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Diseases > Musculoskeletal System > Flashcards

Musculoskeletal System Flashcards

1
Q

fasciculation

A

muscle twitching

can be normal, but increased incidence can be associated w/ conditions like MND

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2
Q

MND

A

motor neurone disease is a condition where motor neurones progressively die, NSWhy

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3
Q

compartment syndrome

A

swelling/bleeding in compartment possible caused by trauma can exert pressure on blood vessels and nerves in that compartment

tiss damage caused by ischaemia

(if numbness/paralysis are developed, then it may be indicative of permanent tiss damage)

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4
Q

how can isotonic contractions cause problems in the body?

A

eccentric contractions, if sustained, can cause delayed onset muscle soreness (soreness that develops 1-3 days after exercising, NSWhy)

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5
Q

how can isometric contractions cause problems in the body?

A

produces a disproportionate increase in heart rate and mean arterial pressure for the muscle involved

this may be due reduced blood flow through the contracted muscle causing a build up of metabolites that stim nerve endings in muscle- Still NSExactly why though

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6
Q

hypotonia and causes

A

a lack of muscle tone

causes: 1) damage to motor cortex/cerebellum/spinal cord
2) degeneration of muscle fibres themselves eg myopathies
3) damage to sensory nerve afferents from spindle fibres
4) damage to motor neurones

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7
Q

polyneuritis

A

clin syndrome involving simultaneous impairment of function of many peripheral nerves incl. motor neurones

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8
Q

Tetanus

A

toxin from bacterium clostridium tetani->blocks inhibitory motor feedback control->unopposed muscle contraction

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9
Q

intermittent claudication

A

pain in leg caused by exercise and relieved by rest

this is due to ischaemia, normally from atherosclerosis, leading to depleted glycogen stores

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10
Q

GH joint dislocations

A

inferior direction, normally anteriorly as it comes to rest underneath coracoid process

caused by extreme rotation making head of humerus pop out/ strong force abducts the shoulder

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11
Q

axillary nerves injury and diagnosis

A

injured during dislocation because of the close proximity to the inferior part of the joint capsule

diagnosed by paralysis of deltoid w/ loss of abduction ability, and a lack of sensation in regimental badge area

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12
Q

rotator cuff injuries, problems, caused by

A

tendons rub underneath CAA causing irritation and inflammation of rotator cuff tendons/ subacromial bursa

leads to variety of problems eg sub acromial bursitis, supraspinatus tendinitis, rotator cuff injury, degeneration and rupture of tendons

caused by repetitive use in sports, work,

  • older people
  • avascularity of supraspinatus tendon
  • slight differences in anatomy

this is all results in painful arc syndrome

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13
Q

painful arc syndrome

A

pain experienced at 70-120o of abduction

due to inflammed rotator cuff tendons, inflammed SA bursa (between acromion and head of humerus)

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14
Q

dislocation of radio-ulnar joint

A

radial head moves inferiorly and laterally

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15
Q

subluxation of proximal radio-ulnar joint

A

head of radius moves laterally/infeiorly ie partial dislocated

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16
Q

‘pulled elbow’ injury

A

more common in children as ligament is underdeveloped and less fibrous, therefore stretchier

head of humerus subluxates from anular ligament so that the radial head does not correctly articulate w/ capitulum of humerus

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17
Q

colle’s fracture

A

a fracture that traverses the entire width of the radius w/in 2cm of distal end, commonest type of fracture

when there is a fracture of the distal radius, there is upward displacement of the wrist due to posterior displacement of fractured part of distal radius

18
Q

what causes a colle’s fracture

A

falling onto an outstretched hand

19
Q

what is this condition?

