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Pathophysiology > Musculoskeletal System pt.1 > Flashcards

Musculoskeletal System pt.1 Flashcards

1
Q

majority of occupational injuries in the hospital are

A

registered nurses

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2
Q

functions of the musculoskeletal system

A
  • first line of defence against external forces
  • enable mobility, protection of internal organs
  • damage to our skeletal or muscle systems makes movement difficult and painful
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3
Q

what population has the highest incidence of fracture

A

males age 15-24 and adults over 65

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4
Q

trauma injury

A

bone is subjected to stress, greater than it can absorb

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5
Q

Pathological injury

A

caused by weakness within bones
- osteoporosis, tumors, infection

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6
Q

stress injury

A

bone not able to adapt to repetitive pressure, bone weakne over time

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7
Q

what are the most common fractures from accidental trauma in young people

A

clavicle, tibia, humerus

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8
Q

what are th emost common fracture sin the workplace

A

hands and feet

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9
Q

what are the most common fractures linked with osteoporosis in older adults

A

upper humerus, upper femur, vertebrae, and pelvis

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10
Q

transverse fracture

A

runs through the bone

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11
Q

linear fracture

A

runs parallel to the bone

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12
Q

oblique/displaced fracture

A

breaks on a an angle

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13
Q

spiril fracture

A

encircles the bone

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14
Q

what are shin splints

A
  • stress on the the tibia by overworking your muscles
  • not allowing your muscle to grow
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15
Q

greenstick fractures are often seen in

A

children

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16
Q

waht is a greenstick fracture

A

more of a bend, not a complete fracture

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17
Q

what is an comminuted fracture

A

fractured into more than 2 fregments

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18
Q

signs and symptoms of fracture

A
  • swelling a the site of injury (soft tissue edema)
  • hemorrhage into muscles and joints
  • pain (muscle spasms; continues until bone fragments are mobilized)
  • loss of fucntion
  • deformity
  • crepitus
  • brusing
  • hypotension
  • pulselessness
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19
Q

what symptoms are diffrent for pathological trauma

A
  • can potentially have asymptomatic deformity and swelling, or more generalized bone pain
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20
Q

what symptoms are diffrent for stress trauma

A
  • pain can occur during repetitive injury, resolved with rest
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21
Q

what is dislocation

A

a complete disruption of the joint
- joint surfaces lose contact with each other

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22
Q

what is subluxation

A

a partial dislocation followed by relocation
- partial contact between opposing joint can damage the ligaments, nerves, joint surfaces (cartilage), as well as bones that make up the joint

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23
Q

causes of dislocation and subluxation

A
  • developing joint (ligaments may have developed looser)
  • trauma
  • muscular imbalance (unbalanced exercise program, bad posture, inactivity)
  • incogruities in surfaces (rheumatoid arthritis)
  • joint stability (repetive dislocations, stretching of the ligaments in previous injury)
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24
Q

direct healing

A

bone cortices are in contact with eachother

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25
Q

indirect healing

A

development of callus and eventual remodeling a solid bone

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26
Q

stages of bone healing

A
  1. Hematoma
  2. Soft callus
  3. Hard callus
  4. remodelling
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27
Q

how long does it take for most fractures to heal

A

4-8 weeks

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28
Q

what factors can prolong fracture healing

A

osteporosis, general health of the individual, can prolong healing

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29
Q

soft tissue injury

A

sprians/strains

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30
Q

strain

A

tearing or stretching of a muscle or tendon

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31
Q

what are the most common strains

A

hands, feet, knees, upper arm, thigh, ankle, and heal

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32
Q

sprain

A

ligament tears

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33
Q

what are the most common sprains

A

wrist, ankle, elbow, and knee

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34
Q

1 degree soft tissue injury

A

fibres are stretched
- muscle and joint remain stable

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35
Q

2nd degree soft tissue injury

A

more tearing of tendon or ligament muscle weakness, joint instability

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36
Q

3rd degree soft tissue injury

A

inability to contact the muscle and significant joint instability

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37
Q

signs and symptoms of sprains and strains

A

pain (sharp, localized), swelling, changes in the contour of ligaments or tendon

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38
Q

3rd degree sprains and strains requires

A

surgery to suture ends together

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39
Q

what is rhabdomyolysis

A

rapid breakdown of muscle causes release of intercellular contents including myoglobin, enzymes, and potassium into the extracellular space and bloodstream

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40
Q

rhabdomyolysis causes

A
  • trauma (crush injuries)
  • medications and rugs
  • excessice muscle contraction
  • infectous afents
  • toxins (carbon monoxide)
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41
Q

complications of rhabdomyolysis

A
  • hyperkalmia
  • cardiac dysrhythmias
  • kidney failure
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42
Q

rhabdomyolysis symptoms

A

muscle pain, weakness, and dark urine
- elevated creatine kinase (most reliable indicator)

