Quiz 4 Clinicals

Question 1

Spina bifida

Answer 1

Congenital defect of the vertebral column in which laminae L5 or S1 fail to develop normally and unite at midline. Includes protrusions of meninges and or the spinal cord through the defect in the laminae. In severe cases there might be partial or complete paralysis, partial or complete loss of urinary and bowel control and an absence of reflexes.

Question 2

What is an increased risk for spina bifida?

Answer 2

Low levels of folic acid (B vitamin) during pregnancy

Diagnosed prenatally by testing mother’s blood for alphafetoprotein

Question 3

Caudal anesthesia

Answer 3

Anesthetic agents that act on the sacral and coccygeal nerves and are injected through the sacral hiatus or posterior sacral foramina. Lumber is preferred because it is easier to locate

Question 4

Rickets

Answer 4

Inadequate calcification of the extracellular bone matrix, usually caused by vitamin D deficiency. Found in children in which growing bones become soft or rubbery and are easily deformed. New bone formed at epiphyseal plates fails to ossify which results in bowed legs, and deformities of the skull

Question 5

Osteomalacia

Answer 5

Adult counterpart of rickets
New bone formed during remodeling fails to calcify and the person experiences varying degrees of pain and tenderness in bones, especially the hips and legs. Bone fractures result from minor trauma

Question 6

How to treat Ricketts/osteomyelitis?

Answer 6

Administration of adequate vitamin D and moderate exposure to sunlight

Question 7

Osteoporosis

Answer 7

Bone resorption outpaces bone deposition
Due to depletion of calcium from the body, more calcium is lost in urine, feces and sweat than is absorbed from diet
Bone mass becomes so depleted bones fracture spontaneously under everyday stresses

Question 8

What stimulates osteoblast activity?

Answer 8

Estrogen and testosterone

Question 9

Bone mineral density test

Answer 9

Performed like x-rays
Measure bone density
Diagnose osteoporosis

Question 10

Osteoporosis Treatment

Answer 10

Calcium
Vitamin D
Antireabsorptive drugs
Bond-building drugs

Question 11

Osteopenia

Answer 11

Low bone mass due to decrease in bone synthesis

Question 12

Scoliosis

Answer 12

Lateral bending of the vertebral column, usually in the thoracic region
May result from malformed vertebrae, chronic sciatica, paralysis of muscles on one side of the vertebral column, poor posture or one leg being shorter than the other

Question 13

Kyphosis

Answer 13

Increase in the thoracic curve of the vertebral column. In tuberculosis of the spine, vertebral bodies may partially collapse, causing an acute angular bending of the vertebral column. In the elderly, degeneration of the intervertebral discs leads to this
Common in women with osteoporosis

Question 14

Lordosis

Answer 14

Increase in the lumbar curve of the vertebral column. May result from increased weight of the abdomen (pregnancy, extreme obesity), poor posture, rickets, osteoporosis or tuberculosis

Question 15

Herniated Disc

Answer 15

Nucleus pulposus protrudes into one of the adjacent vertebral bodies
Caused by stress on intervertebral discs
Most often occur in lumbar area
Slips posteriorly towards the spinal cord and nerves, exerts pressure on nerves causing weakness and acute pain
Sciatic nerve can affects thigh, calf and foot

Question 16

Herniated disc treatment

Answer 16

Rest
Medications for pain
PT
Percutaneous endoscopic disectomy
Laminectomy

Question 17

Laminectomy

Answer 17

Surgical procedure involving removal of a vertebral lamina to access the vertebral canal and relieve the symptoms of a herniated disc

Question 18

Osteomyelitis

Answer 18

Infection of bone characterized by high fever, sweating, chills, pain and nausea, pus formation, edema, warmth over affecting bone and rigid overlying muscle
Caused by bacteria, usualy S. aureus
May reach bone from outside body, blood, other sites of infection or adjacent soft tissue infections

Question 19

Gigantism

Answer 19

Over secretion of human growth hormone during childhood

Person becomes much taller and heavier than normal

Question 20

Acromegaly

Answer 20

Oversecretion of human growth hormone during adulthood
Cannot cause further lengthening o bones because epiphyseal plates have already closed
Bones of hands, feet and jaw thicken
Eyelids, lips, tongue and nose enlarge and the skin thickens and furrows

Question 21

Pituitary dwarfism

Answer 21

Short stature
Under secretion of hGH
Head, trunk and limbs are shorter than normal but proportionate
Can be treated with hGH until epiphyseal plates close

Question 22

Achondroplastic Dwarfish

Answer 22

Inherited condition
Conversion of cartilage to bone is abnormal
Average size trunk, short limbs and slightly enlarged head with a prominent forehead and flattened nose
Essentially untreatable

Question 23

Paget’s disease

Answer 23

Excessive proliferation of osteoclasts so that bone resorption occurs faster than bone deposition.
In response osteoblasts attempt to compensate, but the new bone is weaker because it has a greater amount of spongy bone, mineralization is decreased and the ECM has irregular proteins
The newly formed bone becomes enlarged, hard, brittle and fractures easily

Question 24

Bone scan

Answer 24

Diagnostic procedure
Small amount of radioactive tracer compound that is absorbed by bone is injected intravenously
Amount of uptake is proportional to blood flow to bone
Measures gamma radiated from bones and creates picture