Musculoskeltal Flashcards
Muscular dystrophy
Most MD cases are caused by gene mutations affecting muscle proteins, such as dystrophin, muscle fiber drop out, muscle cell apoptosis, or necrosis; inflammatory cytokines, regeneration, fibrous formation, fatty infiltration and replacement, muscle loss function.
Duchene muscular dystrophy
Mutation in dystrophin an anchor for protein for skeletal muscle cells
Poor anchored muscle fibers tear easily due to muscle contraction, calcium overload, cell death, fiber necrosis, apoptosis, inflammatory cytokines release, regeneration, fibrous, fatty infiltration
1st causes muscle weakness that starts in the hips, pelvis, legs, difficult standing, walking, sitting, unsteady waddling gait; walking on toes or balls of feet, falling
Over time lose ability to sit, walk, lift objects, affects on cardiac and respiratory system
Sarcopenia
Due to aging, physical inactivity, unhealthy diet
Nutritional, hormonal, metabolic, immunologic factors that affect muscle, reduced muscle mass and strength
Muscle weakness, decreased mobility, falls, disability, loss of independence
Osteoporosis
Risk factors-age, post menopause (estrogen and testosterone are decreased), low vitamin D, decreased physical activity, increased caffeine, phosphorus, alcohol and nicotine consumption, low BMI, family hx, endocrine disorder
Cause bone aches, weakness, deformities, fractures
Low estrogen, low OPG, increased RANKL, increased RANK, causes increase formation of clasts, decrease clasts apoptosis, estrogen needed for extra cellular kinases (ERK) to decrease apoptosis blast and increase apoptosis clasts not balanced
Scoliosis
Sideways curvature of spine, more likely in MD or CP
Greater than 25-30 degrees is significant
Greater than 45-50 is severe
Osteoblasts
Formation of nine through ossification or osteogenesis
Osteocytes
Bone maintenance
Osteoclasts
Bone reabsorption and remodeling
Bone matrix
Organic- collagen and proteoglycans 35%
Inorganic- hydroxyapatite 65%
Steps of bone remodeling
Quiescent, activation, resorption, formation, mineralization
Vitamin D
Needed for absorption of calcium from intestines
Deficiency causes rickets, osteomalacia
Vitamin C
Needed for collagen by osteoblasts
Deficiency causes scurvy
Spondylitis
Unknown cause, strong association with HLA B27 antigen and HLA B7 in blacks
Inflammation of fibrocartilage, inflammatory cells and fibrocartilage erosion, repairs and scar tissue forms, calcification leading to join fusion
Early- low back pain, in early 20s progresses overtime, stiffness, pain, restricted motion, loss of normal lumbar curvature (lordosis) and increased con cavity of upper spine (kyphosis)
Osteoarthritis
Idiopathic, generic, biochemical, bio mechanical stress
Local areas of degeneration and loss of articulate cartilage, pro inflammatory cytokines, thickening of joint capsule, osteophytes (bone spurs), variable degrees of synvoitis (inflammation)
Stiffness that diminishes with activity, joint swelling, tenderness, limited mobility, deformity
Rheumatoid arthritis
Multi factor causes, strong genetic predisposition HLA DR4
Primary site is synovial membrane antibodies formed against joint tissue (rheumatoid factor) type 4 hypersensitivity, T cell mediated, inflammatory cells, cytokines (TNF alpha) destruction of cartilage and bone granulation tissue (paninus)
Insidious onset, affected joints initially are wrist, MCP, MTP, symmetric joint involvement, morning stiffness, constitutional symptoms, joint deformity, SQ nodules, in blood work presence of RF and ANA
