Musculoskeletal Flashcards

1
Q

progressive degeneration and weakening of skeletal muscle

A

muscular dystrophy

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2
Q

what is the most common form of muscular dystrophy

A

duchenne MD

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3
Q

cause muscular dystrophy

A

genetic defect because of absences of dystrophin

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4
Q

how is muscular dystrophy diagnosed

A

sx, family history, muscle biopsy, EMG, elevated serum creatine kinase level, DNA blood test

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5
Q

tx muscular dystrophy

A

deflazacort (emfalza), PT, surgery, orthopedic appliances, corticosteroid, feeding tube, anticonvulsants, immunosuppressants

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6
Q

aka club foot

A

talipes equinovarus

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7
Q

anterior half of foot is adducted and inverted

A

clubfoot

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8
Q

cause of clubfoot

A

fetal position and genetics

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9
Q

how is clubfoot diagnosed

A
  • physical exam
  • foot resistance to manipulation
  • shortened achilles heel
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10
Q

tx clubfoot

A

cast, splints, surgery

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11
Q

aka developmental dysplasia of hip

A

conggenital hip dysplasia

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12
Q

abnormal displacement of hip joint

A

congenital hip dysplasia

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13
Q

cause of congenital hip dysplasia is unknown but what are potential causes

A

maternal hormone relaxin or breech

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14
Q

congenital hip dysplasia more commonly affects

A

females

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15
Q

how is congenital hip dysplasia diagnosed

A
  • positive ortolani and barlow maneuvers
  • physical exam
  • ultrasound of hip
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16
Q

tx congenital hip dysplasia

A

pavlik harness, plint, cast

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17
Q

aka cleft lip

A

harelip

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18
Q

sx cleft lip

A
  • obvious deformity
  • difficulty w/nasal regurgitation and feeding
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19
Q

cause of cleft lip

A

genetics

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20
Q

tx cleft lip

A
  • surgery
  • feeding devices
  • speech therapy
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21
Q

chronic pain condition associated with stiffness, tenderness, restless sleep, depression, fatigue, anxiety, bowel dysfunction

A

fibromyalgia

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22
Q

cause of fibromyalgia is unknown but what are some theories

A

change in how brain and spinal cord process pain signals, relatively low serotonin, psychological distress, elevated levels of substance P, trauma, infection

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23
Q

fibromyalgia may be aggravated by these factors

A

poor posture, inappropriate exercise, weight, smoking

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24
Q

how is fibromyalgia diagnosed

A
  • blood testing and physical exam to rule out other conditions
  • diagnostic criteria (widespread pain lasting at least 3 months, other sx, no other underlying conditions)
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25
Q

tx fibromyalgia

A
  • pt education
  • stress reduction
  • exercise
  • meds (antidepressant amitriptyline [elavil], pregabalin [lyrica], duloxetine [cymbalta], milnacipran [savella], NSAIDS, muscle relaxants)
  • stress reduction/relaxation techniques
  • massage therapy
  • acupuncture
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26
Q

aka lordosis

A

swayback; saddle back deformity

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27
Q

cause of lordosis

A

excessive abdominal weight (pregnancy, obesity, abdominal tumors), unknown, rapid skeletal growth, osteoporosis

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28
Q

lordosis is often seen in this group

A

prepubescent girls

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29
Q

how is lordosis diagnosed

A

observation of spine and xray

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30
Q

tx lordosis

A

delivery of fetus, weight loss and exercise, spinal fusion and displacement osteotomy

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31
Q

abnormal outward curvature of spine

A

kyphosis

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32
Q

exaggerated inward curvature of spine

A

lordosis

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33
Q

cause of kyphosis

A

development, Scheuermann disease, tumors, TB, ankylosing spondylitis, osteoporosis

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34
Q

how is kyphosis diagnosed

A

visual inspection, xrays, bone scans

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35
Q

tx kyphosis

A

exercise, back brace, spinal fusion w/instrumentation and temporary immobilization, vertebroplasty

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36
Q

lateral curvature of spine

A

scoliosis

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37
Q

cause of scoliosis

A

idiopathic, genetic, deformed vertebrae, uneven leg lengths, muscle determination

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38
Q

how is scoliosis diagnosed

A

visual exam of back and xrays

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39
Q

tx scoliosis

A

milwaukee brace, boston brace, molded plastic clamshell jacket, wilmington brace, exercise program, fusion of vertebrae and internal fixtures, body casts, plstic jackets

