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Anatomy > patho final > Flashcards

patho final Flashcards

1
Q

what is immediate response to MSK injury

A

generalized inflammation
vascular, chemical and cellular events that prepare for repair

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2
Q

what is preclinical disability? how would it present?

A

progressive and detectable but unrecognizable decline in physical function

increased time to complete a task / decrease in frequency in which a task is performed

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3
Q

what causes fibrinogen clots

A

vasoconstriction

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4
Q

what is margination

A

when WBCs move to the periphery of the vessel

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5
Q

what is diapedesis

A

allowance of WBC to squeeze through the blood vessel wall

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6
Q

what is chemotaxis

A

WBC being guided to the site of injury beyond the blood vessel walls

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7
Q

what is the inflammatory response in steps

A

fibrinogen clots
margination
diapedesis
chemotaxis
phagocytosis

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8
Q

what is sarcopenia

A

age related loss in muscle mass, strength and endurance

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9
Q

how to treat sarcopenia

A

high resistance training exercise
functional measures or specific weights rather than MMT

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10
Q

what can lead to decreased flexibility in aging populations

A

a build up of fibrinogen/collagen in joints due to lack of motion

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11
Q

what cells provide proprioception

A

mechanoreceptors

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12
Q

strength training in older adults

A

program of 1-2x weekly
improved neuromuscular performance

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13
Q

ACSM recommendation for strength training in aging pop

A

up to 15 reps performed a minimum of twice per week

generally = 2-3 sets of 8-12 reps for 8-10 major muscle groups

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14
Q

ACSM recommendation for cardiovascular health in aging pop

A

> 85+ = 2x/week with intensity of 40-60% of HRR for more than 20 min

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15
Q

what chemicals make up bone

A

calcium and phosphate
- mixed with water forming hydroxyapatite

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16
Q

% of bone composition

A

20% - trabecular
80% - cortical

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17
Q

what is the % comp of cortical bone and trabecular bone is calcified

A

80-90 = cortical
15-25 = trabecular

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18
Q

what does BMD represent

A

mineral content of bone in grams/square cm

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19
Q

what % of bone loss on an x-ray is significant

A

30% must occur before the abnormalities can be seen

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20
Q

what standard dev are associated with osteoperosis or penia

A

perosis - >2.5 SD below normal peak bone mass

penia - 1-2.5 SD

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21
Q

modifiable risk factors for osteoperosis

A

calcium intake
smoking / drinking
low body weight (<127)
exercise
caffeine / soda

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22
Q

what medications can cause osteoperosis

A

corticosteroids
loop diuretic
immunosuppressants
anticonvulsants

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23
Q

what diseases are associated with osteoperosis

A

hyperparathyroidism
cushings disease
anorexia nervosa
female athlete triat
hyperthyroidism

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24
Q

injuries related to osteoperosis

A

hip / spine fractures
radius / femur
ribs
vertebral bodies

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25
Q

treatment of osteoperosis

A

weight bearing exercises
aerobics / yoga / pilates

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26
Q

what to avoid if diagnosed with osteoperosis

A

vertebral osteo - anything with a major component of spinal flexion, side bending, or rotation

things that are nonweightbearing

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27
Q

what is osteomalacia?

A

lack of mineralization of new bone matrix results in a softening of bone without loss of the present bone matrix

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28
Q

what are the two main causes of osteomalacia

A

insufficient intestinal calcium absorption

increased renal phosphorus losses

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29
Q

what is an osteoid

A

bone that has not matured/calcified

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30
Q

what is milkman syndrome

A

moderately severe form of osteomalacia

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31
Q

How is bone remodeling affected with Paget disease?

A

increased bone resorption and excessive, unorganized new bone formation caused by activated osteoclasts

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32
Q

diagnostic s/s of milkman syndrome

A

looser zones that occur due to healing of multiple microstress fractures causing aching, fatigue, weight loss

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33
Q

what is the result of paget’s disease in the bone

A

Bone resorption is so rapid that osteoblastic activity cannot keep up, and fibrous tissue replaces the bone.

