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Pathophysiology Exam II > Musculoskeletal and Cardiac Alterations > Flashcards

Musculoskeletal and Cardiac Alterations Flashcards

1
Q

Two systems

A
  • skeleton bones and joints
  • skeletal muscles – soft tissue, tendon, ligaments
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2
Q

functions of the skeletal system

A
  • forms the body
  • supports tissue
  • permits movement
  • protects vital organs
  • blood cell formation
  • mineral storage
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3
Q

Elements of bone tissue

A
  • rigid connective
  • constituents
  • cells
  • fibers
  • ground substances
  • calcium
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4
Q

osteoblasts

A
  • bone forming cells
  • from stem cells
  • type I collagen
  • responds to PTH
  • produces osteocalcin stimulated by vitamin D
  • active on outer layer of bone
  • bone is shaped by function
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5
Q

osteoclasts

A
  • resorptive cells
  • clears out damaged cells
  • ruffled border increases surface area to bind to bone surface
  • when resorption is complete, retract and loosen through action of calcitonin
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6
Q

osteocytes

A
  • osteoblast that is surrounded in osteoid as it hardens from deposited minerals
  • function is not known, but they are abundant, concentrate nutrients in bone matrix, obtain nutrients from capillaries, determine bone structures
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7
Q

collagen fibers

A
  • proteoglycans = strengthens bones, plays a role in calcium deposition and calcification
  • glycoproteins = control collagen interactions that lead to fibril formation
  • bone minerals = formation of initial mineral deposit, proliferation of mineral crystals on initial mineral deposits (calcium and phosphate)
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8
Q

Bone types

A
  • compact bone (hard bone) = highly organized, solid strong, structural unit is Haversian system
  • spongy bone (soft bone) = less complex, lacks Haversian system
    1. lamellae = where bone marrow lies
    2. periosteum = attaches ligament
  • these bones have the same structure, just different organization
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9
Q

Bone remodeling

A
  • activation = hormone, drug, vitamin, or stressor activates basic multicellular units
  • resorption = osteoclasts leaves behind resorption cavity
  • formation = new bone formed by osteoblasts lining the walls of the resorption cavity, termed secondary bone
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10
Q

Complete fracture

A

break is across entire width of bone, bone divided sections

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11
Q

Incomplete fracture

A

bone is damaged, but remains in one piece, break is through only one part of the bone

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12
Q

closed (simple) fracture

A

fracture does not extend through the skin

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13
Q

open (compound) fracture

A

fracture does result in a break of the skin – external wound

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14
Q

oblique fracture

A

diagonal to shaft to bone

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15
Q

spiral fracture

A

encircles bone

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16
Q

transverse fracture

A

across the bone

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17
Q

causes of fracture

A

at pre-existing abnormality or stress

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18
Q

pathophysiology of fracture

A

force applied to bone, disruption of periosteum, marrow and surrounding tissue, bleeding occurs, bone necrosis, inflammatory response

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19
Q

manifestations of fracture

A

deformity, numbness, flaccidity or spasm, pain, ecchymosis, swelling, loss of function, crepitus or crackling, visible bleeding

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20
Q

stages of bone healing

A
  • hematoma
  • procallus formation
  • callus formation
  • callus replacement
  • bone remodeling
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21
Q

osteoporosis

A
  • porous bone, bone mass decreased
  • spongy bone becomes less thick and viscous, compact bone more porous
  • decreased quantity and quality of bone
  • fractures = vertebrae, distal radius, ribs, long bones, neck of femur
  • clinical manifestations = pain, deformity, hunch, shortened height, psychosocial effect
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21
Q

osteoporosis

A
  • porous bone, bone mass decreased
  • spongy bone becomes less thick and viscous, compact bone more porous
  • decreased quantity and quality of bone
  • fractures = vertebrae, distal radius, ribs, long bones, neck of femur
  • clinical manifestations = pain, deformity, hunch, shortened height, psychosocial effect
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22
Q

pathophysiology of osteoporosis

A
  • bone remodeling cycle is altered
  • decreased osteoblasts, increased osteoclasts
  • bone remodeling is prolonged
  • decreased bone density and quality
23
Q

