Patho Musculoskeletal System Flashcards
1
Q
Two functions of Skeletal System
A
Protection- supports organ systems; bone functions as levers for muscles to pull on
Production- blood cells produced; mineral storage and metabolism
2
Q
Corticol Bone
A
(Compact bone)
- outer portion of bone
- bulk of diastasis of bones
- tolerates compression and shearing forces
3
Q
Cancellous Bone
A
(Spongy bone)
- inside long bones and marrow cavities
- can’t tolerate compression forces
- tolerates shearing (toritional) stresses
4
Q
Transverse Fracture
A
straight line, 90 degrees to longitudinal axis
5
Q
Spiral Fracture
A
- due to rotational force
- S-shape
- wrap itself around corticol surface on outside of bone in spiral fashion
- not easy to fix
6
Q
Longitudinal Fracture
A
- along bone length
- run up and down length of bone
7
Q
Oblique Fracture
A
- due to rotational forces
- doesn’t circulate around bone
- at angle in between transverse and longitudinal without spiraling or rotation
8
Q
Comminuted Fracture
A
- more than one fracture line and the bone is going to be broken into more than 2 fragments
- 1+ fracture line and 2+ bone fragments
- happens commonly in feet
9
Q
Impacted Fracture
A
- telescoping of fragment into another
- typically in long bones
- creates internal damage of bone and makes it very hard to reduce bones back into place
10
Q
Greenstick Fracture
A
- incomplete fracture with intact corticol side flexed
- cortex stays intact, but is going to be flawed
- little broken off piece of bone
11
Q
Stress Fracture
A
- failure of one corticol surface
- crack developing in the bone with no real separation between 2 bone fragments
12
Q
Avulsion
A
- separation at site of attachment of ligament or tendon
- common in knee cap
13
Q
Displaced Fracture
A
- ends of fracture are separated
- greater damage to surrounding soft tissue
- harder to realign when it comes time to fix
14
Q
Non-displaced Fracture
A
- fragments remain in alignment and position
- easy to fix
15
Q
Complete Fracture
A
disrupts continuity through whole bone
16
Q
Incomplete Fracture
A
- cortex buckles/cracks
- no loss of continuity
- bone ends still together
17
Q
Open (compound) Fracture
A
- bone exposed outside integument
- open wound from outside world into skin
- increased rate of infection
18
Q
Closed (simple) Fracture
A
bone contained inside integument
19
Q
Delayed Healing
A
Delayed Union
Malunion (fracture improperly repaired)
Nonunion
20
Q
Soft Tissue Complication
A
primary damage and damage during immobilization
Compartment Syndrome
Neurovascular Injury
21
Q
Dislocation
A
- displacement of bone from normal
- articulating surfaces lose contact
- lead joint beyond anatomical limits
- significant soft tissue damage
22
Q
Sublaxation
A
- displacement
- articulating surfaces partially lose contact, but don’t completely separate
- lead joint beyond anatomical limits
- significant soft tissue damage
23
Q
Non-Structural Scoliosis
A
- resolves when patient bends to affected side
- curve resolves itself when patient bends to affected side
- no rotation of vertebral column along with lateral curvature
- usually due to inflammation, legs of different lengths without corrective footwear, poor posture
24
Q
Structural Scoliosis
A
- lateral curve fails to correct on forced bending against curvature
- vertebrae start to rotate around axis along with curvature
- more serious form of scoliosis
- hip, shoulder, rib cage start to change position
25
Osteoporosis
- common metabolic disorder
- Reabsorption rate greater than formation (osteoclasts outpace osteoblasts)
- fragile, fracture susceptible bones due to decrease in density, width, mass
- cancellous (spongy) lost faster than corticol (compact)
- Risk factors: age, genetics, estrogen
26
Disuse Osteoporosis
- bones degrade if person is not putting stress on bone (i.e. bed rest pt)
- bones will start growing again once stress the bones
27
Rickets & Osteomalacia
- rickets=child; osteomalacia= adult rickets
- Deficit in mineralization of osteoid leading to the production of soft osteopenic bone
- Vitamin D deficiency prevents normal calcium & phosphorus maintenance
- worse in children because bones are growing
28
Paget's Disease
- Osteitis deformans (i.e. deformed bone)
- Progressive, slow, metabolic disorder
- Excess bone resorption followed by excessive bone formation
- Disorganized bone matrix - overproduction of cancellous bone
- Fragility leads to deformities and fractures
- Unknown cause
29
Soft Tissue Injuries
- soft tissue injuries are very common with sublaxation, dislocations and fractures
- trauma due to stress
- contractile and non-contractile types of injuries
30
Non-contracile (Inert) Soft Tissue Injuries
