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PATHOLOGY II > quiz #1 - musculoskeletal pathologies > Flashcards

quiz #1 - musculoskeletal pathologies Flashcards

1
Q

-degeneration of joints articular cartilage along high stress lines that causes inflammation
-cartilage softens & lose elasticity/ resiliency
-joint pain with crepitus
*Herben’s nodes: found at DIP joints in women – hard/ bony swellings over joint

A

osteoarthritis

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2
Q

fusion of joint through osteophyte formation & calcifications, insidious onset with low back pain that is worse in morning/ with inactivity → has lasted at least 3 months
defect in gene: human leukocyte antigen; HLA-B27 (90% of sufferers)

A

ankylosing spondylitis

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3
Q

-joint stiffness, swelling & pain triggered by bacterial infection
-pain felt in low back, ankles, knees, feet & IP joints
-enthesitis common
-if involving eye (uveitis)/ urinary symptoms & follows chlamydia (urethritis/) = “Reiter’s syndrome”
-associated with HLA-B27
-improves on its own, not contagious

A

reactive arthritis

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4
Q

-chronic arthritis, affects people with psoriasis 20-30% of the time
-skin conditions & joints
-red patches with silvery scales, may affect nails
-remission & flare up periods
-first symptoms are fingers & toes/ asymmetrical
-may cause dactylitis (“sausage finger”)
-from environmental factors
-immune system attacks healthy cells causing production of IL-23, a cytokine that produces chronic inflammation

A

psoriatic arthritis

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5
Q

-arthritis that causes pain, swelling, tenderness & redness at a joint, often big toe (1st MTP)
-caused by crystallization of uric acid inside a joint forming a tophi or tophus surrounding joint – tophus is a deposit of monosodium urate crystals with macrophages & lymphocytes

A

gout

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6
Q

-invasion of a single joint space (monoarticular) with pathogenic microorganisms like bacteria, virus or fungi
-often involve knee, shoulder, hip or elbow
-invasion causes one acutely painful & swollen joint
-most common organisms causing this = staphylococcus aureus (56% of cases)
-swelling, fatigue, mild fever, erythema, tenderness & decreased ROM – may have pre existing rheumatoid arthritis

A

infectious or septic arthritis

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7
Q

activation of T helper cells that produce cytokines, then activate B cells to produce antibodies – 80% of RA sufferers have an autoantibody (an antibody against our own antibody = IgG) called ‘rheumatoid factor’

A

rheumatoid arthritis

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8
Q

how does ankylosing spondylitis typically affect the spine curve and which areas?

A

-insidious or gradual onset of low back pain
-sacroiliac involvement
-cause vertebrae to fuse

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9
Q

primary differences between osteoarthritis and rheumatoid arthritis

A

OSTEOARTHRITIS = degeneration

RHEUMATOID ARTHRITIS = autoimmune disease

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10
Q

role of HLA-B27 antigen in ankylosing spondylitis

A

cause of AS unknown, but may have a defect in the gene called human leukocyte antigen or HLA-B27 – 90% of sufferers have this gene mutation

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11
Q

-imbalance between bone deposition (bone making) & bone decomposition (bone break down) causing bone tissue to become “porous”
-more bone being decomposed than deposited, making bone tissue weak & brittle
-activity of osteoclasts increased & osteoblasts decreased – may be caused by calcium metabolism disorders/ from inadequate intake of calcium or Vitamin D – loss of estrogen for menopausal women decreases osteoblastic activity

A

osteoporosis

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12
Q

-genetic or heritable disease in which bones fracture (break) easily, often with no obvious cause or minimal injury
-can be cause of “pectus excavatum” (chest wall grows inward)

A

osteogenesis imperfecta

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13
Q

degeneration of a joints articular cartilage along high stress lines that causes inflammation

A

osteoarthritis

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14
Q

bone infection, almost always caused by a bacteria

A

osteomyelitis

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15
Q

how does Paget’s disease of bone typically present radiographically?

A

-dysfunction in bone remodelling process, where bone is replaced faster than it is broken down

bone usually appears larger & denser than a normal bone – may also have a deformed shape

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16
Q

Paget’s disease treatment

A

biphosphates or calcitonin

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17
Q

-degenerative osteoarthritis between centers of spinal vertebral joints around discs, bodies, & end plates
-bone spurs grow & change movement in spine – common in mild form

A

spondylosis

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18
Q

inflammation of the intervertebral joints

A

spondylitis

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19
Q

-defect in PARS of interarticularis of vertebral arch
-may be congenital or acquired (stress fracture) – weakened bone/ fractures/ cracks from repetitive stress
-bone affected most by repetitive stress → common in lumbar spine

A

spondylolysis

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20
Q

-forward displacement of vertebra on one below, most often 5th lumbar vertebra
-most commonly occurring after a break/ fracture, causing low back pain
-due to degeneration/ wear & tear

A

spondylolisthesis

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21
Q

difference in presentation between adhesive capsulitis and rotator cuff tendonitis

A

ADHESIVE CAPSULITIS: pain, stiffness, begin gradually & worsen over time, then resolve (often over 1-3 years), more common in diabetics

ROTATOR CUFF TENDINITIS: dull deep ache at rest, unable to lift arm, disturbs sleep, arm weakness

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22
Q

4 compartment syndromes of the lower leg

A

-anterior
-superficial posterior
-deep posterior
-lateral

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23
Q

what is lower extremity compartment syndrome?

