Musculoskeletal System

Question 1

Explain fractures

Answer 1

As a result of trauma.
Can occur in healthy bone or in a bone that is diseased- e.g. deposit of cancer in the bone.
Treat with realigning the bone.

Question 2

Explain fracture healing.

Answer 2

Straight after fracture, rupture of the book vessels causes haematoma which fills the fracture gap.
This provides a fibrin meshwork to allow the formation of granulation tissue.
Carilage caps forms and bone deposition strengthens callous.

Question 3

What are the obstacles of fracture healing?

Answer 3

If bones are not aligned.
If areas not immobilised.
If fracture site contains dead bone.
Infection.

Question 4

Explain osteoporosis

Answer 4

A decrease in bone mass and density that can lead to fractures.
Imbalance between bone reabsorption and bone production.

Question 5

What causes osteoporosis?

Answer 5

Hormal influences- lack of oestrogen (e.g in post menopausal women) causes an increase in bone reabsorption and decreases new bone formation.
Calcium metabolism and vit D deficiency can hinder bone formation.
Oral steroids.

Question 6

Explain osteoarthritis

Answer 6

Most common form of arthritis that is associated with age and obesity.

Question 7

What are the risk factors of osteoarthritis?

Answer 7

Age, female sex (menopause), obesity, joint deformity, mechanical stress, genetics and hyper mobility.

Question 8

What are the features of osteoarthritis?

Answer 8

Morning stiffness
Pain- worse on movement. 
Reduced range of movement
Joint effusions
Crepitus.
Herberden's node and Bouchard's node (lumps in fingers)

Question 9

Explain rheumatoid arthritis.

Answer 9

Usually affects small joints in hands and feet.
Painful swelling and deformity.
Causes fever, fatigue and pain.
Joints stiff without prior activity.
Swan neck diformity and boutonniere deformity.

Question 10

Explain the diagnosis for RA.

Answer 10

Morning stiffness that lasts more than an hour. 
Arthritis in 3 or more joints. 
Arthritis typical of hand joints.
Symmetric arthritis. 
Rheumatoid nodules.
Serum rheumatoid factor. 
Typical radiographic changes.

Question 11

Explain gout.

Answer 11

Caused by raised uric acid and is produced by the breakdown of purine bases.
Usually excreted in the kidneys. Urate is deposited as crystals in the joints.
Repeated attacks of gout causes chronic arthritis.

Question 12

What causes gout?

Answer 12

Drugs (aspirin and diuretics)
Alcohol
Renal disease
Hypothyroidism
Dehydration

Question 13

What are the features of gout?

Answer 13

Sudden onset of burning joint pain.
Redness, warmth, tenderness, stiffness.
First attack is usually in big toe.
Subsequent attacks are less severe.

Question 14

What is pseudo gout?

Answer 14

Precipitation of calcium pyrophosphate crystals in connective tissue.
Usually in knees and ankles.

Question 15

What causes pseudo gout

Answer 15

Can be hereditary
Associated with osteoarthritis
Trauma or surgery
More common with increasing age.

Question 16

What causes septic arthritis?

Answer 16

Inflamed joint caused by bacterial infection.
Commonly affects the knee
Causes severe pain, swelling, redness, heat and fever.
Symptoms can develop quickly over a few hours.

Question 17

What is osteomyelitis?

Answer 17

Bone infection usually caused by bacteria.
Caused by trauma, surgery or presence of foreign bodies.
Diabetics at increased risk
Haematogenous spread.

Question 18

Explain bone tumours

Answer 18

Metastatic disease from a distant cancer.

Primary bone tumours are rare however benign- osteoid osteoma and malignant osteoid sarcoma.

Question 19

Name skeletal muscle disorders

Answer 19

Muscluar dystrophies and neuromuscluar disorders

Question 20

Name a smooth muscle disorder.

Answer 20

Leiomyomas.