Musculoskeletal Flashcards
1
Q
progressive degeneration and weakening of skeletal muscle
A
muscular dystrophy
2
Q
what is the most common form of muscular dystrophy
A
duchenne MD
3
Q
cause muscular dystrophy
A
genetic defect because of absences of dystrophin
4
Q
how is muscular dystrophy diagnosed
A
sx, family history, muscle biopsy, EMG, elevated serum creatine kinase level, DNA blood test
5
Q
tx muscular dystrophy
A
deflazacort (emfalza), PT, surgery, orthopedic appliances, corticosteroid, feeding tube, anticonvulsants, immunosuppressants
6
Q
aka club foot
A
talipes equinovarus
7
Q
anterior half of foot is adducted and inverted
A
clubfoot
8
Q
cause of clubfoot
A
fetal position and genetics
9
Q
how is clubfoot diagnosed
A
- physical exam
- foot resistance to manipulation
- shortened achilles heel
10
Q
tx clubfoot
A
cast, splints, surgery
11
Q
aka developmental dysplasia of hip
A
conggenital hip dysplasia
12
Q
abnormal displacement of hip joint
A
congenital hip dysplasia
13
Q
cause of congenital hip dysplasia is unknown but what are potential causes
A
maternal hormone relaxin or breech
14
Q
congenital hip dysplasia more commonly affects
A
females
15
Q
how is congenital hip dysplasia diagnosed
A
- positive ortolani and barlow maneuvers
- physical exam
- ultrasound of hip
16
Q
tx congenital hip dysplasia
A
pavlik harness, plint, cast
17
Q
aka cleft lip
A
harelip
18
Q
sx cleft lip
A
- obvious deformity
- difficulty w/nasal regurgitation and feeding
19
Q
cause of cleft lip
A
genetics
20
Q
tx cleft lip
A
- surgery
- feeding devices
- speech therapy
21
Q
chronic pain condition associated with stiffness, tenderness, restless sleep, depression, fatigue, anxiety, bowel dysfunction
A
fibromyalgia
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
23
Q
fibromyalgia may be aggravated by these factors
A
poor posture, inappropriate exercise, weight, smoking
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)
25
tx fibromyalgia
- 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
26
aka lordosis
swayback; saddle back deformity
27
cause of lordosis
excessive abdominal weight (pregnancy, obesity, abdominal tumors), unknown, rapid skeletal growth, osteoporosis
28
lordosis is often seen in this group
prepubescent girls
29
how is lordosis diagnosed
observation of spine and xray
30
tx lordosis
delivery of fetus, weight loss and exercise, spinal fusion and displacement osteotomy
31
abnormal outward curvature of spine
kyphosis
32
exaggerated inward curvature of spine
lordosis
33
cause of kyphosis
development, Scheuermann disease, tumors, TB, ankylosing spondylitis, osteoporosis
34
how is kyphosis diagnosed
visual inspection, xrays, bone scans
35
tx kyphosis
exercise, back brace, spinal fusion w/instrumentation and temporary immobilization, vertebroplasty
36
lateral curvature of spine
scoliosis
37
cause of scoliosis
idiopathic, genetic, deformed vertebrae, uneven leg lengths, muscle determination
38
how is scoliosis diagnosed
visual exam of back and xrays
39
tx scoliosis
milwaukee brace, boston brace, molded plastic clamshell jacket, wilmington brace, exercise program, fusion of vertebrae and internal fixtures, body casts, plstic jackets
40
type of arthritis involving break down and eventual loss of cartilage
osteoarthritis
41
cause of osteoarthritis
hormonal disorders, injury, diabetes, obesity
42
classic bony enlargement
heberden node
43
aka osteoarthritis
degenerative joint disease; degenerative arthritis
44
tx osteoarthritis
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
45
infectious disease caused by Borrelia burgorferi transmitted through ticks
lyme disease
46
cause of lyme disease
Borrelia burgdorferi (US) or Borrelia afzeli (Europe) transmitted from tick
47
how is lyme disease diagnosed
pt history, physical exam, lab testing, positive test for lyme antibodies
48
tx lyme disease
removal of tick, oral antibiotics (doxycycline, amoxicillin, cefuroxime), IV antibiotics, antipyretics, bed rest, physical therapy, anti-inflammatory meds, hydroxychloroquine
49
inflammation of bursa
bursitis
50
cause of bursitis
continual or excessive friction, systemic diseases, trauma
51
how is bursitis diagnosed
pt history, physical exam, impaired ROM, acute pain, MRI, xrays show calcified deposits
52
tx bursitis
avoid activity, moist heat, immobilize joint,, aspirin/acetaminophen, NSAIds, local injection of corticosteroid, active ROM exercises, surgical excession
53
serious infection of bone
osteomyelitis
54
cause of osteomyelitis
