The Musculoskeletal System Flashcards
What is Osteoporosis?
Bone Disease characterised by a Low Bone mass due to Deterioration of the Bone Tissue, leading to Increased Fragility and a Consequent risk of a Fracture.
Porous Bones.
What is Senile Osteoporosis?
The Cause is unclear but it may be that both Osteoblasts and Osteoclasts shrink or undergo altercations to diminish their activity.
Factors important in pathogenesis are;
Less Sunshine, hence Vitamin D synthesis in the Skin
Diet - Lower calcium intake, Less Vitamin D containing foods.
What are Factors impacting Osteoporosis?
Reduction in physical activity in older people may be an important factor in bone loss because preservation of bone mass depends on skeletal stress through muscle contraction and weight bearing.
Calcium absorption from the gut decreases with age
Endocrine Disorders - hyperparathyroidism, Hyperthyroidism, Cushings Syndrome, Acromegaly.
Menopause - calcium depositing effects of oestrogen are lost.
What are the Risk Factors for Osteoporosis?
Oral Corticosteroid Therapy
Oestrogen deficiency before 45yrs
Low Levels of Gonadal Hormones
Some medical conditions
Smoking
Excessive alcohol/caffeine consumption
Family History and Genetic Factors
Maternal Hip Fractures
Insufficient dietary Calcium Intake
Thin Build
White or Asian Race
Sedentary Life Style
Reduced Mobility
Anorexia Nervosa
Coeliac Disease
Inflammatory Bowel Disease
Kidney or Liver Disease
Cancer
Multiple Myeloma
Rheumatoid Arthritis
What are the Signs and Symptoms of Osteoporosis?
Often None
Fragility Fractures
- Wrist
- Hip
- Vertebral Fractures
Loss of Height
Spinal Deformity
Bone Pain
What is Osteoarthritis?
Common painful, disabling, Degenerative Joint Disease. Primarily affects Cartilage of Weigh Bearing Joints e.g. Knees, Hips Erosion of Cartilage leads to Secondary Changes in Underlying bone
Often Limited Inflammatory changes in Synovial Membrane. OA of Hip and Knee treated surgically with Joint Replacement.
Degenerative Disease due to wear and tear of articular cartilage.
Disease causes damage to cartilage surface of synovial joints.
Severe - Joint space becomes narrowed and osteophytes form.
Pain and Difficulty in mobilising sends pt to doctor.
What are the Risk Factors for Osteoarthritis?
45 Years of Age or Over (uncommon in young people)
More Likely in Women
Higher incidence in Black and Asian Populations
May be Genetic Predisposition
Overweight and Obesity
Those with Poor Muscle Function
Occupational e.g. Farming, Healthcare
Experience of Previous Fractures
People who have had Menisectomy in the past.
What are the Signs and Symptoms of Osteoarthritis?
Joint Pain
History of Joint Stiffness
Crepitus
Swelling and Muscle weakness/Wasting
Increasing immobility and loss of function.
What is Rheumatoid Arthritis?
Common Inflammatory Auto Immune Disease of Synovial Joints. Affects Small and Large Joints.
Most Predominant in Females
Prevalence increases with age.
What is the Aetiology of Rheumatoid Arthritis?
Believed that an Antigen initiates the Auto Immune Response. Other Factors include:
- Genetic Factors
- Sex Hormones
- Diet
- Environmental Factors.
What are the Stages of Rheumatoid Arthritis?
Stage 1 - Body Mistakely attacks its own joint tissue.
Stage 2 - Body makes antibodies and joints start swelling up.
Stage 3 - Joints start becoming bent and deformed, the fingers become crooked. Can press on nerves and cause nerve pain as well.
Stage 4 - If not treated, Disease progresses to last stage, where no joint remained and joint is essentially fused.
What are the Clinical Features of Articular Rheumatoid Arthritis?
Small Joints of Hands and Feet
Hot
Swollen
Painful
Reduced range of Movement
What are the Clinical Features of Systemic Rheumatoid Arthritis?
Pain - Constant, Widespread and worse on Movement.
Stiffness - Particularly in Morning, Hours to Resolve
Fatigue
Anaemia - Suppression of Connective Tissues, Bleeding problems with long term NSAIDS.
Weight Loss - Worse initially, then stabilises.
Nodules - Soft Spongy Lumps that appear on Extensor surfaces of joints.
Vasculitis - Inflammation and Destruction of Blood Vessels.
What are Fractures?
A Fracture is a Partial or Complete Break in a Bone.
Classified as either Open or Closed
Open Fracture (Compound Fracture) - Bone pokes through the skin and can be seen. Or Deep bone exposed the Bone through the Skin.
Closed Fracture (Simple Fracture) - Bone Broken but skin remains intact.
What are the Different Types of Fractures?
Transverse - Breaks that are in a straight line across the bone. May be Caused by Trauma such as Falls and RTAs.
Spiral - Fracture spirals around the bone. Usually in long bones. E.g. Femur, Tibia or Fibula. Caused by twisting Injuries e.g. Sports
Greenstick Fracture - Mostly in Children. Bone Bends and Breaks but does not separate into two pieces. Children have soften and more flexible bones.
Depressed - Occur in Skull when broken piece is forced inward onto Brain.
Stress Fractures (Hairline Fractures) - Like a Crack, diificult to detect on X-rays. Caused by repetitive motions such as Running or Marching.
Compression Fractures - Crushing of Bones where the broken bone is wider and flatter in appearance that it was before injury. Common in Spine, cause collapse of vertebrae. Osteoporosis most common compression fracture.
Oblique Fracture - Diagonal across bone, mostly long bones. Result of Sharp blow from an angle.
Impacted Fracture - Broken ends of bone driven together, jammed together by force of injury.
Segmental Fracture - Bone is Fractured in two places, leaving ‘floating’ segment of bone between two breaks. Usually long bones. Longer heal time.
Comminuted Fracture - 3 or more pieces with bone fragments. High impact trauma.
Avulsion Fracture - Fragments of Bone is pulled off by a Tendon or Ligament. More common in children.