Bone is enlarged/weak with chaotic woven pattern

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34
Q

what neuro complications can be seen with paget’s disease

A

headache, radicular, osteoarthritic, muscular or other skeletal pain

hearing loss, tinnitus and vertigo

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35
Q

how will bone look in those with paget’s disease

A

fuzzy / like a cotton ball

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36
Q

what enzyme is used to diagnose paget’s disease

A

alkaline phosphate is over produced in paget disease

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37
Q

what are avoided in paget disease

A

jogging, running, jumping or anything promoting bone growth

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38
Q

what bacteria is associated to exogenous osteomyelitis

A

staphylococcus aureus

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39
Q

what region of the body is osteomyelitis more common in adults vs children

A

adults - lumbar spine
children - metaphyseal areas of long bones

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40
Q

symptoms of myelitis in adults

A

back pain
radiculopathy / myelopathy

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41
Q

symptoms of myelitis in children

A

high fever, intense pain, local manifestations

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42
Q

primary cause of prosthetic failure

A

implant infection

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43
Q

routes of infection in prosthetic joints

A

hematogeneous - 30%
contiguous - 70%

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44
Q

3 categories of prosthetic joint infections and time of onset

A

early - develops <3 mo after surgery
delayed - 3 to 24 mo after surgery
late - > 24 months after surgery

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45
Q

diskitis symptoms in adults

A

spinal pain and severe radiation of pain into LE

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46
Q

diskitis symptoms in children

A

back pain / refusal to walk
pain with hip extension

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47
Q

s/s of septic arthritis

A

infection s/s - temp, swelling, redness infection

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48
Q

most common sites of septic arthitis

A

adults - knee or hip
children - ankle or elbow

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49
Q

treatment of septic arthritis

A

medical emergency
admission to hospital with specific IV

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50
Q

3 forms of myositis

A

dermatomyositis
polymyositis
inclusion body myositis

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51
Q

symptoms of myositis

A

dropfoot/tripping
weak grip
difficulty swallowing
muscle atrophy
weakness

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52
Q

treatment of dermatomyostitis

A

immunosuppressive therapy / corticosteroids

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53
Q

treatment of polymyostitis

A

immunosuppressive therapy / corticosteroids

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54
Q

treatment of inclusion body myostitis

A

no established treatment

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55
Q

common causes of hand infections

A

60% trauma
25% human bites
15% animal bites

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56
Q

s/s of hand infections

A

pain, loss of function, swelling, cellulitis

finger maintained in slight flexion, pain on extension with tenderness on tendon sheath

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57
Q

what organ systems can be affected by extrapulmonary tuberculosis

A

pulmonary
genitourinary
MSK
lymphatic

58
Q

what is pott disease

A

lower thoracic / lumbar spine extrapulmonary TB caused by mycobacterium tuberculosis

