Musculoskeletal System Flashcards
How do fractures naturally heal immediately (blood vessels) ?
- blood vessels cause haematoma which fills the fracture gap
- provides a fibrin meshwork to allow formation of granulation tissue
How do fractures heal naturally?
- inflammatory cells release cytokines to activate osteoblast and osteoclast
- development of cartilage cap (1 week)
- bone deposition begins to strengthen callous
What may hinder fracture healing?
- bones not aligned
- area not immobilised
- if fracture site contains dead bone
- infection
What is osteoporosis when looking at the bones?
- decrease in bone mass and density
- can lead to fractures
What are the hormonal influences of osteoporosis?
- lack of oestogen (increases bone resorption and deceases bone formation)
- calcium metabolism and vitamin D deficiency
- certain drugs
What is the drug of choice in treating osteoporosis?
- alendronic acid
What is arthritis and its characteristics?
- inflammation of the joints
- pain, swelling, stiffness, warmth and redness in joint
- restricted movement
- can get bone thickening or outgrowth (osteophytes)
What are the risk factors in osteoarthritis (progressive deterioration in weight bearing joints) ?
- increasing age
- female sex, menopause
- obesity
- pre-existing joint deformity
- excess mechanical stress
- family history / genetics
- hypermobility
- other diseases
What are the features of osteoarthritis?
- morning stiffness
- pain worse with movement
- reduced range of movement
- progressive reduction in mobility
- joint effusions (fluid in the joints)
- crepitus (sounds like crackles )
Rheumatoid arthritis is an auto immune disorder. What happens in in it?
rheumatoid factors help to form immune complexes in the circulation
- generates inflammation in synovium
- membranes thicken
- chronic inflammation leads to cartilage and joint destruction
- other tissues can be involved eg. lungs and vessels
What are the features of rheumatoid arthritis?
- usually affects small joints of hands and feet
- pain
- swelling and deformities (swan neck deformities)
- fever, fatigue, generalised pain
- joints often stiff without prior activity
How is rheumatoid arthritis diagnosed?
- morning stiffness that last over an hour
- effects 3 or more joints
- arthritis typical of hand joints
- symmetric arthritis
- rheumatoid nodules
- serum rheumatoid factor
- typical radiographic changes
- must have 4 of these
Crystal arthropathies are associated with intra-articular crystals. What are two examples of this?
- gout
- pseudogout
- crystals in the joint space
What can cause gout?
- drugs (aspirin, diuretics)
- alcohol
- renal disease
- hypothyroidism
- dehydration
What happens in gout?
- raised uric acid (produced by breakdown of xanthine oxidase) - usually excreted by kidneys
- deposits as crystals in the joint
- repeated attacks lead to chronic arthritis
What is the difference between what is deposited in the joints in gout and pseudogout?
gout - uric acid
pseudogout - calcium pyrophosphate
What are the features of gout?
- sudden onset excruciating burning joint pain
- redness, warmth, tenderness, stiffness
- usually first attack involved big toe
- subsequent stacks are less severe
Where does psuedogout usually appear?
knees and ankles
What can happen with the crystals in psuedogout?
crystals in cartilage can enlarge and rupture
- shows symptoms of arthritis
What are the causes of pseudogout?
- can be hereditary
- associated with osteoarthritis
- trauma or surgery
- more common with increasing age
What is septic arthritis?
inflammation of the joint caused by bacterial infection
Where does septic arthritis usually affect?
the knee
What does septic arthritis cause/symptoms
- severe pain, swelling, redness and heat in affected joint
- difficulty moving joint
- tends to develop quickly over a few hours or days
- Some people have high temp
- can cause sepsis which can case death
How do you treat septic arthritis?
- iv antibiotics
- may require washout of the joint
- can cause sepsis! serious !
What is osteomyelitis?
- bone infection usually caused by bacteria
What causes osteomyelitis?
- trauma
- surgery
- presence of foreign bodies
- diabetics at increased risk
How does osteomyelitis spread?
haematogenous spread
- so can develop sepsis
The most common bone tumour is from metastatic disease. where is it from normally?
prostate
kidney
breast
What are the three types of muscle?
- striated (skeletal)
- smooth
- cardiac
What is striated muscle involved in?
involved in voluntary movement eg. biceps, legs
What is smooth muscle involved in?
involuntary actions eg. bowel peristalsis
controlled by autonomic nervous system
What can go wrong in the skeletal muscles ?
muscular dystrophies
neuromuscular disorders
What can go wrong in smooth muscles?
leiomyomas
