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Health Status > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

1
Q

Why do the number of bones in the body reduce from childhood?

A

Smalls bones fuse together

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2
Q

How many bones in the adult human body?

A

206

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3
Q

What is the purpose of many small bones through childhood?

A

Allows birth and development e.g. cranial softer for birth
Fusion concludes at puberty

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4
Q

What are the two sections of the skeleton?

A

Axial for protection: skull, ribs, sternum, spine
Appendicular for movement

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5
Q

What is bone remodelling?

A

The constant breaking down of old or damaged bone and replacement of new bone

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6
Q

What are bone building cells?

A

Osteoblasts (from osteogenic stem cells
They undergo complex processes to become interconnected osteocytes - bone calcification

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7
Q

What are bone cells called?

A

Osteocytes which form when osteoblasts become interconnected
They have multiple nuclei to regulate busy cell processes

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8
Q

What are bone destroying cells?

A

Osteoclasts break down old/damaged bone cells

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9
Q

Describe the remodelling process?

A
  1. Reabsorption: liberation of minerals from bone breakdown
  2. Reversal: generation of environment to allow bone formation
  3. Formation: new bone forms
  4. Mineralisation: calcium bonds and collagen matrix forms
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10
Q

What is hard/spongey bone?

A

80% Compact/cortical outer: surrounds inner bone and is dense/strong
20% Cancellous/trabecular inner: metabolic processes occur here

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11
Q

What is the epiphysis?

A

Each end of the bone
Spongey bone with hard coating
Has red bone marrow for RBC production
Cartilage lines each end

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12
Q

What is the diaphysis?

A

The middle ‘shaft’ of bone
Has yellow bone marrow
Stores fat and stem cells to help with bone cell formation

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13
Q

What is the metaphysis?

A

Point at each end of the bone where it gets wider and the diaphysis becomes the epiphysis

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14
Q

What is a growth plate?

A

Also called physis
Active fourth region of bone during childhood
Grows bone tissue to add to the epiphysis and diaphysis to lengthen bone

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15
Q

What is the membranous bone cover called?

A

Periosteum

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16
Q

Describe long bone

A

Cylinder shape, longer than wide
Functions to lever
E.g. femur, ulna

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17
Q

Describe short bone

A

Cube shape, roughly equal length/width/height
Function is stability/support, some motion
E.g. carpal, tarsal

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18
Q

Describe flat bone

A

Thin and curved
Function to protect organs
E.g. sternum, cranium

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19
Q

Describe irregular bone

A

Complex shape
Function to protects organs
E.g. vertebra, facial bones

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20
Q

Describe sesamoid bone

A

Small, round, embedded
Function to protect tendons
E.g. patella

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21
Q

What are sutural bones?

A

Extra bones in some people within joints in skull bones

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22
Q

What is osteoporosis?

A

Gradual loss of bone density as bone is lost quicker than it is replaced
SX: fractures, reduced height, stooped posture, pain
TX: lifestyle, vitD, Ca, biophosphonates, selective estrogen receptor modulators, denosumab

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23
Q

What is the vasculature of bone?

A

Highly vascular
Nutrient artery enters via foramen
Supplies central artery which runs through the medulla and branches to supply all cells
Branches converge into central sinus
Blood then exits via venous sinus to central vein and out foramen
(Periosteal arteries also supply blood via foramen)

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24
Q

What are the names and differences between C1 and C2?

A

C1 is atlas and it supports the weight of the skull
C2 is axis and it allows pivoting of the skull

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25
Q

What is the general structure of vertebrae?

A

Central vertebral body
Spinous process (posterior)
Transverse processes on each side allow muscle attachment
Vertebral foramen houses cord
Cartilage disks in-between

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26
Q

Where in the spine does the cord end?

A

L1/L2
Here it forms a group of nervous tissue called cauda equina

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27
Q

What is SCI?

A

Spinal cord injury
Not all spine fractures result in SCI
Swelling in the column can cause transient symptoms

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28
Q

What issues can occur with spinal discs?