A

groups of mm with nearby blood vessels & nerves contained in a compartment by fascia – if inflammation or swelling, pressure inside compartments increases to the point that it restricts blood flow to the region, possibly causing damage to mm, nerves & all other nearby structures

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24
Q

how is osteogenesis imperfecta genetically inherited?

A

-gene causes body to not make enough collagen – leads to weak bones that break easily
-most inherit gene from one parent or they occur for first time in the person – child has to inherit a mutation in a gene from both parents

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25
Q

acute pain at one joint (monoarticular) with swelling, fatigue, mild fever, erythema, tenderness & decreased ROM affecting that one single joint – may have pre existing rheumatoid arthritis

A

septic arthritis

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26
Q

which nerve is affected in: upper extremity - saturday night palsy, cheiralgia paresthetica, crutch palsy

A

radial nerve

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27
Q

which nerve is affected in: entrapment, Erb’s palsy

A

suprascapular nerve

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28
Q

which nerve is affected in: entrapment, weakness in shoulder with minor pain, “winged scapula”

A

long thoracic nerve

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29
Q

which nerve is affected in: pronator teres syndrome, anterior interosseous nerve syndrome

A

median nerve

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30
Q

which nerve is affected in: lower extremity - meralgia paresthetica

A

lateral femoral cutaneous nerve

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31
Q

differences between Dupuytren’s contracture & Volkman’s contracture

A

DUPUYTREN’S: slow gradual, fibrosis of palmar fascia that creates shortening & thickening of 3, 4, 5 digits – causing them to be flexed

VOLKMAN’S: permanent shortening of forearm mm including hand, fingers & wrist (may also occur in foot) results in a claw-like deformity due to ischemia

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32
Q

cause of: Klumpke’s

A

stretching or neuropraxia, tearing, scarring of the nerve – nerve damage interrupts nerve impulse transmission

33
Q

cause of: Erb’s palsy

A

birth trauma – causes inflammation & interrupts nerve transmission

34
Q

cause of: horner’s syndrome

A

cause unknown, possible underlying causes: stroke, tumor or spinal cord injury – disruption of nerve pathway to face & eye

35
Q

cause of: saturday night palsy

A

pressure injury, inflammation – inflammation disrupts nerve impulses

36
Q

compression neuropathy of the “median nerve” at the elbow by the pronator teres muscle

A

pronator teres syndrome

37
Q

anterior interosseous nerve is a terminal motor branch of the median nerve that branches between two heads of pronator teres & runs deep along interosseous membrane – this nerve becomes entrapped causing compression & symptoms

A

anterior interosseous syndrome

38
Q

compression of the motor posterior interosseous nerve where it passes through the musculotendinous radial tunnel – may cause paralysis of the digit & thumb extensor muscles

A

posterior interosseous syndrome

39
Q

compression of the ulnar nerve in the cubital tunnel (made of mm, ligament & bone) – this causes pain, swelling & inflammation

A

cubital tunnel syndrome

40
Q

inflammation of patellar ligament on tibial tuberosity commonly in adolescents (especially during growth spurt) – painful bump just below the knee – worsens with activity & improves with rest – Episodic pain → from repetitive stress

A

osgood schlatters

41
Q

pain at & around patella, called “runner’s knee”, common in active people

A

patellofemoral syndrome

42
Q

softening & breakdown of cartilage tissue on the underside of patella, causing anterior knee pain

A

chondromalacia patella

43
Q

repetitive movements causing constant friction, loss of elasticity & increased microtears, injury like a direct fall – causes inflammation & swelling

A

prepatellar bursitis

44
Q

signs & symptoms of Horner’s syndrome

A

subtle symptoms, decreased pupil size, drooping eyelid & decreased sweating on one side of face

45
Q

reactive arthritis causes joint stiffness, swelling & pain, its triggered by a _____ infection & shows up _____ weeks after infection

A

bacterial

2-6

46
Q

2 types of scoliosis

A
  1. structural: spine curved
  2. functional: mm cause curvature
47
Q

5 stages of RA

A

Stage 1: Synovitis: inflammation

Stage 2: Pannus formation: granulation tissue

Stage 3: Cartilage erosion: creates unstable joint

Stage 4: Fibrosis: calcifies & joint space is obliterated

Stage 5: Ankylosis: joint fixation & deformity develop

48
Q

what type of disease is RA?