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40
Q

type of arthritis involving break down and eventual loss of cartilage

A

osteoarthritis

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41
Q

cause of osteoarthritis

A

hormonal disorders, injury, diabetes, obesity

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42
Q

classic bony enlargement

A

heberden node

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43
Q

aka osteoarthritis

A

degenerative joint disease; degenerative arthritis

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44
Q

tx osteoarthritis

A

physical and drug therapy, good diet, supportive care, surgery, massage, heat & cold, elastic bandages/splints, analgesics, muscle relaxants, NSAIDs, intraarticular steroid injections, intraarticular hyaluronic acid, fish oil, food supplementation w/glucosamine and chondroitin, mobility aids, restrict activity, joint fusion, joint replacement

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45
Q

infectious disease caused by Borrelia burgorferi transmitted through ticks

A

lyme disease

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46
Q

cause of lyme disease

A

Borrelia burgdorferi (US) or Borrelia afzeli (Europe) transmitted from tick

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47
Q

how is lyme disease diagnosed

A

pt history, physical exam, lab testing, positive test for lyme antibodies

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48
Q

tx lyme disease

A

removal of tick, oral antibiotics (doxycycline, amoxicillin, cefuroxime), IV antibiotics, antipyretics, bed rest, physical therapy, anti-inflammatory meds, hydroxychloroquine

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49
Q

inflammation of bursa

A

bursitis

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50
Q

cause of bursitis

A

continual or excessive friction, systemic diseases, trauma

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51
Q

how is bursitis diagnosed

A

pt history, physical exam, impaired ROM, acute pain, MRI, xrays show calcified deposits

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52
Q

tx bursitis

A

avoid activity, moist heat, immobilize joint,, aspirin/acetaminophen, NSAIds, local injection of corticosteroid, active ROM exercises, surgical excession

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53
Q

serious infection of bone

A

osteomyelitis

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54
Q

cause of osteomyelitis

A

staphylococcus aureus or streptococcal bacteria, bloodborne pathogen deposited from surgery or trauma

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55
Q

list risk factors for osteomyelitis

A
  • diabetes mellitus
  • peripheral vascular disease
  • streptococcal pharyngitis in kids
  • sickle cell disease
  • prosthetic hardwar
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56
Q

how is osteomyelitis diagnosed

A

aspiration and culture of material from site of infection, blood culture, WBC, erythrocyte sedimentation rate, MRI, CT< bone scan

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57
Q

tx osteomyelitis

A

parenteral or local antibiotics (aqueous penicillin, cephalosporin, ampicillin), increased intake of proteins and vitamins A/B/B, bed rest, immobilization, surgical drainage, hyperbaric oxygen

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58
Q

chronic disorder of uric acid metabolism manifesting as acute and episodic form of arthritis

A

gout

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59
Q

cause of gout is

A

inherited abnormality of metabolism, deficiency of enzymes

60
Q

how is gout diagnosed

A

microscopic exam of aspirated synocial joint fluid, serum uric acid test, xray

61
Q

tx gout

A

bed rest, immobilize, joint, cold packs, NSAID (colchicine/Colcrys), corticosteroid, dietary medication, dairy products

62
Q

aka paget disease

A

osteitis deformans

63
Q

irregular breakdown and formation of bone tissue

A

paget disease aka osteitits reformans

64
Q

what are the 2 stages of paget’s disease

A

vascular and sclerotic

65
Q

describe the vascular stage of paget disease

A

bone tissue broken down and spaces filled with blood vessels and fibrous tissue

66
Q

describe the scleratic stage of paget disease

A

highly vascular fibrous tissue hardens and becomes simular to bone

67
Q

what are the most common sites for paget disease

A

femur, spine, skull, clavicle, pelvis, tibia

68
Q

list other complications of paget disease

A
  • frequent fractures, spinal cord injuries, hypercalcemia, renal calculi, bone sarcoma
69
Q

how is osteomyelitis diagnosed

A

physical exam and pt history, xray, bone scan, bone marrow biopsy, elevated serum concentration of alkaline phosphatase, elevated hydroxyproline concentration

70
Q

group of inherited conditions featuring abnormal connective tissue with weakness of blood vessels and excessive length and flexibility of extremeties