A

Wear = bone-on-bone
Slip from position and be pinched by vertebra

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29
Q

What parts make up the pelvis?

A

Hips, pubis, ischium, ilium, sacrum, coccyx

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30
Q

What is the greater pelvis?

A

False pelvis
Holds intestines, uterus, ovaries and tubes

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31
Q

What is the lesser pelvis?

A

True pelvis
Holds rectum, bladder, vagina/cervix, prostate

32
Q

How do the female and make pelvis differ?

A

Male: denser, carries more weight
Female: wider, greater arch, flexible coccyx

33
Q

What is cartilage?

A

A firm and flexible connective tissue
Provides support, structure, cushioning/absorption and joint movement

34
Q

What is the makeup of cartilage?

A

Chondrocytes in a matrix of collagen fibres (strength) and proeoglycans (water balance)

35
Q

What are the 3 types of cartilage?

A

Hyalin: on bone ends to allow smooth movement and line respiratory tract

Elastic: shape/support and deform/recoil e.g. ears, larynx

Fibrocartilage: tough/durable to provide shock and resist compression e.g. vertebral discs

36
Q

Why are cartilage injuries slow to heal?

A

Cartilage is avascular

37
Q

What is a synovial joint?

A

Joint which permits free movement
-cushioning between bones (cartilage)
-ligaments on each side to stabilise
-muscles and tendons
-synovial fluid in a cavity

38
Q

What is a hinge joint?

A

One direction of movement only
E.g. elbow, knee

39
Q

What is a ball-and-socket joint?

A

Movement in multiple directions
E.g. shoulder, hip

40
Q

What is a pivot joint?

A

Allows rotation around a central axis
E.g. between C1 and C2

41
Q

What is a gliding joint?

A

Allows slide movement between joint surfaces
E.g. carpals in wrist

42
Q

What is a saddle joint?

A

Allows movement in two planes
E.g. the thumb’s base joint

43
Q

What are cartilaginous joints?

A

Have cartilage between bones that restrict movement
E.g. rib-sternum

44
Q

What is a fibrous joint?

A

Connected by fibrous tissue to reduce movement
E.g. cranial bones

45
Q

What is osteoarthritis and rheumatoid arthritis?

A

Osteo: inflammation in joints from wear and tear
Rheumatoid: autoimmune causes inflammation of synovial membrane

SX: pain, swell, deform, stiff
TX: lifestyle, cold/hot tx, NSAID, methotrexate, sulfasalazine, leflunomide

46
Q

What is the structure of muscle?

A

A single muscle fibre wrapped in endomysium is made from myoblasts
Each fibre has nerve and vascular supply

A bunch of fibres wrapped in perimysium is a fascicle (compartments)
A bunch of fascicles wrapped in epimysium is a muscle

47
Q

What is the structural unit of a muscle cell?

A

A sarcomere
Contains long fibres called myofibrils which contain strands of actin + myosin

48
Q

How does muscle contraction occur?

A

Sliding filament theory
ATP is consumed to release calcium ions
Calcium creates linkages between filaments of actin + myosin
They bind together and uncouple repeatedly to produce movement

49
Q

What is rigor mortis?

A

Calcium floods cells activating actin + myosin but ATP is no longer being produced so the calcium cannot be pumped back out - therefore prolonged contraction occurs

  1. Onset 2-6h>death: contractions begin in small muscles and eventually occur in all
  2. Peak 12-24h>death: fully rigid
  3. Resolution 24-48h>death: contraction gradually resolves
50
Q

What is muscular dystrophy?

A

Group of genetic diseases affecting muscle causing weakness and degeneration over time
Caused by abnormal proteins

51
Q

What is motor neuron disease?

A

(ALS/Lou Gehing)
Disease affecting nerve cells that control muscle resulting in weakness and paralysis

52
Q

What are tendons?

A

Connect muscle to bone
Function to allow movement and stabilise
Primarily collagen fibres
Dense, avascular, strong

53
Q

What are ligaments?

A

Connect bone to bone
Function to reduce excess ROM and stabilise
Primarily collagen fibres
Elastic, band structure

54
Q

What is tetanus?