43
Q

what is compartment syndrome

A

occurs when there is damage to a compartment but the fascia encicleing the compartment is intact

44
Q

result of compartment syndrome

A

increased pressure within the compartment restricting blood flow

45
Q

compartment syndrome is caused by

A
  • bleeding within the compartment or increased pressure outside of the compartment or a combination of both
  • severe bursn, bleeding, crush injuries, bites, tight casts or bandages
46
Q

what leads to msucle infraction and neural injury

A

muscle ischemia, can cause edmea, increased compartment pressure, and tamponade

47
Q

what are the 6 P’s of compartment syndrome

A

Pain - beyond what is expected for the injury
Pressure - sweeling or tenderness felt over affected area
Pallor - decreased blood flow to extremity
paresthesia - numbness or tingling due to nerve impingement
Paresis - muscle weakness
Pulselessness - inadequate blood perfusion

48
Q

compartment syndrome diagnosis

A

measurement of intercompartmental pressure
manometer

49
Q

what is osteoporosis

A
  • decreased bone density and increased risk of fractures
  • chronic disease
  • old bone is being absorbed faster than new bone is being made
50
Q

where is osteoporosis commonly seen

A

spine vertebrae, femoral neck, and wrist

51
Q

postmenopausal osteoporosis is caused b

A

estrogen deficency

52
Q

secondary osteoporosis can be caused by

A

dysfunction of the endocrine system
- parathyroid hormone, cortisol, thyroid hormone and growth hormone (most commonly associated with osteoporosis)
- medications, lack of physical activity, abnormal BMI

53
Q

what age is peak bone mass

A

30

54
Q

most common complication of osteoporosis

A

fractures
- vertebral fractures

55
Q

signs and symptoms of osteoporosis

A
  • bone deformity and pain due to fractures
  • vertebral fractures can cause kyphosis (hump back)
  • fractured hip
  • fractured femur (falls)
56
Q

osteoporosis diagnosis

A

x ray
- loss of 25-30% bone tissue

57
Q

osteomyelitis

A
  • infection of the bone
  • most often caused by bacteria (staph aureus)
58
Q

hematogenous osteomyelitis

A
  • caused by a pathogen carried in the bloodstream
  • more common in children
59
Q

continous osteomyelitis

A

caused by infection, spread from adjacent bone

60
Q

continous osteomyelitis is cuased by

A
  • caused by open fractures, penetrating wounds, or surgical procedures
  • metabolic or vascular disease (diabetes, PVD)
  • lifestyle risks (smoking, alcohol, drug abuse and age)
61
Q

who is at risk for osteomyelitis

A

chronically ill, diabetics, alcoholics, individuals on high dose of steroids or immunosuppressive medications

62
Q

osteomyelitis process

A

intitial infection- inflammatory response - forms biofilms that adhere to surfaces - increase antibiotic resistance - small terminal vessels thrombose and exudate seals the bone canaliculi - exudate extends into the marrow cavity - blood flow is disrupted which leads to necrosis and death producing sequestrum - osteoblasts lay down new bone over affected bone - openings in the incoluccrum allow exudate to escape to surrounding tissues through skin by sinus tracts

63
Q

signs and symptoms of hematogenous osteomyelitis

A

vague: fever, malaise, anorexia, weight loss, and pain in or around infected area

64
Q

continous osteomyelitis signs and symtoms

A

inflammatory exudate in soft tissues
- abscesses form, low grade fever, lymphadenopathy, local pain, and swelling of puncture wound

65
Q

osteomyelitis treatment

A
  • antimicrobial agents
  • debridement of infected bone
  • would irrigation and antibiotics
66
Q

what is osteoarthritis

A

loss of protective cartilage

67
Q

osteoarthrisis is cuased by

A

physical use (wear and tear of joint)

68
Q

what is the most common form of arthritis

A

osteoarthritis

69
Q

osteoarthristis most commonly affects

A

hands, knees, and hips

70
Q

what components of the joint are affected in osteoarthritis

A

all components of the joint
- cartilage, bone and synovial fluid

71
Q

osteoarthrisitis process

A
  • articular cartillage breaks down, can flake off and develop longitudinal fissures, underlying unprotected bone becomes sclerotic, as the articular bone breaks down, ostophytes will try to build new bone forming bone spurs - into the synovial cavity, these spurs can break off increasing the irritation and volume of the joint - contributes to immobility
72
Q

osteoarthrisis sings and symptoms

A
  • intially asymptomatic
  • pain, stiffness, swelling, decreased ROM< muscle wasting, partial dislocation, and deformity
    joint stiffness
    joint effusion (swelling of joint)
73
Q

risk factors for osteoarthritis

A

trauma, mechanical stress, inflammation in the joint, joint instability due to damage to supporting structures, neurological blood or endocrine disorders, cogenital deformities, medications

