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PathoPharm Final Exam > Musculoskeletal Function > Flashcards

Musculoskeletal Function Flashcards

1
Q

Skeletal Trauma

A

Fractures and Dislocations

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2
Q

Support Structure Trauma

A

Sprains and strains
Tendinopathy and bursitis
Muscle strains

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3
Q

What is a Fracture

A

A break in the continuity of a bone

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4
Q

Classifications of bones

A

Complete, Incomplete, Open (compound), Closed (simple), Comminuted

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5
Q

What else can a fracture be classified under

A

Linear, oblique, spiral, transverse or greenstick

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6
Q

What is a pathologic fracture

A

Break at the site of a preexisting abnormality

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7
Q

What is a Stress fracture

A

Due to being subjected to repeated stress
EX. Athletics

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8
Q

What are the 2 types of stress fractures

A

Fatigue- abnormal stress
Insufficiency- lack normal ability to deform and recover

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9
Q

What is a transchondral fracture

A

Fragmentation and separation of portion of articular cartilage

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10
Q

What are the 2 parts of the body that can regenerate itself

A

Fractures (bones)
Liver

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11
Q

What are the steps in a fracture (4)

A
  1. Periosteum and blood vessels disrupted
  2. Bleeding from ends and neighbouring soft tissue
  3. Clot forms in medullary canal
  4. Adjacent bone tissue dies which stimulates intense inflammatory response
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12
Q

How long does it take for vascular tissue to invade the area which leads to blood flow to increase to the bone

A

48 hours

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13
Q

How is a fracture healed

A
  1. Bone forming cells activated to produce subperiosteal procallus along the bone shaft and over the break
  2. Osteoblasts synthesize collagen and matris to form a callus
  3. Remodelling occurs, tebeculae formed along lines of stress
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14
Q

Clinical manifestation of Fractures

A
  • Vary according to type of fracture, site and associated soft tissue damage
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15
Q

Signs and symptoms of fractures

A

Impaired function, unnatural alignment, swelling, muscle spasm, tenderness, pain and impaired sensation

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16
Q

What is the position of bone affected by

A

pull of attached muscles, gravity, direction and magnitude of fracture force

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17
Q

What is the immediate pain due to in a fracture

A

trauma

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18
Q

What is the secondary pain due to in a fracture

A

soft tissue or muscles

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19
Q

Treatment of fractures

A

Must realign bone fragments (reduction) (most done by closed reduction)
Traction to maintain reduction
External fixation used external frame of clamps
Open reduction- Surgery

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20
Q

What are the 2 types of traction

A

Skin or skeletal

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21
Q

What is a dislocation

A

A temporary displacement of 2 bones in which the bone surfaces lose contact entirely
Often accompany a fracture

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22
Q

What is a subluxation

A

The displacement of 2 bones in which the bone surfaces contact is only partially lost
Often accompany a fracture

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23
Q

What age are dislocations and subuxations most common

A

Below the age of 20

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23
Q

What bones are most common for dislocations & subluxations

A

Shoulder, elbow, wrist, finger, hip and knee

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24
Q

What often also occurs when a dislocation and subluxation is present

A

A fracture, bruised nerves, vessels, ligaments, supporting structure, soft tissues, pain, edema, limited motion and deformity

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25
Q

What is a ligament

A

A band of fibrous connective tissue that connects bones at a joint

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26
Q

What is a tendon

A

Tendon: fibrous connective tissue that attaches skeletal muscle to bone

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27
Q

What is a strain

A

A tear in a tendon

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28
Q

What is a sprain

A

A tear in a ligament

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29
Q

What happens when you injure a tendon or ligament

A

Inflammation develops between the torn ends, granulation tissues form containing macrophages, fibroblasts and capillary buds
Within 5 days, collagen forms

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30
Q

When can a tendon start to withstand pull

A

After 5 weeks but the entire process could take years to repair (longer than a break)

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31
Q

What is a rotator cuff tear

A

A tear through supporting tendons

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32
Q

Signs and symptoms of tendon and ligament tears

A

Pain, edema, changes in tendon or ligament contour, dislocation and subluxation of bones, tenderness

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33
Q

Where can bursas be found in the body

A

Can occur in the shoulder, elbow, hip or knee

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34
Q

What can be done for bursitis

A

Drainage or injection

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35
Q

What happens in a muscle tear

A

Muscle fibres are torn resulting in bleeding

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36
Q

Do fibres heal

A

No, other fibres compensate

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37
Q

What is primary osteoarthritis

A

Idiopathic: may be inherited (no known cause)