A

colle’s fracture

displacement and angulation of distal end of radius can be seen

20
Q

scaphoid fracture cause, consequences

A

fall onto an outstretched hand

there is tenderness over the anatomical snuff box

scaphoid bone receives trauma and can fracture

as the scaphoid receives its blood supply distally this can be disrupted on fracture causing avascular necrosis

21
Q

osteoarthritis definition

A

clinical and pathological outcome of a range of disorders that result in structural and functional failure of synovial joints

22
Q

in short, why does osteoarthritis occur?

A

imbalance towards degradation away from repair of the cartilage

23
Q

3 stages of osteoarthritis

A

1 excessive proteolytic breakdown of the cartilage matrix

2 fibrillation and erosion of cartilage liberates the breakdown products into synovial fluid

3 synovial cells take up these products, causing a chronic synovial inflammatory rxn and ongoing production of proinflammatory cytokines

-> these cytokines then diffuse back into cartilage, -vely impacting on chondrocytes, which have been excessively sensitised to the cytokines due to an increased no. of cytokine cell receptors

24
Q

clin features of osteoarthritis

A

pain, stiffness, deformity, loss of function, crepitus (cracking/popping sounds heard and experienced under skin due to presence of air in subcutaneous tissue)

25
Q

radiographic features of osteoarthritis

A

loss of joint space

osteophytes

subchondral sclerosis

subchondral cysts

deformity

26
Q

two types of treatment for osteoarthritis

A

conservative (eg drugs) or surgery

27
Q

conservative treatment for osteoarthritis

A

analgesics/NSAIDs (non steroidal anti inflamm drugs)

physiotherapy

joint injection

glucosamine

28
Q

surgical treatment for osteoarthritis

A

joint replacement

fusion

excision

29
Q

explain rheumatoid arthritis

A

chronic systemic inflammatory disease w/ unknown cause

external trigger leads to an autoimmune response

synovial hypertrophy

chronic joint inflammation

30
Q

explain the criteria for diagnosing Rheu. Arth

A

they come from the American college of Rheumatology (ACR)/European league against Rheumatism (ELAC)

categories are essentially:

  • joints involved: large/small, inc no.?
  • serology: rheumatoid factor, anticitrullunated protein AB
  • inflamm markers (acute phase prots) eg CRP, ESR
  • duration of symptoms: > 6 weeks
31
Q

pathophysiology of Rheum. Arth.

A

synovium hyperplasia (pannus formation->inflammed excessive synovium), endothelial cell activation

-> uncontrolled inflammation, cartilage and bone destruction

32
Q

clin exam of Rheum Arth

A

stiffness, tenderness, pain on motion, swelling, deformity, limitation of motion, extra articular manifestations, rheumatoid nodules

33
Q

radiological features of Rheum arth

A

joint space narrows

peri-articular erosions

diffuse osteopenia (slightly lower than normal bone mineralisation density)

deformity

34
Q

clin features of rheum arth

A

z thumb

subluxation of MCPJ (metacarpalphalangeal joint)

radial deviation of wrist

ulnar deviation of MCPJ

boutonniere (prox interphal joint is bent towards palm, dist interphal joint is bent away)

swan neck deformity (the opposite of the above)

35
Q

what are the man outcomes for treatment of rheum arth?

A

relive pain while maintaining function

36
Q

difference between osteoarthritis and rheum arth in synovial joint

A

OA: bone ends rub together due to loss of articular cartilage

RA: there is a swollen inflammed synovial membrane

37
Q

septic arthritis

A

bacterial invasion

damage to articular cartilage

organism releases chondrocyte invasion

host inflammatory response to infection

38
Q

what are the signs of septic arthritis and what is it caused by?

A

painful hot swollen joint

systemically unwell

caused by staphylococcus aureus

39
Q

kocher’s criteria for septic arth

A

fever >38.5oC

non weight bearing

ESR>40mm/hr, CRP>20mg/dl

serum WCC>12*(10^9)/l

40
Q

crystal deposit that causes pseudo/gout?

A

calcium pyrophosphate/monosodium urate crystals

Diseases (4 decks)

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