Osteomyelitis

A
  • infectious bone disease
  • caused by bacteria
  • exogenous = entered from outside the body and spreads from soft tissue to bone
  • endogenous = occurs from within body, blood to infected area, bone to soft tissue
  • acute = fever, swelling, tenderness, redness, bone pain
  • chronic = low grade fever, malaise, anorexia, weight loss, localized pain, skin ulceration, drainage
24
Q

pathophysiology of osteomyelitis

A
  • initial infection
  • inflammatory response
  • abscess formation
  • ischemia
  • necrosis
  • sequestrum
  • involucrum
  • systemic infection
25
Q

osteoarthritis

A
  • degeneration of joint cartilage and hypertrophy of bone, wear and tear
  • primary effects = hips, knees, vertebral column, hands
  • primary (idiopathic) or secondary (stress, congenital musculoskeletal abnormalities, damage)
  • manifestations = pain, stiffness, joint enlargement and deformity, limited ROM, crepitus with movement
26
Q

pathophysiology of osteoarthritis

A
  • erosion of the articular cartilage
  • formation of bone spurs
  • sclerosis of bone beneath cartilage
27
Q

arthritis

A

inflammatory damage or destruction in the synovial membrane or articular cartilage

28
Q

rheumatoid arthritis

A
  • systemic inflammatory autoimmune disease associated with swelling and pain in multiple joints
  • primarily affects synovial joints
  • causes is unknown, most likely a combination of genetics interacting with inflammatory mediators
29
Q

Gout

A
  • caused by defects in uric acid metabolism which disrupts the body’s control of uric acid production or excretion
  • uric acid crystallizes and deposits in connective tissue
  • gouty arthritis when crystals occur in synovial fluid
30
Q

Fibromyalgia

A
  • chronic syndrome with diffuse pain, fatigue, and tender point
  • often vague symptoms
31
Q

Rhabdomyolysis

A
  • breakdown of muscle tissue releasing myoglobin, which damages the kidneys
  • can be life threatening complication of severe muscle trauma or secondary to malignant hyperthermia
  • crush syndrome – most severe
  • compartment syndrome – less severe forms which are localized
32
Q

varicose veins

A
  • blood has pooled in the vein
  • distended, tortuous and palpable veins
  • caused by trauma, valve damage, gradual vein distention
  • risk factors = age, family history, gender, obesity, injury, standing, crossing legs, restrictive clothing
33
Q

chronic venous insufficiency

A
  • dark brown color in lower extremities
  • inadequate venous return
  • results in fibrosclerotic remodeling of skin and possible ulceration – venous stasis ulcers
34
Q

Deep vein thrombosis

A
  • thrombus = blood clot attached to vessel wall
  • thrombus embolus = blood clots becomes unattached from vessel wall
  • virchow’s triad = venous stasis, venous endothelial damage, hypercoagulable states
35
Q

Superior vena cava syndrome

A
  • progressive occlusion of the superior vena cava that leads to distention of upper extremities and head
  • causes = cancer, pacemaker implantation, pleural effusion, CVC
36
Q

Classifications of HTN

A
  • normal = 120/80
  • pre-hypertension = 120-129/<80
  • stage 1 = 130-139/80-89
  • stage 2 = <140/90 `
37
Q

Blood Pressure

A

Cardiac output x stroke volume

38
Q

cardiac output

A

stroke volume x heart rate

39
Q

Factors for cardiac

A
  • SNS
  • RAAS
  • Baroreceptors
  • Natriuretic peptides
  • inflammation, endothelial damage
  • insulin resistance
40
Q

angiotensin II

A
  • promote vascular remodeling
  • promotes accelerates atherosclerosis – stimulates smooth muscle proliferation
  • results in permanent increase in peripheral resistance
41
Q