- have no ability to contract and can’t relax
- Joint capsules, ligaments, bursae, fasciae, dura mater, nerve roots
- Includes ligament injuries; joint capsule injuries; internal joint derangement; injuries to fascia and bursae
31
Ligament Injuries
- injury when load exceeds physiology range of motion
- stretched ligament= sprained ankle
- Total failure - damage to surrounding tissues in which lose ability to keep 2 tissues together
- have loose ligaments once damaged
- Classified by extent of tear
32
Joint Capsule Injury
- swelling and tissue scarring decreases the range of motion
- occurs during immobilization
- swelling--> lack nutrient flow and ischemia
- if arm is bent at minimal joint angle, capsule will shrink
33
Internal Joint Derangement
- injury to inert soft tissue in joint leading to restriction of motion & pain
- example: torn meniscus in knee or TMJ
34
Injuries to fasciae & bursae
- Fasciae and bursae normally there to reduce friction
- Pain with restriction of motion
- Bursitis - inflammation of bursae at stress point
35
Contractile Soft Tissue Injuries
- involve tissues actually involved in contraction: muscle, tendon, and bony insertion point that tendon is going to attach to
- if get too damaged, can affect ability of that part to contract
- Include: Injury to tendons, Muscle & tendon strains, Blunt trauma, Compartment syndrome
36
Injury to Tendons
- strain to rupture
- Tendonitis - inflammation of tendon sheath (essentially bursae underneath tendon)
- Loss of function, pain, inflammation
37
Muscle & tendon strains
-minor to major tear in muscle due to abnormal muscle contraction
Grade I - minute tear, no loss of continuity
Grade II - large portion of contractile unit torn, maintain continuity but need surgical repair
Grade III - loss of continuity of contractile unit; surgical repair necessary
38
Blunt trauma
- contusion or crush injury to soft tissue can compromise contractile structures
- Bleeding into muscle leads to inability to contract
- Hemorrhage - leads to myositis ossificans (blood pools lead to calcifications)
39
Compartment syndrome
- Soft tissue trauma due to unyielding structure of inert tissues (i.e. joint capsule)
- Decreased compartment size, increased compartment content, externally applied pressure
- All cause pressure - ischemia & pain leading to medical emergency
40
Muscular Dystrophy
Group of genetic myopathies that lead to progressive muscle weakness and degeneration
41
Duchenne's Muscular Dystrophy
- common, severe, X-linked
- Muscle cells lack dystrophin (structural protein underneath plasma membrane) leading to weakened cell structures that get replaced with fatty tissues
- don't live past 14 because diaphragm stops working
42
Becker Muscular Dystrophy
- mild, inherited, X-linked
| - Reduced production of abnormal dystrophin
43
Facioscapulohumeral Muscular
-inherited, autosomal dominant, face and shoulder affected
44
Myasthenia Gravis
- chronic autoimmune disease of neuromuscular function
- Voluntary muscle weakness & fatigue
- ACH receptor antibodies
45
Fibromyalgia syndrome
- unknown etiology
- Pain syndrome - chronic muscle pain
- everyone has same threshold of pain but what may be physiological reason and people with this have a lower threshold than most (so stimulus can be less to stimulate muscle fibers)
46
Osteoarthritis
- Degenerative, progressive, non-inflammatory disease
- Loss of articular cartilage
- Formation of thick subchondral bone and new bone
- More prevalent with age and everyone gets it
- Etiology varies: Biochemical, biomechanical, inflammatory & immunologic factors
- non inflammatory disease- once person has it, the actual disease does not cause inflammation in the joints (does not mean it can not be caused by inflammation)
47
Symptoms of Osteroarthritis
- Bony enlargement of joints
- crepitus
- Morning stiffness,
- pain w/function
48
Rheumatoid Arthritis
- Systemic inflammatory disease
- Unknown etiology (infectious or abnormal autoimmune response)
- Characterized by inflammation in joint cavity
- Stimulate edema, neovascularization, synovial proliferation
- Hypertropied synovium invades surrounding tissue - granulation tissue forms - pannus formation which erodes articular cartilage
49
Symptoms of Rheumatoid Arthritis
- Morning stiffness for 1 hr
- Soft tissue swelling of 3 or more joint areas
- Swelling of at least one wrist, MCP or PIP joint
- Simultaneous symmetric swelling in joints
- Subcutaneous rheumatoid nodules
- Presence of rheumatoid factor
- Radiographic erosions and/or periarticular osteopenia in hand and/or wrist joints
50
Depressed Fracture
- fragment displaced below leek if surface of bone
| - skull is most common