A

margan syndrome

71
Q

cause of marfan syndrome

A

autosomal dominant genetic disease

72
Q

tx marfan syndrome

A

control excessive height w/hormones before puberty, preventing glaucoma, control blood pressure, prevent aortic dissection

73
Q

how is marfan syndrome diagnosed

A

family history and physical exam

74
Q

tx marfan syndrome

A

hormones before puberty, prevent glaucoma, control blood pressure, prevent aortic dissection

75
Q

the general term of bone tumors include these types

A

chodnrogenic, osteogenic, fibrogenic

76
Q

who is more likely to get bone cancer

A

men

77
Q

these cancer types commonly metastasize to bone

A

breast, lung, prostate, kidney, thyroid

78
Q

what is the most common primary bone cancer

A

osteoporosis

79
Q

osteosarcoma most commonly occurs in the

A

distal femur

80
Q

ewing sarcoma most commonly involves

A

pelvis and lower extremity

81
Q

chondrosarcoma most commonly involve

A

pelvis and proximal femur

82
Q

how is bone cancer diagnosed

A

pt history, physical exam, lab studies, radiograph, radionuclide bone scanning, PET, CT, MRI, bone marrow aspiration, elevated serum alkaline phosphate, (osteosarcoma), lactate dehydrogenase elevated (ewing sarcoma), biopsy

83
Q

tx bone cancer

A

surgical excision & bone graft

84
Q

muscle tumors most commonly occur in these areas

A

buttocks, groin, extremities, head and neck, trunk, retroperitoneum

85
Q

muscle sarcomas most commonly affect pts

A

older than 50 yrs of age

86
Q

how are muscle tumors diagnosed

A

MRI

87
Q

tx muscle tumor

A

surgical resection & chemotherapy

88
Q

cause of osteoporosis

A

radiation, malabsorption, smoking, alcohol, calcium wasting nephropathy, immobility, chronic disease, lack of estrogen or testosterone, medications

89
Q

what is the most common metabolic bone disease

A

osteoporosis

90
Q

tx osteoporosis

A

increased dietary calcium/calcium carbonate/calcium carbonate with sodium fluoride/phosphate supplements/vitamins, estrogen replacement (alendronate sodium, risedronate, ibandronate, zoledronate, calcitonin nasal spray, parathyroid hormone), exercise, physical therapy, analgesics, muscle relaxants

91
Q

cause of osteomalacia

A

deficiency or ineffective use of vitamin D, inadequate sunlight, intestinal malabsorption of vitamin D, chronic renal disease

92
Q

aka osteomalacia

A

ricketts

93
Q

how is osteomalacia diagnosed

A

blood test (serum calcium, serum alkaline phosphatase, vitamin D, ESR), radiographic studies, bone scan, bone biopsy

94
Q

tx osteomalacia

A
  • vitamin D supplements
  • dietary vitamin D, calcium, and calcitonin
  • exposure to sunlight
  • tx underlying disorder
95
Q

aka hallux valgus

A

bunion

96
Q

localized area of enlargement of inner portion of first metatarsophalangeal joint at base of big toe

A

hallux valgus (bunion)

97
Q

cause of hallux valgus

A
  • great toe positioned toward midline
  • rheumatoid arthritis
  • flatfoot
  • improperly fitted shoes/high heels
  • familial
  • profession (ballet)
98
Q

how is hallux valgus diagnosed

A

physical exam, pt history, xray

99
Q

tx hallux valgus

A
  • wear shoes with roomy toe box
  • wear shoes with lower heels
  • pad toes
  • analgesics
  • surgery (bunionectomy & arthroplasty)
100
Q

stiff big toe as a result of degeneration of cartilage of first metatarsalphalangeal joint

A

hallux rigidus

101
Q

cause of hallux rigidus

A

injury, underlying arthritis, constant wear

102
Q

how is hallux rigidus diagnosed

A

pain when continuous/walking, restriction of motion of great toe, straight hallux with enlarged and tender joint with limited dorsiflexion, xray

103
Q

tx hallux rigidus

A

antiinflammatories, shoes with thick hard soles and low heels, surgery (cheilectomy), arthrodesis, arhtroplasty

104
Q

toe bends upward like claw because of abnormal flexion of PIP joint and can occur in any of the four lesser toes