staphylococcus aureus or streptococcal bacteria, bloodborne pathogen deposited from surgery or trauma
55
list risk factors for osteomyelitis
- diabetes mellitus
- peripheral vascular disease
- streptococcal pharyngitis in kids
- sickle cell disease
- prosthetic hardwar
56
how is osteomyelitis diagnosed
aspiration and culture of material from site of infection, blood culture, WBC, erythrocyte sedimentation rate, MRI, CT< bone scan
57
tx osteomyelitis
parenteral or local antibiotics (aqueous penicillin, cephalosporin, ampicillin), increased intake of proteins and vitamins A/B/B, bed rest, immobilization, surgical drainage, hyperbaric oxygen
58
chronic disorder of uric acid metabolism manifesting as acute and episodic form of arthritis
gout
59
cause of gout is
inherited abnormality of metabolism, deficiency of enzymes
60
how is gout diagnosed
microscopic exam of aspirated synocial joint fluid, serum uric acid test, xray
61
tx gout
bed rest, immobilize, joint, cold packs, NSAID (colchicine/Colcrys), corticosteroid, dietary medication, dairy products
62
aka paget disease
osteitis deformans
63
irregular breakdown and formation of bone tissue
paget disease aka osteitits reformans
64
what are the 2 stages of paget's disease
vascular and sclerotic
65
describe the vascular stage of paget disease
bone tissue broken down and spaces filled with blood vessels and fibrous tissue
66
describe the scleratic stage of paget disease
highly vascular fibrous tissue hardens and becomes simular to bone
67
what are the most common sites for paget disease
femur, spine, skull, clavicle, pelvis, tibia
68
list other complications of paget disease
- frequent fractures, spinal cord injuries, hypercalcemia, renal calculi, bone sarcoma
69
how is osteomyelitis diagnosed
physical exam and pt history, xray, bone scan, bone marrow biopsy, elevated serum concentration of alkaline phosphatase, elevated hydroxyproline concentration
70
group of inherited conditions featuring abnormal connective tissue with weakness of blood vessels and excessive length and flexibility of extremeties
margan syndrome
71
cause of marfan syndrome
autosomal dominant genetic disease
72
tx marfan syndrome
control excessive height w/hormones before puberty, preventing glaucoma, control blood pressure, prevent aortic dissection
73
how is marfan syndrome diagnosed
family history and physical exam
74
tx marfan syndrome
hormones before puberty, prevent glaucoma, control blood pressure, prevent aortic dissection
75
the general term of bone tumors include these types
chodnrogenic, osteogenic, fibrogenic
76
who is more likely to get bone cancer
men
77
these cancer types commonly metastasize to bone
breast, lung, prostate, kidney, thyroid
78
what is the most common primary bone cancer
osteoporosis
79
osteosarcoma most commonly occurs in the
distal femur
80
ewing sarcoma most commonly involves
pelvis and lower extremity
81
chondrosarcoma most commonly involve
pelvis and proximal femur
82
how is bone cancer diagnosed
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
tx bone cancer
surgical excision & bone graft
84
muscle tumors most commonly occur in these areas
buttocks, groin, extremities, head and neck, trunk, retroperitoneum
85
muscle sarcomas most commonly affect pts
older than 50 yrs of age
86
how are muscle tumors diagnosed
MRI
87
tx muscle tumor
surgical resection & chemotherapy
88
cause of osteoporosis
radiation, malabsorption, smoking, alcohol, calcium wasting nephropathy, immobility, chronic disease, lack of estrogen or testosterone, medications
89
what is the most common metabolic bone disease
osteoporosis
90
tx osteoporosis
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
cause of osteomalacia
deficiency or ineffective use of vitamin D, inadequate sunlight, intestinal malabsorption of vitamin D, chronic renal disease
92
aka osteomalacia
ricketts
93
how is osteomalacia diagnosed
blood test (serum calcium, serum alkaline phosphatase, vitamin D, ESR), radiographic studies, bone scan, bone biopsy
94
tx osteomalacia
- vitamin D supplements
- dietary vitamin D, calcium, and calcitonin
- exposure to sunlight
- tx underlying disorder
95
aka hallux valgus
bunion
96
localized area of enlargement of inner portion of first metatarsophalangeal joint at base of big toe
hallux valgus (bunion)
97
cause of hallux valgus
- great toe positioned toward midline
- rheumatoid arthritis
- flatfoot
- improperly fitted shoes/high heels
- familial
- profession (ballet)
98
how is hallux valgus diagnosed
physical exam, pt history, xray
99
tx hallux valgus
- wear shoes with roomy toe box