ADH

A
  • released from hypothalamus in response to decreased BP and increased plasma osmolality
  • vasoconstricting effect
  • prevents excretion of water by kidneys
42
Q

natriuretic peptides

A
  • from atrium
  • released in response to increased volume
  • decreased BP and increases urine output
43
Q

Aneurysms

A
  • local dilation or outpouching of a vessel wall or cardiac chamber
  • aorta is the most common location
  • true aneurysms = involve three layers of arterial wall
  • false aneurysms = dissecting saccular aneurysms
44
Q

Causes of Aneurysms

A
  • trauma/stress
  • atherosclerosis
  • infection
  • congenital defects
  • smoking
  • age
45
Q

Manifestations of aneurysms

A
  • asymptomatic until they rupture
  • dysphagia
  • breathlessness
  • fullness
  • chest or back pain
  • aortic regurgitation
  • shortness of breath
  • heart failure
46
Q

Thromboangitis Obliterans

A
  • in young men who smoke
  • inflammatory disease of peripheral arteries resulting in the formation of nonatherosclerotic lesions
  • symptoms = slow, sluggish blood flow, pain, tenderness, hair loss, gangrenous lesions
47
Q

Raynaud’s disease

A
  • episodic vasospasm in arteries and arterioles of the fingers, less commonly on the toes
  • secondary to other systemic diseases
48
Q

Arteriosclerosis

A
  • chronic disease of the arterial system
  • abnormal thickening and hardening of the vessel walls
  • smooth muscle cells and collagen fibers migrate to the tunica intima causing stiffness and thickening of arterial lumen
49
Q

Atherosclerosis

A
  • fat filled macrophages with the arterial wall harden over time
  • plaque development
  • risk factors = HTN, smoking, diabetes, hyperlipidemia, decreased HDL, hyperhomocysteinemia
50
Q

Peripheral artery disease

A
  • arteriosclerotic disease of arteries that perfuse limbs – lower extremities
  • ischemia can be acute or gradual
  • intermittent claudication – occlusion
  • loss of blood flow – emergency
51
Q

Coronary artery disease

A
  • any vascular disorder that narrows or occludes the coronary arteries
  • atherosclerosis is the most common cause
  • risk factors = dyslipidemia, HTN, smoking, diabetes, obesity, sedentary lifestyle
52
Q

myocardial ischemia

A
  • local, temporary deprivation of the coronary blood supply
  • stable angina
  • prinzmetal angina
  • silent ischemia
53
Q

stable angina

A
  • pain caused by intermittent myocardial ischemia – lack of oxygen to heart muscle
  • resolved with rest
  • no cellular death if blood flow is resolved
  • pain d/t decreased O2 and increased lactic acid or abnormal stretching of myocardium that irritates myocardial nerve fibers
  • patient has heaviness, pressure, pallor, diaphoresis, dyspnea
54
Q

Unstable angina

A
  • attacks increase in frequency and duration
  • still reversible
  • pain can differ, unpredictable
  • reversible myocardial ischemia – plaque has become complicated, transient episode of thrombolytic vessel occlusion and vasoconstriction
55
Q

Prinzmetal’s Angina

A
  • unpredictable
  • angina attributable ischemia of entire thickness of myocardium
  • pain caused by vasospasm
  • hyperactivity of SNS
  • pain usually occurs at rest
  • woken up with pain
56
Q

Infective endocardium

A
  • inflammation of endocardium
  • agents = bacteria, virus, fungi, parasites
  • pathogenesis = damaged endocardium, blood borne microorganism adherence, proliferation of the microorganism
  • manifestations = fever, new or changed cardiac murmur, petechial lesions of skin, conjunctiva, oral mucosa

Pathophysiology Exam II (3 decks)

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