Musculoskeletal changes Flashcards
Musculoskeletal system Changes
- Changes in Bone Structure
- Changes in Cartilage Structure
- Deterioration of The Intervertebral Disk Structure
- Problems in Tendons and Ligaments
- Changes in Muscle Structure
Main structure of cartilage consist of
water
collagen
proteoglycans
chondrocytes
what component of cartilage important in resisting mechanical force
collagen network
types of cartilage
Fibrous
hyaline
elastic
Elastic cartilage
external ear
epiglottis
auditory tube
hyaline cartilage
between tip of the rib and bone of sternum
bone surface of synovial joint
supporting larynx
trachea and bronchi
part of nasal septum
fibrous cartilage
Pads within knee joint
between pubic bones of pelvis
intervertebral disc
1st cartilage change stage
doubtful
minimum disruption
about 10% cartilage loss
2nd stage cartilage changes
mild
joint space narrowing
cartilage begin to break down
occurrence of osteophytes
3rd stage of cartilage changes
moderate joint spaces reduction
gaps in cartilage can expand until they reach the bone
4th stage of cartilage changes
joint space greatly reduced
severe
large osteophytes
60% of cartilage loss
changes in intervertebral disc
reduction of water in nucleus pulp which makes it more fibrotic and creates cracks
types of intervertebral degeneration
type 1 to 6
type 1
normal end plate with no interaction
no Modric changes
health
type 2
thinning of endplate, no obvious break
no mordic changes
aging
type 3
-focal endplate defect with established disc marrow contact but with maintained endplate contour
-no mordic changes
-aging
type 4
- endplate defects 25% of endplate area
-associated with mordic changes
-degenerative
type 5
-endplate defect up to 50%
type 6
extensive damage endplate up to total distruction
changes in bones
decreased bone density
increased bone remodelization
mechanisms of bone loss
menopausal bone loss [rapid]
senile mechanism [40 to 50 age ]
menopausal bone loss
due to sudden loss of sex hormones
marrow adipose tissue or bone marrow adipose tissue
type of fat deposit in the marrow
it increases in state of low bone density
osteoporosis
a skeletal disorder with compromised bone strength as determined by bone density and bone quality.
modifiable risk factors for osteoporosis
smoking
inadequate calcium intake
inadequate vitamin D
low body weight
estrogen deficiency
Nonmodifiable risk factors for osteoporosis
female
age
low peak bone mass
ethnicity [ white/Asian]
low BMI
family history
osteopenia
low bone density
exercises to avoid with osteoporosis
high impact exercise
excessive bending
twisting activities
certain pilates or yoga moves
low impacts weight bearing exercises
sit to stand
squat
walking
toe raises
low impacts aerobics
tendons and ligaments changes
calcification
small tearing
increased fibrovascular proliferation
increased formations of cross links
loss of elastic fibers which increase joint stiffness
muscle changes
slowing of mvmnts
muscle weakness
loss of muscle power
early muscle fatigue
neurogenic factors for muscle changes
muscle atrophy
change in neuromuscular compounds
incomplete reinnervation
decrease in number and size of fibers
myogenic factors for muscle changes
- Trauma caused by contraction
- Decrease in muscle renewal capacity with age,
- Depending on an increase in mechanical weakness
sarcopeny
decreased in the mass of skeletal muscle which can start to be observed in the third decade of life
what factor contribute to loss of muscle mass with age
reduction in the numbers of both type I and type II muscle fibers and a decline in cross-sectional area of type II fibers, the cross-sectional area of type I fibers seems to be well maintained.
sarcopenia
decreased in muscle mass and function
causes of sarcopenia
*Cellular changes
*PIA
*Endocrine factors
*Denervation of muscle fibers
*Predisposing genetic factors
*Nutrition and metabolism
*Muscle protein degradation
*Inflammation
Primary sarcopenia
age related
secondary sarcopenia
activity related
disease related
nutrition related
stages of sarcopenia
Pre sarcopenia
sacrcopenia
severe sarcopenia
Pre sarcopenia
decrease muscle mass
sarcopenia
decreased muscle mass with decreased strength or performance
severe sarcopenia
decreased muscle mass with decreased strength and performance
test for sarcopenia
Measure gait speed
Measure grip strength
Measure muscle mass
Balance test
side by site
semi tandem stand
tandem stand
gait speed test
measure the time required to walk 4meters at normal pace