59
Q

what physical s/s are associated with down syndrome

A

muscle hypotonia
cognitive delay
abnormal facial features

60
Q

what abnormal facial features are seen in down syndrome

A

flat nasal bridges
eye shape
short limbs
mild/moderate hypotonia

61
Q

what are the testing procedures for down syndrome detection

A

alpha fetoprotein gonadotropin
unconjugated estrogen

ultrasound identification of nuchal translucency

62
Q

what may cause high mortality rate in those with DS

A

congenital malformations in heart and GI system

decreased respiratory expansion - upper tract infection

63
Q

how is scoliosis named

A

depending upon the convexity of the curvature

point toward the name

64
Q

what degree of curvature is significant in scoliosis

A

> 45 - neuro symptoms and needs surgery

<45 - conservative care

65
Q

what nerual tube defects affect neurologic dysfunction

A

myelomeningocele

66
Q

main difference between myelo and meningocele

A

myelo - meninges and spinal cord
mening - just meninges

67
Q

what forms of developmental hip dysplasia are there

A

unstable
subluxation/incomplete
complete

68
Q

how is developmental hip dysplasia diagnosed in newborn

A

ROM asymmetry
buttock/glute fold asymmetry
leg length discrepenc

69
Q

how is developmental hip dysplasia diagnosed in ambulating child

A

trendelenburg
flexion contracture due to posterior displacement

70
Q

what is barlow test

A

dislocation test - hip flex and IR

71
Q

what is ortolani test

A

reduction test
hip IR

72
Q

what is galeazzi test

A

leg length discrepancy
knees bent, check for shorter knee

73
Q

complication of developmental hip dysplasia

A

avascular necrosis
premature physeal arrest

74
Q

protein associated with muscular dystrophy

A

dystrophin

75
Q

common muscular weaknesses associated with muscular dystrophy

A

difficulty getting up, falling frequently, climbing stairs

waddling gait and increased lumbar lordosis

76
Q

what is type 1 spinal muscular atrophy

A

werdnig hoffman - severe

respiratory failure and early death

77
Q

what is type 2 spinal muscular atrophy

A

intermediate

significant functional impairment and reliance on power mobility

78
Q

what is type 3 spinal muscular atrophy

A

mild - kugelberg welander

relatively slow progression, learn how to walk with assistance

79
Q

what muscle is involved with torticollis? what happens

A

SCM - tilt to affected side with rotation to opposite side

80
Q

what is osteogenesis imperfecta

A

congenital disorder of collagen synthesis affecting bones and CT

making too little type 1 collagen or defective collagen

81
Q

what is the beighton scale

A

assesses joint hypermobility, especially with those who have Ehlers-Danlos syndrome

82
Q

sections of the beighton scale

A

1 - passive extension of pinky finger past 90 (1 pt for each hand)

2 - passive opposition of thumb to flexor surface of forearm (1pt for each hand)

3 - elbow hyperextension >10 deg (1pt for each arm)

4 - knee hyperextension > 10 deg (1 pt for each knee)

5 - forward flexion of trunk w/ knees extended and hands resting flat on the floor
1pt

83
Q

positive ehlers-danlos scores

A

adults - >5
child - >6

84
Q

which soft tissues may tumors origninate in

A

muscle
cartilage
nerve
collagen
adipose
lymph or blood vessel
skin

85
Q

what variations are associated with slow vs fast growing tumors

A

slow - well defined borders with sclerotic borders

fast - permeated/moth eaten borders

86
Q

what is codman’s triangle

A

triangle shaped area of reactive bone formed when neoplasm has eroded the cortex

87
Q

what is a bone island

A

oval sclerotic lesions of bone
well defined/developed haversian canal (<1cm)

88
Q

what is osteoid osteoma

A

found in cortex of long bones near the end of diaphysis - will not be in skull

area of immature bone surrouned by prominent osteoblast/clasts

89
Q

treatment of osteoid osteoma

A

excision
full recovery
no potential for malignant transformation

90
Q

where are osteoblastomas found

A

spine
sacrum
flat bones

91
Q

how are osteoblastomas diagnosed / what is the treatment

A

radiography, surgery with wider excision due to high recurrence rate
chemo/radiation

92
Q

what anotomical sites are most commonly affected by osteosarcoma

A

long bones
distal femur

common in codman’s triangle

93
Q

what is repiphysis prostheses

A

pediatric osteosarcoma

expandable metal rod that relaces long bones, will not have repeated procedureswh

94
Q

what is rotationplasy

A

using the remaining bottom segment of the leg and ankle joint as the new knee

95
Q

what is tibial turn up

A

tibia fused to femur allowing for longer limb with an above knee prosthesis

96
Q

what is the functional motor assessment? what is it used with?

A

osteosarcoma

pain, function, support, satisfaction with walking quality, participation, endurance

97
Q

what is ewing sarcoma

A

malignant, nonosteogenic primary tumor or bone/soft tissue

98
Q

s/s of ewing sarcoma

A

soft, viscous tumor with hemorrhagic necrosis caused by tumor out pacing blood supply

