Q

what are the different categories used to classify fractures

A
  1. complete vs incomplete
  2. open vs closed
  3. impacted
  4. pathologic
  5. stress
  6. depressed
25
Q

describe a complete vs incomplete fracture

A
  • complete: bone is broken into 2 or more separate pieces

- incomplete: bone is partially broken

26
Q

describe an open vs closed fracture

A
  • open or compound fracture = the skin is broken

- closed fracture = the skin is intact

27
Q

describe an impacted fracture

A

one end of the bone is forced into the adjacent bone

28
Q

describe a pathologic fracture

A

this is the result from weakness in bone structure secondary to bone tumors or osteoporosis

29
Q

describe a stress fracrture

A

occurs from repeated excessive stress

- common in tibia, femur, and metatarsals

30
Q

describe a depressed fracture

A

occurs in the skull when a broken piece is forced inward to the brain

31
Q

describe the pathway of the body fixing a fracture

A
  1. break in the bone
  2. blood from damaged vessels pour into the fracture and produce a hematoma and blood clot
  3. within a few days, fibroblasts invade the clot
  4. fibroblasts secrete collagen fibers and form mass of cells and fibers called callus
  5. callus bridges the broken bone ends together (takes 2-6wks)
  6. osteoblasts from the periosteum invade the callus and slowly convert the callus to bones (4-6wks)
  7. callus begins as a large mass
  8. osteoclasts gradually remodel the bone by removing the excess bone until it leaves little to no evidence that a fracture occurred (can take up to a year)
32
Q

describe fibroblasts

A

connective tissue from periosteum

33
Q

clinical manifestations while the body is fixing a fracture

A
  1. deformity (shortening appearance/rotation)
  2. swelling at the site
  3. inability to move the affected limb
  4. crepitus (grating sound or sensation during movement)
  5. pain
  6. paresthesia
34
Q

factors that affect bone healing

A
  1. age
  2. nutritional status
  3. blood supply
  4. fracture type
35
Q

complications of bone healing

A
  1. compartment syndrome
  2. fat embolism
  3. osteomyelitis
  4. osteonecrosis
36
Q

describe compartment syndrome

A
  • this is a serious condition due to increased pressure within a “compartment” usually the muscle fascia as a result of fracture
  • the pressure impinges the nerves and blood vessels within that part of the body compromising distal part of the affected area
37
Q

clinical manifestations of compartment syndrome

A
  • extreme pain beyond what is expected!!!
  • 5 P’s
    1. pain
    2. paresthesia
    3. paralysis
    4. pulselessness
    5. pallor
38
Q

treatment of compartment syndrome

A
  • remove the cast

- perform a fasciotomy to release the pressure

39
Q

describe a fat embolism

A
  • happens when fat has an opportunity to enter the bloodstream.
  • in long bones, fatty marrow can the the culprit
  • the fat emboli can travel to vital organs like lungs, brain, heart
    = can be fatal!!
40
Q

prevention of a fat embolism

A

early immobilization of the fracture

41
Q

describe osteomyelitis

A

infection of the bone tissue
- can take months to cure

treatment:
- antibiotics

42
Q

describe osteonecrosis (aka avascular necrosis)

A

death of bone tissue due to loss of blood supply

treatment:
- surgical removal and replacement of the necrotic bone or joint

43
Q

general treatment of traumatic musculoskeletal injury

A
  1. realignment (reduction) should be done ASAP b/c tissue swelling tends to increase 6-12hrs after injury
    - can be done with open or close reduction or with traction
  2. pain management
44
Q

describe close realignment/reduction

A

done through manual manipulation which allows realignment of the broken bone without visualization

45
Q

describe open realignment/reduction

A

involves surgery within 24-48 hrs in medically-stable patient

46
Q

describe traction

A

used to realign broken bone
- after fracture is in its normal anatomical position, alignment is maintained by immobilizing the extremity with a cast or splint

47
Q

what pain management is used for treating traumatic musculoskeletal injuries

A
  • narcotics

- NSAIDS

48
Q

what is a musculoskeletal disorder

A

fibromyalgia

49
Q

describe fibromyalgia

A

syndrome characterized by a widespread muscular pain and fatigue

  • affects the joints, muscles, tendons, and surrounding tissues
  • linked to sleeping problems, fatigue, headaches, depression, and anxiety
50
Q

what are the 18-fibromyalgia pressure point

A

pressure points where pain or tenderness can be stimulated in the

  • neck
  • shoulder
  • trunk
  • limbs
51
Q

what is the cause of fibromyalgia

A

the exact cause is unknown, can be related to altered central neurotranmission that results in a sensitivity to substance P
- it is postulated that the brains pain receptors develop pain memory and become very sensitive to pain signals

52
Q

how do we diagnose fibromyalgia

A

based on the presence of widespread pain at least 3 months duration and tenderness on at least 11/18 pressure points

53
Q

treatment of fibromyalgia

A
  • focus on minimizing s/s and improving health overall
    1. stress reduction
    2. adequate rest
    3. proper nutrition
    4. heat application
    5. massage therapy; acupuncture
    6. physical therapy
    7. analgesics - NSAIDs (non- steroidal anti-inflammatory drugs) like Ibuprofen, naproxen
    8. antidepressants
    9. muscle relaxants
    10. antiseizure (specifically pregabalin)
54
Q

what are 2 common myths about fibromyalgia

A
  1. fibromyalgia is an autoimmune disease
    - There is no evidence that it follows the pattern of autoimmunity
  2. fibromyalgia is a psychological problem
    - it is physical disorder with real, measurable biological abnormality
    - While depression can cause physical pain and fatigue, NOT all pain and fatigue are caused by depression
    - but if fibromyalgia is not addressed early, it can cause depression!

Patho Exam 2 (3 decks)

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