74
Q

stae 1 OA

A

patients will develope very minor wear and tear and bone spurs at the end of the knee joints

75
Q

stage 1 OA treatments

A

supplements such as glucosamine and chondotin may be recommended

76
Q

stage 2 OA

A

more bone spur growth, space between the bones appears normal, symtoms of joint pain
- area around the knee may feel stiff and uncomfortable

77
Q

stage 2 OA treatments

A
  • relieve the pain and discomfort
  • strict regime of exercise and strength training for increased joint stability
  • braces, knee support, or shoe inserts (protect knee from stress)
78
Q

stage 3 OA

A

obvious erosion to the cartilage surface between bones and fibrilation narrows the gap between the bones
- bones develop spurs at the joints as it becomes rougher
- frequent pain when walking, running, squating, extending kneeling
- joint stiffness after sitting for a long time or when waking in the morning
- may be popping or snapping sound when walking

79
Q

stage 3 OA treaments

A
  • over the counter NSAIDS
  • may require intra-articular injections of hyaluronic acid
80
Q

stage 4 OA

A

joint space between the bones are considerably reduced, causing the cartilage ot wear off, leaving the joint stiff
chronic inflammatory response, with decreased synovial fluid causes friction, greater pain and discomfort when walking or moving the joint
development of more spurs causeing excrutiation pain, which makes everyday chores, including walking, difficult

81
Q

stage 4 OA treatments

A
  • osteotomy or bone realignment surgery
  • total knee replacement or arthroplasty
82
Q

what is Rheumatoid arthritis

A

chronic autoimmune disease

83
Q

what is typically seen in rheumatoid arthritis

A
  • joint swelling and tenderness
  • destruction of synovial joints
  • disability and in some cases premature death
84
Q

hwo is RA diffrent than OA

A

Ra: synovial membrane is the first tissue affected

85
Q

what are the msot common site for rheumatoid arthritis

A
  • fingers, feet, wrist, elbows, and knees
86
Q

signs and symptoms of rheumatoid arthritis

A
  • joint degration is symmetrical
    stiffness (more prounced in the morning, last longer than 1 hour)
    symmetrical involvment of hands
    3 or more affected joints
    low grade fever
    fixed flexion of smaller had joints “swan neck (thumbs) and boutomiere”
    other organ involvement: lymphadenopathy, spenomegaly, nephronpathy, eyes
87
Q

rheumatoid arthritis risk factors

A

enviorments, diet, socialeconomic status, smoking

88
Q

grout is caused by

A

overproduction of uric acid or under excretion (90%) of uric acid by the kidneys

89
Q

with grout inflammation and pain of the joints is most common in

A

feet and legs

90
Q

gout pathophysiology

A

concentration of urice acide increases to the point it cristalizes
- insolvable precipiates deposited in connective tissue
- crystalization in synovial fluid results in painful inflammation of the joint

91
Q

risk factors for gout

A

male gender, increasing afe, high intake of alcohol, read meat and fructose, increasing BMI

92
Q

gout can lead to

A

chronic disbaility, HTN, and renal disease

93
Q

gout signs and symtoms

A

pain, inflammation of the joints, kidney stones, joint enlargements (crystals harden, eroding bone and cartilage), back pain (pain in kidenys)

94
Q

fibromyalgia

A

Syndrome of chronic pain (not inflammation)
- abnormally low levels of serotonin, typically reduces pain signals
- sleep pattern is affected

95
Q

fibromyalgia sings and symtoms

A
  • chronic generalized pain and fatigue
  • cognitive dysfunction, changes in mood
96
Q

Disuse atrophy

A

muscle wasting
- reduction in normal size of muscle fibres after prolonged inactivity from bed rest, trauma, or local nerve damage

97
Q

muscular deconditioning

A

can occur within days of inactivity

98
Q

noral individuals will lose muscle mass at a rate of

A

3% per day

99
Q

disue atrophy treatment

A

frequent forceful contractions
passive lengthening exercises
get up walking and moving quickly

100
Q

Contractures

A

loss of passive ROM
- secondary to joint, muscle or soft tissue limitation
- trauma, arthritis, CNS disease

101
Q

most common contractures

A

joint immobilaization

102
Q

dupuytrens contracture

A
  • caused by connective tissue in palm thickens and becomes scare like
  • not painful but restricts movement
103
Q

risk factors for Dupuytrens contracture

A

genetic factors, alcohol, tobacco use, and diabetes

Pathophysiology (22 decks)

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