onion skin

local bone pain

99
Q

where does ewing sarcoma typically manifest

A

long bones and pelvis

100
Q

what is a lipoma

A

superficial/subcutaneous tumor made of mature fat cells
asymptomatic

101
Q

what is ganglia

A

benign tumor in joint capsule/tendon sheath

102
Q

what can a ganglia lead to

A

pressure on a nerve

103
Q

where are ganglia most common

A

wrist - between scaphoid and lunate

104
Q

what is a baker/popliteal cyst

A

subtype of ganglion cyst that communicates with joint space

105
Q

what is a neurofibroma

A

single lesion/greater number as a part of schwann cell build up

106
Q

what is a schwannoma

A

coverage of peripheral/cranial nerves that stays on the outside of the nerve

107
Q

what anatomical region is most often associated with metastatic bone cancer

A

spine

108
Q

how can cancer metastisize

A

blood
lmyph
direct expansion

109
Q

what is a sprain

A

injury to ligamentous structures around a joint

110
Q

first degree strain

A

mild tear
stretching / minor tearing of a few fibers without loss of integrity

111
Q

second degree strain

A

moderate tear
partial tearing of tissue with clear loss of function

112
Q

what is a third degree tear

A

severe tear
complete loss of structural / biomechanical integrity

surgical repair necessary

113
Q

common sites of compartment syndrome

A

lower leg
forearm
thigh
foot

114
Q

symptoms of compartment syndrome

A

ischemia pain out of proportion

115
Q

what may occur with compartment syndrome

A

sensory deficit or paresthesia

116
Q

heterotropic ossifican

A

bone formation in non-osseous tissue

117
Q

hallmark s/s of heterotropic ossificans

A

progressive loss of joint motion when post-traumatic inflammation should be resolving

pain and loss of ROM

118
Q

sites of heterotropic ossificans

A

hip
elbow
knee
shoulder
TMJ

119
Q

treatment of heterotropic ossificans

A

NSAID
low dose external bema radiation
comprehensive rehab

120
Q

what is rhabdomyolysis? what can it lead to

A

breakdown of skeletal muscle
large amount of creatinine phosphokinase enzymes

acute renal failure - color change in urine

fatal heart arrythmias

121
Q

hallmark signs of myofascial pain syndrome

A

taut, palpable band that is very tender
reproducible referred pain pattern

122
Q

treatments of myofascial pain syndrome

A

injection
ice
PT
laser

123
Q

what chemical leads to trigger points

A

ACh

124
Q

what joint is most commonly affected by chondrolysis

A

hip

can affect knee, shoulder and ankle

125
Q

prominent sign of OA

A

inflammation
soft tissue edema
stiffness of <30 min

126
Q

treatment of OA

A

moderate exercise
maintaining appropriate body weight

127
Q

what are s/s of disc protrusion/herniation

A

centralization of radiating pain

128
Q

what is cauda equina syndrome’s s/s

A

pain in upper sacrum
paresthesia of buttocks
possible b/b incontenince
saddle distribution of pain

129
Q

what is rheumatoid arthritis

A

systemic, bilateral symptoms
more destructive than OA
occurs in multiple joints

130
Q

what is lhermitte sign? what is the test?

A

joint rheumatoid arthritis
positive test - shock like sensation and numbness down arms with forward flexion of head

131
Q

what is ankylosing spondylitis

A

inflammatory arthropathy of axial skeleton

lead to fibrosis, calcification, ossification with fusion of involved joints

132
Q

what is classic s/s of ankylosing spondylitis

A

chronic, non granulomatous inflammation at the area where ligamnets attach to vertebrae

typical in lumbar spine then SI

133
Q

s/s of ankylosing spondylitis

A

insidous onset of LBP for atleast 3 months

134
Q

what is gout

A

elevated levels of serum uric acid

deposition of urate crystals in the joint, soft tissue, and kidney

135
Q

fracture repair process

A

formation of acute hematoma and early inflammatory response (48hr)

granulation tissue

recruitment

proliferation

differentiation of osteogenic cells

matrix formation

mineralization

remodeling

136
Q

fracture healing timeline

A

children - 4 to 6 weeks
adolescent - 6 to 8 week
adult - 10 to 18 week

137
Q

malunion fracture

A

correct timing, unsatisfactory position with residual bony deformity

138
Q

delayed union fracture

A

may heal but takes longer than should

139
Q

non-union fracture

A

may fail to heal – may lead to psuedoarthrosis

140
Q

psuedoarthrosis fracture

A

resultant formation of fibrous union or false joint

141
Q

what is osteochondritis dissecans

A

disorder of ossification sites - recalcification that affects the subchondral bone and articular cartilage

142
Q

what population is osgood-schlatter found in

A

adolescent boys 10-15
girls 8-13

Anatomy (19 decks)

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