A

autoimmune

49
Q

most common cutaneous lesion in RA

A

rheumatoid nodules

50
Q

in which pathology do vertebrea grow unevenly during childhood while growth is still occurring, & it causes a wedging of vertebrae thus causing spine to curve more than normal

A

Scheuermann’s disease

51
Q

cause of psoriatic arthritis

A

unknown, high genetic link with environmental factors, considered autoimmune disease, immune system attacks healthy cells thinking they are foreign invaders - causes inflammation in joints & overproduction of skin cells - production of IL-23

52
Q

calcium pyrophosphate crystal deposition disease (CPPD) or “pseudogout” has similar crystal deposition as gout joints, but the crystals are made of _______

A

calcium pyrophosphate dihydrate

53
Q

causes of central canal stenosis/ spinal stenosis

A

degeneration (osteoarthritis)

54
Q

typical cause of tendinitis

A

repetitive movements

55
Q

medications for gout & pseudogout

A

gout: medications can block uric acid production

pseudogout: NO medications to prevent joint damage

56
Q

which pathology is known as tuberculosis of the spine?

A

Pott’s disease

57
Q

what is a contracture?

A

permanent shortening of mm/ soft tissues crossing a joint

58
Q

inflammation of the achilles ligament where it attaches to the growth plate on the calcaneus commonly in adolescents (especially during a growth spurt)

A

Sever’s

59
Q

in childhood (4-10yrs) interruption of blood supply to femoral head causing avascular necrosis & tissue death - bone is weakened & fractures easily - blood supply is improved & bone begins to heal & grows back again

A

legg-calve perthes

60
Q

congenital anomaly, elevated, dysplastic (underdeveloped & smaller) scapula restricting shoulder ROM

A

Sprengel’s deformity

61
Q

half of the vertebral body fails to form causing a wedge shaped vertebrae

A

hemivertebrae

62
Q

an extra rib that forms above the first rib usually asymptomatic - may cause thoracic outlet syndrome (TOS)

A

cervical rib

63
Q

congenital anomaly where two vertebrae are fused or partially fused together through the disc

A

block vertebrae

64
Q

cause of Paget’s disease

A

unknown, but suspect environmental (virus) or genetic factors contribute or work together

65
Q

symptoms in cauda equina

A

severe low back pain, pain in both legs, saddle anaesthesia, motor weakness & sensory loss, bladder dysfunction, bowel incontinence, sexual dysfunction & may cause permanent neurological damage

66
Q

symptoms in meralgia paresthetica

A

compression of lateral femoral cutaneous nerve causing burning pain, numbness & tingling in upper lateral thigh that may extend to knee - worsened by walking or standing for long periods

67
Q

treatment for rotator cuff tear

A

80% non surgical tx is adequate, rest, NSAIDS, activity modification, strengthening exercises, steroid injection, 20% require surgery

68
Q

treatment for adhesive capsulitis

A

ROM exercises, mobilization, injected steroids, surgery

69
Q

which nerve is affected in: axillary nerve palsy, Erb’s palsy

A

axillary nerve

70
Q

traction or compression injury to the lower trunk of the brachial plexus at C8 & T1

A

Klumpke’s

71
Q

traction or compression injury to the upper trunk of the brachial plexus at C5 and C6

A

Erb’s palsy

72
Q

nerves affected in Erb’s palsy

A

axillary nerve, musculocutaneous, suprascapular nerves

73
Q

sacralization vs. lumbarization

A

sacralization: congenital anomaly where TVP L5 fuses to sacrum or ilium on one side or both - often L5/S1 disc is thinner & narrow

lumbarization: congenital anomaly where first & second segments of sacrum fail to fuse & are freely movable - appears lumbar spine has 6 vertebrae

74
Q

injury of a growth plate affecting adolescents - causes abnormal growth around ossification centres (Legg-Calve-Perthes, Osgood Schlatter, Sever’s)

A

juvenile osteochondrosis

75
Q

nonunion of ossification centres of a bone, most often affecting right side of body & girls

A

upper extremity: congenital pseudarthrosis
(clavicle, radius, ulna)

76
Q

causes of heel spurs

A

repetitive stresses, or sudden increases in activity
-calcium deposits at insertion site of plantar fascia into calcaneal bone

77
Q

pain on posteromedial border of tibia bone due to overuse & repetitive stresses like running & jumping - periostitis occurs in tibia & surrounding musculature (including tendons & ligaments) become damaged & inflamed, with not enough time to heal in between activities - sports activities are number one cause

A

shin splints or medial
tibial stress syndrome

78
Q

compression of the superficial branch of the radial nerve, a sensory only nerve, often where it lies between brachioradialis & extensor carpi radialis longus, also when it flows more superficially is susceptible to a crush injury from the skin

A

cheiralgia paresthetica

PATHOLOGY II (10 decks)

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