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38
Q

What is secondary osteoarthritis

A

Associated with joint stress, congenital abnormalities or joint instability caused by trauma

39
Q

What is osteoarthritis

A

Erosion of articular cartilage

40
Q

What is subchondral sclerosis

A

Thickening and hardening of bone underneath cartilage

40
Q

What are osteophytes

A

Formation of bone spurs

41
Q

What makes osteoarthritis worse

A

aging

42
Q

Where does osteoarthritis affect the most

A

Hands, wrists, neck, lower back, hip, knees, ankles and feet

43
Q

What can osteoarthritis be associated with

A

Trauma, long term stress, inflammation, joint instability, neurological disorders, congenital, hemtological disorders, congenital, hematologic or endocrine, drugs
(all accelerate cartilage loss)

44
Q

What happens to cartilage in osteoarthritis

A

Cartilage turns yellow, brownish, surface areas flake off, becomes thin or absent, bone becomes unprotected (sclerotic), cartilage coated osteophytes can grow outwards, joint capsules become thickened

45
Q

What happens when spurs break off with osteoarthritis

A

Irritate synovial membrane

46
Q

Clinical manifestations of osteoarthritis

A

Occurs in 50s or 60 year olds, pain and stiffness in one or more joints, aggravated by weight bearing and relieved by rest, nocturnal pain not relieved by resting

47
Q

What could pain be caused by in osteoarthritis

A

articular distention

48
Q

What is articular distention

A

Stretching of joint capsule or fibrous shrinking irritated by movement

49
Q

What could cause joint effusion be caused by

A

osteophyte fragments in synovial cavity, drainage of cysts from diseased subchondral bone or acute trauma to joint structures

50
Q

What is joint effusion

A

Why could there be inflammation exudate or blood in the synovial cavity

51
Q

What can happen in osteoarthritis

A

Limited range of motion, crepitus (grating or creaking), changes in ambulation, affected joint more symptomatic after use

52
Q

How is osteoarthritis diagnosed

A

Through clinical assessment, X-ray, CT scan, MRI

53
Q

What is the conservative treatment of osteoarthritis

A

Rest, ROM exercises, use of aids, weight loss, analgesic and inflammatory drugs

54
Q

Treatments for osteoarthritis

A

Conservative treatment
Surgical treatment

55
Q

What is rheumatoid arthritis

A

Autoimmune disease, chronic inflammation of connective tissue, affects synovial membrane by lining the joint cavity, inflammation spread to other tissues, causes pain, joint deformity and loss of function

56
Q

What are the most affected rheumatoid arthritis joints

A

Fingers, feet, wrists, elbows, ankles, knees
May affect lungs, heart, kidneys, skin

57
Q

What group does Rheumatoid Arthritis most often affect

A

Women
*lessens during pregnancy but exacerbated during postpartum
*increases with age

58
Q

What happens in Rheumatoid Arthritis

A

Autoantibodies attack host tissue (are called rheumatoid factors)

59
Q

What obscures Rheumatoid Arthritis

A

Genetics, environmental factors, hormonal factors, reproductive system

60
Q

Signs and symptoms from Rheumatoid Arthritis

A

Stiff, tender and painful joints, Morning stiffness that last more than 1 hour
Progresses from smaller joints to weight bearing joints
Joint swelling that is widespread and symmetric
Joint deformities, loss of joint motion, contractures, muscle atrophy, Rheumatoid nodules found in areas of pressure or trauma,

61
Q

What are Rheumatoid nodules

A

Swellings
aggregates of inflammatory cells and are usually in the elbows and fingers, scalp, back, hands and feet
*Can be found in the skin, heart, lungs and spleen

62
Q

What is the diagnosis for Rheumatoid Arthritis

A

Diagnosis on PE, x-ray, blood tests

63
Q

What is the treatment for Rheumatoid Arthritis

A

Conservative: rest of joint and body, heat and cold, physical therapy, hi calorie and vitamin rich diet
Drugs: corticosteroids, anti-inflammatory, immunosuppressants
Surgery: decrease inflammatory effusion and remove pannus, fix deformity or replace joint