A

Bacterial clostridium infection that releases toxins that interfere with NTs causing continual contractions and spasms
SX: stiff (jaw/neck), sore, fever, dysphagia, spasms, arched back, stiff abdomen, dyspnoea
TX: transport to ED for antitoxin, AB, wound care and vax

55
Q

What is the insertion point (movement)?

A

Point where tendon attaches to the most mobile or distal part of the bone
This point will be pulled toward the origin during contraction

56
Q

What is the origin point (movement)?

A

Point where tendon attaches to a more stable or proximal point on the bone
Provides a stable point for the muscle to pull against to create movement

57
Q

What is an agonist muscle?

A

Creates specific movement
Generates force to move the joint
E.g. bicep is agonist when bending elbow

58
Q

What is an antagonist muscle?

A

Opposes agonist muscle to return the joint to original position
E.g. tricep is antagonist when bending elbow

59
Q

What is a stabilising muscle?

A

Supports during movement to prevent excessive ROM
Maintains control and allows for smooth movement

60
Q

What is an isometric movement?

A

Muscle contracts without changing length
E.g. posture, holding something

61
Q

What is an isotonic movement?

A

Muscle contracts and changes length

Eccentric: lengthens (when putting down a weight)
Concentric: shortens (when lifts a weight)

62
Q

What are the 3 phases of a muscle twitch?

A

Latent: AP travels neuron and stimulates membrane of muscle

Contraction: calcium is released = actin + myosin. Contraction occurs and force generated

Relaxation: calcium pumped back. Contraction stops and fibre returns to rest

63
Q

How does the paediatric musculoskeletal system differ?

A

Growth plate active so fracture here may result in deformation
If struck by a car, more likely to be head injury and knocked underneath
Joints and ligaments are more relaxed
Bone is less dense and more flexible so greenstick fracture more likely. Also means they can absorb more traumatic energy so tissue injuries may also occur

64
Q

How does the geriatric musculoskeletal system differ?

A

Low calcium reduces bone density
Reduced stability/coordination increases falls
Joint cartilage wear and tear = pain
Reduced synovial fluid = stiff joints
Reduced height from discs reducing

65
Q

What are the symptoms of a fracture?

A

Pain
Swelling
Bruising
Deformation
Reduced movement
Bleeding
Crepitus (sounds when moving from bone on bone)

66
Q

What are the treatment goals with fractures?

A

Control bleeding: splint for internal/bandage for external
Stabilise/immobilise to align and hold: reduce pain and further injury
Analgesia

Refer minor to X-ray clinic; transport severe

67
Q

What is a closed or open fracture?

A

Closed: bone stays in skin
Open: bone protrudes skin (may retract so need thorough assessment)

68
Q

What is a transverse and oblique fracture?

A

Transverse: occurs at right angel to bone axis

Oblique: occurs at a different angle. Surrounding muscles may cause bone to slide into nearby tissues

69
Q

What is a spiral fracture?

A

Twisting force causes fracture which wraps around bone

70
Q

What is an impacted fracture?

A

Caused by compressive forces

71
Q

What is a comminuted fracture?

A

Fractures into multiple fragments

72
Q

What is a greenstick fracture?

A

Common in children due to softer bones
Fracture breaks half the bone and may split up/down

73
Q

What is a sprain?

A

Ligament stretch or tear
Usually from physical activity

74
Q

What is a strain?

A

Muscle/tendon stretch or tear
Usually from overuse

75
Q

What are the SX of strain/sprain injury?

A

Pain
Swelling
Bruising
Reduced movement or weight bearing

76
Q

What is the treatment for strain/sprain?

A

Rest
Ice (20mins, QID)
Compress
Elevate (6-10inch above heart)

77
Q

What is malignant hyperthermia?

A

Reaction to methoxyflurane
Causes mass release of calcium into cells causing muscle contraction and metabolism
SX: hyperthermia, tachycardia, tachypnoea, hypercapnoea, rigid, acidosis
TX: stop med, cooling, transport urgently

Health Status (15 decks)

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