Musculoskeletal Flashcards
Ankylosing spondylitis
-Hereditary, chronic inflammatory disease. May affect cervical, thoracic, and lumbar spine and will also involve the sacroiliac joints
Patho: inflamed intravertebral disc‘s and longitudinal ligaments ossify leads to eventual fusion and severe deformity of the vertebral column
Subjective: men between 20 and 40 years old. Begins with low back and buttock pain, also involving hips and shoulders. Buttock pain can fluctuate from one side to the other
Objective: restriction in the lumbar flexion of the patient. Limited range of motion of the shoulders, chest wall, hips, and needs me to fill up. Uveitis present
Lumbosacral ridiculopathy (herniated lumbar disc)
-Herniation of the lumbar disc that irritates the corresponding spinal nerve root
Patho: Degenerative changes in the desk. Most common and L4, L5, and S1 nerve root. Usually between 31 and 50 years old
Subjective: can’t be associated with lifting heavy objects. Low back pain with radiation to the buttocks and posterior thigh or down the leg in the distribution of the dermatome of the nerve root. Pain relief is achieved by lying down
Objective: Spasm and tenderness over the paraspinal muscular chart maybe present. Potential difficulty with heel walking (L4 and L5.) And toe walking (S1). Numbness, tingling, or weakness in the involve extremity.
Lumbar stenosis
-Narrowing of the spinal canal
Patho: Narrowing from bone and ligament hypertrophy may lead to entrapment of the spinal cord
Subjective: Pain with walking or standing upright that often seems to originate in the buttocks and then may radiate down the legs. Relief with sitting or bending forward. Worsened by prolonged standing, walking, or hyperextending back
Objective: In early stages, normal exam. With progression, may have lower extremity weakness and sensory loss
Carpal tunnel syndrome
-Compression of the median nerve
Patho: Compression of the nerve with its flexor tendon sheath due to microtrauma, local Adema, repetitive motion, or vibration of the hands.
Subjective: Numbness, burning, and tingling in the hands often occur at night. Can also be elicited by rotational movements of the rest. Pain may radiate to the arms
Objective: Weakness of the farm and flattening of the evidence of the palm. Reproduction of symptoms with provocation of Tinel and Phalen maneuvers.
Gout
-A form of arthritis. A disorder of purine metabolism that results from elevated serum uric acid level
Patho: Monosodium urate crystals deposition and joints and surrounding tissues results and acute inflammatory attacks
Subjective: Set an onset of hot, swollen joint. Exquisite pain, limited range of motion. Affects men older than 40 years in women in a post menopausal age. I faxed proximal phalanx of the great toe, all of the wrist, hands, ankles and knees may be involved.
Objective: skin over the swollen joint maybe shining in red or purple. Uric acid crystals may form as tophi under the skin with chronic gout.
TMJ
-Painful jaw movement
Patho: Caused by congenital anomalies, malocclusion, trauma, arthritis, and other joint diseases
Subjective: Unilateral facial pain that usually worsens with jock movement. Maybe referred to any point on the face or neck.
Objective: most patients have a muscle spasm, and may have clicking, popping, or crepitus in the affected joint
Osteomyelitis
-Infection in the bone
Patho: Usually results from an open wound or systemic infection. Pieriel it matter spreads to the cortex of the bone into the soft tissue. May lead to necrosis.
Subjective: Dull pain develops insidiously at the involve the site and progresses over days two weeks.
Objective: Signs of infection include Adema, erythema, and warmth of the site. Tenderness to palpation, pain with movement, and signs of inflammation such as fevers
Bursitis
-Inflammation of the bursa
Patho: Due to repetitive movement and excessive pressure on the bursa. Can also be due to infection or gout
Subjective: Common sites are shoulder, elbow, hip, Anthony, with pain and stiffness surrounding joint around the inflamed bursa. Pain worse with activity.
Objective: Limitation of motion caused by swelling. Pain on movement. Point tenderness. Erythematous warm site.
Paget disease of the bone (osteitis deformans)
-A focal metabolic disorder of the bone
Patho: Older than 45 years. Excess of bone resorb shin and bone formation produce a mosaic pattern of lamellar bone
Subjective: Bones of the skull are often affected, which can produce symptoms of vertigo and headache. Progressive deafness from involvement of the ossicles or neural elements may develop
Objective: Bowed tibias, miss shape in pelvis, or prominent skull four head may be evident. Frequent fractures
Osteoarthritis
-The deterioration of the articular cartilage covering the ends of the bone in synovial joints
Patho: Result of cartilage abrasion, padding, and thinning, the bone services are eventually exposed with the bone rubbing against bone. Bone spurs.
Subjective: Pain in hands, feet, hips, knees, and cervical or lumbar spine. And said usually after 40 years of age.
Objective: Enlarged joints due to bone growth. May have S and limited, painful range of motion
Rheumatoid arthritis
-Chronic systemic inflammatory disorder of the synovial tissue surrounding the joints
Patho: Unknown cause
Subjective: Joint and pain stiffness, especially in the morning or after. I’m in activity. Constitutional symptoms of fatigue, myalgias, weight loss, and low-grade fever common.
Objective: joints include the hands, wrists, feet, and ankles as well as hips, knees, and cervical spine. Synovitis with soft tissue swelling and effusions Is present on exam. Nodules and deformities can develop
Tenosynovitis (tendinitis)
- Inflammation of a synovium line to sheath around tendon
Patho: Repetitive actions associated with sports
Subjective: pain with movement such as common in shoulder, knee, heel, and wrist
Objective: . To tenderness over the involved tendon. Pain with active movement, and some limitation of movement in the affected joint
Rotator cuff tear
-Microtrauma and tearing of the rotator cuff muscles, most often the supraspinatus.
Patho: Usually from repeated overhead lifting and compression, or a cute tear from a fall on outstretched arm
Subjective: pain in the shoulder and deltoid area common. May awaken patient at night.
Objective: and ability to maintain a lateral raise arm against resistance. Tenderness over the acromioclavicular joint. Grating sound and movement, crepitus, and weakness and external shoulder rotation
Osteoporosis
-Disease in which a decreased bone mass occurs because bone resorption is more rapid than bone deposition.
Patho: Bones become fragile into susceptible to spontaneous fractures. Most commonly seen in postmenopausal women. Glucocorticoid access and hypogonadism are also risk factors
Subjective: Loss of height or in a cute, painful fracture. Most common factor sides her hip, vertebrae, and wrist.
Objective: Affect a persons lose height and have decreased abdominal thoracic space. In the spine, vertebral compression fractures lead to kyphosis or scoliosis
Dupuytren contracture
-Contractors involving the flexor hand tendons
Patho: Cause unknown
Subjective: Flexion contractures develop insidiously. Happens after age 40. More common in men.
Objective: Flexor tendons generally of the fourth and fifth digits contract, causing the fingers to curl, with impaired extension. Tendons on palm of hand are easily palpable