- wear shoes with lower heels
- pad toes
- analgesics
- surgery (bunionectomy & arthroplasty)
100
stiff big toe as a result of degeneration of cartilage of first metatarsalphalangeal joint
hallux rigidus
101
cause of hallux rigidus
injury, underlying arthritis, constant wear
102
how is hallux rigidus diagnosed
pain when continuous/walking, restriction of motion of great toe, straight hallux with enlarged and tender joint with limited dorsiflexion, xray
103
tx hallux rigidus
antiinflammatories, shoes with thick hard soles and low heels, surgery (cheilectomy), arthrodesis, arhtroplasty
104
toe bends upward like claw because of abnormal flexion of PIP joint and can occur in any of the four lesser toes
hammer toe
105
cause of hammer toe
shoes too short, pointed toe shoes, high heels, arthritis, injury
106
how is hammer toe diagnosed
pt history, physical exam, imaging
107
tx hammer toe
wear properly fitted shoes, splinting, physical therapy, arthroplasty, arthrodesis
108
fracture of distal head of radius and possibly involving ulnar styloid
colles fracture
109
cause of colles fracture
attempt to break fall
110
obvious displacement of bone of upper arm with shortening of extremity and abnormal mobility of upper arm
humerus fracture
111
complications of pelvic fracture
- lacerated colon, paralytic ileus, bladder & urethral injury, intrapelvic hemorrhage
112
tx pelvic fracture
bed rest, immobilization w/pelvis slin/skeletal traction, open reduction & repair
113
outward rotation and shortening of affect extremity generally happening in women older than 60 yrs bc of a fall
fractured hip
114
notable angulation deformity and shortening of affected leg and unable to move knee/hip caused by severe direct impact like MVA or severe trauma
fracture of femoral shaft
115
cause of tibia fracture
strong force on lower leg
116
cause of vertebral fracture in neck
acceleration-deceleration trauma
117
cause of thoracic/lumbar fracture
fall and landing directly on butt
118
fracture of floor of cranial vault gen bc of massive trauma to head like MVA
basilar skull fracture
119
bilateral horizontal fracture of maxilla gen when face forced against steering wheel
lefort
120
lower part of fibular fractured and lower tibial articulation sustain serious injury
pott fracture
121
cause of bone fractures
trauma, neoplasms, TB of bone, paget disease, osteoporosis
122
cause of strains and sprains
acute trauma or cumulative trauma
123
how is sprains and strains diagnosed
physical exam, pt history, xrays
124
tx sprains and strains
elevation, rest, cold packs, immobilization, analgesics, antiinflammatory, surgery
125
cause of joint dislocations
severe injury tearing joint ligaments or congenital weakness
126
shoulder severely limited in ROM bc of inflammation, scarring, thickening, and shrinkage of capsule surrounding shoulder
adhesive capsulitis (frozen shoulder)
127
cause of adhesive capsulitis
inflammation of capsule of joint w/secondary scarring from slight injury worsening over time
128
how is adhesive capsulitis diagnosed
pt history, xray, pt sx
129
tx adhesive capsulitis
PT/OT, analgesics, antiinflammatory, injection of steroid, shoulder manipulation
130
cause of severed tendon
injury or laceration
131
how is severed tendon diagnosed
physical exam, imaging
132
tx severed tendon
surgery (tenorrhaphy)
133
painful condition involving inflammation of periosteum and surrounding tissues
shin splints
134
cause of shin splints
overuse and overpronation
135
how is shin splints diagnosed
physical exam and pt history
136
tx shin splints
rest, ice or heat, aspirin, physical therapy, orthotic device, correct overpronation
137
aka plantar fasciitis
calcaneal spur
138
cause of plantar fasciitis
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
how is plantar fasciitis diagnosed
physical exam, pt history, xray
140
tx plantar fasciitis
rest, ice, anti-inflammatories, analgesics, heel pads, shoe with good arch support, local cortisone injection, taping foot, orthotics, PT, surgery
141
benign saclike swelling or cyst filled with colorless jelly-like fluid formed from tissue lining joint or tendon
ganglion
142
cause of ganglion
repetitive minor injury, arthritis, unknown
143
how is ganglion diagnosed
palpation and observation, needle aspiration
144
tx ganglion
rupture, needle aspiration, instillation of steroid, ganglionectomy, resolve on own
145
cause of torn meniscus
sudden twisting or external rotation of leg while knee is flexed
146
tx torn meniscus
immobilize, ice, antiinflammatories, analgesics, PT, surgery