64
Q

What is ankylosing Spindylitis

A

Chronic inflammatory joint disease characterized by fusion of spine and sacroiliac joints

65
Q

Who is more susceptible to getting Ankylosing Spondylitis

A

3:1 male to female ratio

65
Q

What is the most known symptom of Ankylosing Spondylitis

A

Bamboo spine

65
Q

What is Gout

A

Excess uric acid in blood that causes precipitation of urate crystals in joints

66
Q

How is Gout treated

A

NSAID’s, Allopurinol and water

67
Q

What is a contracture

A

Shortening of muscles
Can be physiological or pathological

68
Q

What is a Physiological contracture

A

Occurs in the absence of muscle action potential

69
Q

What is Pathological contractures

A

May be a response to pain or secondary to scar formation (burns)

70
Q

What is the diagnosis and treatment for physiological contractures

A

Failure of calcium pump in presence of ATP- temporary if underlying pathology reversed

71
Q

What is Osteomyelitis

A

Infectious bone disease caused by bacteria, viruses, fungi or parasites

72
Q

Why is Osteomyelitis hard to treat

A

Bone contains multiple channels that encourage proliferation of infectious cells (natural defenses do not penetrate), Tiny vessels (easy damaged and obstructed easily), bone cells destroyed by infection are not easily replaced

73
Q

How is Osteomyelitis categorized

A

By pathogen

74
Q

What is Exogenous osteomyelitis

A

Infection from the outside of the body- spread from soft tissues to bone

75
Q

What is endogenous osteomyelitis

A

Infection carried in blood from other sites within the body- spreads from bone to soft tissue

76
Q

What are special characteristics of endogenous osteomyelitis (3)

A
  • Most often caused by staph aureus
  • Most commonly from subcutanous, sinus, ear or dental infection
  • Spine, pelvis and small bones most often affected
77
Q

What are special characteristics of Exogenous osteomyelitis (3)

A
  • often caused by shallow human bites or fist blows to the mouth
  • most common pathogen is staph aureus
  • direct contamination with bone can occur with fractures, surgery with implants, or IV sites of drug users
78
Q

Diagnosis and treatment of osteomyelitis

A
  • elevated WBC
    -Bone scan very sensitive
  • CT, MRI
  • IV antibiotics
  • If chronic use surgical debridement
  • Hyperbaric O2 therapy
79
Q

What is Osteoporosis

A

Reduced bone mass or density

80
Q

What is a BMD of a patient with osteoporosis

A

BMD of -2.5 SD
Severe osteoporosis is below -2.5 SD

81
Q

When is peak bone mass acheived

A

mid 20s

82
Q

What are the symptoms of Osteoporosis

A

Back pain, kyphosis, height loss, improper fit of clothing, protruding abdomen, negative body image

83
Q

Risk factors for osteoporosis

A

Smoking, lack of physical activity, excess alcohol consumption, low calcium and vitamin D, thinness, genetics, premature menopause

84
Q

Main factors for those at risk of osteoporosis

A

BMD, fracture history, age, family history

85
Q

Clinical manifestations of osteoporosis

A

Dependant on bones involved, pain, fractures, bone deformity

86
Q

What is bone generation directly related to

A

Physical activity, calcium intake, vitamin D, hormone levels

87
Q

Secondary treatment of osteoporosis

A

HRT- estrogen allows for bone to absord
Calcitonin- acts as an anti-resorptive agent
Bisphosphonates- effects osteoclasts

88
Q

What is the acronym for treatment of osteoporosis

A

C- calcium
D- Vitamin D
E- exercise
F- prevent falls
G- gain weight
S- stop smoking

89
Q

what medication should a patient with osteoporosis go on

A

statins- lovostatin
significantly increases bone growth

90
Q

Osteoporosis diagnosis

A

Bone mineral density test, x-ray, ct scan, serum test (calcium, phosphorus, alkaline phosphatase

91
Q

What is the treatment for osteoporosis

A

prevent bone loss with vitamin supplements of Ca and vit D, fracture prevention, weight bearing exercises

92
Q

Who should have the bone mineral density test done

A

women over 65, people who are under 65 and have 1 major symptom or 2 minor symptoms

93
Q

What are the different kinds of bone tumors

A

Fibroblasts (osteoblasts, chondroblasts and fibroblasts)
Reticulum (blood cell precursors)

PathoPharm Final Exam (11 decks)

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