Pathophysiology of musculoskeletal system Flashcards
What breaks during a fracture ?
bone but also soft tissue around it
which fracture is the worst ?
if it goes through the cartilage at a joint -> cartilage won’t heal
stages of bones healing (and phases)
1) inflammatory phase
- hematoma formation
2) reparative phase
- fibrocartilage formation (progenitor for final bone)
- callus formation
- ossification
3) remodelling phase (consolidation)
what are ligaments useful for ?
control the gliding of the bones in the joint
most common ligament injury ? symptoms ? diagnosis ?
Ankle sprain -> pain, hematoma, instability.
We test if there is a smooth glide or shifting -> stability testing
what are the 3 stabilizing factors of joints ?
1) osseous configuration, ex : ball and socket joint
2) tendons (bone-muscle, can be strengthened)
3) ligaments (bone-bone)
why is shoulder joint less stable than hip joint ?
because less coverage of the ball, but that means higher range of motion
treatment for ankle sprains ?
Most of the time : RICE.
Rarely : surgery if severe instability or recurrent sprains (or elite athletes) -> ligament reconstruction
what can cause a diseased tendon ? how do we diagnose a tendon injury ?
cortison : interference with collagen synthesis.
single heel rise test, continuity
difference between tendons and ligaments
both are made of collagen, but different types.
Ligaments are always the same length, but tendons have an elasticity of 15-20% for propulsion
wound repair : two stages, tensile strength, 2 things it requires (disease example ?)
Acute and subacute phases.
Max stremgth is about 70-80% pre-injury level.
Requires metabolites and circulation -> problem for people with diabetes for ex.
3 examples of metabolic bone diseases (definition, consequences, challenges, …)
1) osteoporosis :
- bone resorption > formation
- nb of trabeculae reduced
- width and mass of bone are reduced
- common fracture sites are vertebrae, wrist, hip (femoral neck)
- risk for fracture but also harder to heal
2) Pagets disease
- excessive bone resorption followed by excessive bone formation
- resulting bone is very hard and thus fragile (brittle) -> fractures and deformity
3) rickets / osteomalacia
- deficits in mineralization of newly formed bone matrix in growing and mature skeleton
- not enough vitamin D, Ca, Phosphorous
- bone becomes soft -> knock knees, bent spine, …
ortheoarthritis : when does it develop
In case of dysbalance of cartilage degeneration and regeneration -> chronic disease
osteoarthritis : 2 groups of causes, what is the main cause ?
Primary : poor biologic quality, we don’t really know why it happens
Secondary :
- inflammatory disease
- metabolic disease
- MECHANICAL OVERLOAD (initial blow on cartilage causes defect that starts inflammation)
types of mechanical overload
1) acute
- ankle sprain (cartilage damage in 89%)
- fracture (90%)
2) chronic
- instability : shift at every step, not smooth gliding (95%)
- deformity : crooked legs -> load is shifted