A

hammer toe

105
Q

cause of hammer toe

A

shoes too short, pointed toe shoes, high heels, arthritis, injury

106
Q

how is hammer toe diagnosed

A

pt history, physical exam, imaging

107
Q

tx hammer toe

A

wear properly fitted shoes, splinting, physical therapy, arthroplasty, arthrodesis

108
Q

fracture of distal head of radius and possibly involving ulnar styloid

A

colles fracture

109
Q

cause of colles fracture

A

attempt to break fall

110
Q

obvious displacement of bone of upper arm with shortening of extremity and abnormal mobility of upper arm

A

humerus fracture

111
Q

complications of pelvic fracture

A
  • lacerated colon, paralytic ileus, bladder & urethral injury, intrapelvic hemorrhage
112
Q

tx pelvic fracture

A

bed rest, immobilization w/pelvis slin/skeletal traction, open reduction & repair

113
Q

outward rotation and shortening of affect extremity generally happening in women older than 60 yrs bc of a fall

A

fractured hip

114
Q

notable angulation deformity and shortening of affected leg and unable to move knee/hip caused by severe direct impact like MVA or severe trauma

A

fracture of femoral shaft

115
Q

cause of tibia fracture

A

strong force on lower leg

116
Q

cause of vertebral fracture in neck

A

acceleration-deceleration trauma

117
Q

cause of thoracic/lumbar fracture

A

fall and landing directly on butt

118
Q

fracture of floor of cranial vault gen bc of massive trauma to head like MVA

A

basilar skull fracture

119
Q

bilateral horizontal fracture of maxilla gen when face forced against steering wheel

A

lefort

120
Q

lower part of fibular fractured and lower tibial articulation sustain serious injury

A

pott fracture

121
Q

cause of bone fractures

A

trauma, neoplasms, TB of bone, paget disease, osteoporosis

122
Q

cause of strains and sprains

A

acute trauma or cumulative trauma

123
Q

how is sprains and strains diagnosed

A

physical exam, pt history, xrays

124
Q

tx sprains and strains

A

elevation, rest, cold packs, immobilization, analgesics, antiinflammatory, surgery

125
Q

cause of joint dislocations

A

severe injury tearing joint ligaments or congenital weakness

126
Q

shoulder severely limited in ROM bc of inflammation, scarring, thickening, and shrinkage of capsule surrounding shoulder

A

adhesive capsulitis (frozen shoulder)

127
Q

cause of adhesive capsulitis

A

inflammation of capsule of joint w/secondary scarring from slight injury worsening over time

128
Q

how is adhesive capsulitis diagnosed

A

pt history, xray, pt sx

129
Q

tx adhesive capsulitis

A

PT/OT, analgesics, antiinflammatory, injection of steroid, shoulder manipulation

130
Q

cause of severed tendon

A

injury or laceration

131
Q

how is severed tendon diagnosed

A

physical exam, imaging

132
Q

tx severed tendon

A

surgery (tenorrhaphy)

133
Q

painful condition involving inflammation of periosteum and surrounding tissues

A

shin splints

134
Q

cause of shin splints

A

overuse and overpronation

135
Q

how is shin splints diagnosed

A

physical exam and pt history

136
Q

tx shin splints

A

rest, ice or heat, aspirin, physical therapy, orthotic device, correct overpronation

137
Q

aka plantar fasciitis

A

calcaneal spur

138
Q

cause of plantar fasciitis

A

fascia put under tension (flat feet, high arched rigid feet, toe running, ,hill running, running on soft terrain, poor shoe support, sudden increase in activity, sudden weight gain, age, familial, underlying disease)

139
Q

how is plantar fasciitis diagnosed

A

physical exam, pt history, xray

140
Q

tx plantar fasciitis

A

rest, ice, anti-inflammatories, analgesics, heel pads, shoe with good arch support, local cortisone injection, taping foot, orthotics, PT, surgery

141
Q

benign saclike swelling or cyst filled with colorless jelly-like fluid formed from tissue lining joint or tendon

A

ganglion

142
Q

cause of ganglion

A

repetitive minor injury, arthritis, unknown

143
Q

how is ganglion diagnosed

A

palpation and observation, needle aspiration

144
Q

tx ganglion

A

rupture, needle aspiration, instillation of steroid, ganglionectomy, resolve on own

145
Q

cause of torn meniscus

A

sudden twisting or external rotation of leg while knee is flexed

146
Q

tx torn meniscus

A

immobilize, ice, antiinflammatories, analgesics, PT, surgery