Unit 2 - Chapter 9 - Musculoskeletal System Disorders Flashcards
what are the 4 different types of bones
long bones
short bones
flat bones
irregular bones
what does bone tissue consist of
- matrix
- mature bone cells (osteocytes)
- bone producing cells (osteoblasts)
- bone reabsorbing cells (osteoclasts)
what are the 2 types of bone structure and expand on both
compact - outer covering of bone
cancellous (spongy) - interior of bone
what is the periosteum
connective tissue covering over the bone
what is the endosteum
osteoblast-rich lining of medullary cavity
what are the 4 functions of skeletal muscle
- facilitate body movement
- maintain body position
- stabilize joints
- produce heat
what are some characteristics of skeletal muscle
- usually under voluntary control
- bundles of protein fibers covered by connective tissue
- well supplied with nerves and blood vessels
- stimulation occurs at myoneural junction
- myoglobin stores oxygen in fibers
- glucogen stored for energy
- attachechements - directly to periosteum or by tendon
- cells do not undergo mitosis after birth
what are the 3 types of connective tissue coverings of skeletal muscle
epimysium
perimysium
endomysium
where does the epimysium surround
the entire muscle
what does the perimysium surround
muscle fascicles
what does the endomysium surrond
individual muscle fibers
expand on the motor unit
motor neuron in the spinal cord and all muscle fibers innervated by the neurons
expand on the neuromuscular junction
synapse between the motor neuron nerve fiber and muscle fiber
what is the step by step process of neuromuscular transmission and muscle contraction
- arrival of the action potential
- depolarization of the presynaptic terminal
- calcium influx
- exocytosis of the neurotransmitter
- diffusion of neurotransmitter to postsynaptic receptors
- generation of muscle action potential
- release of calcium from sarcoplasmic reticulum
- power stroke (contraction of muscle fiber)
expand on joints
- connection between bones
- accomplished by tendons and ligaments
- little blood supply (healing is slow and difficult)
what are the 3 different types of joints and expand on each of them
- synarthroses, immovable joints
- amphiarthroses, slightly movable
- diarthroses, freely moveable
what is articular cartilage in the synovial joint
coverring over ends of bones
what isthe synovial membrane in the synovial joint
- produces synovial fluid that fills space between ends of bones
what is articular capsule in the synovial joint
consists of synovial membrane, a fibrous capsule
what are ligaments in the synovial joint
reinforce capsule, links bones, supports joint
what is the menisci in the synovial joint
lateral pads in some joints to stabilize
what is bursae in the synovial joint
fluid filled sacs to add extra cushion
what tests would you do for suspected bone disorders
radiography and bone scan
what tests would you do for suspected muscular disorders
electromyography (EMG) and biopsy
what tests would you do for suspected joint disorders
radiography, arthoscopy, mri, examination of synovial fluid
what is a fracture and what can cause them
- a break in the integrity of a bone
- occur because of trauma, neoplasms, or increased stress on bones
what is a complete fracture
when the bone is broken and forming seperate pieces
what is a incomplete fracture
bone only partially broken
what is a open fracture
when the skin is open and broken
what is a closed fracture
when the skin is closed and not broken
what is a simple fracture
single break, maintaining alignment and position
what is a comminuted fracture
multiple fractures and bone fragments
what is a compression fracture
when the bone is crushed or collapsed into small pieces
what are other types of fracture
- impacted (one end forced into adjacent bone)
-pathologic (results from weakness) - stress, depressed, transverse, linear, oblique and spiral fracture
expand on the pathophysiology of a bone fracture
- fractures initiate an inflammatory response and hematosis
- bleeding
- edema causes stretching of periosteum and swelling of soft tissues (severe pain)
- release of bradykinin and other chemical mediators also contribute to main
- clot forms ar fracture site
- systemic signs of inflammation may occur
- hematoma (fibrin newwork is formed)
- phagocytic cells remove debris
- fibroblasts lay down new collagen fibers
- chondoblasts form new cartilage
- formation of procallus (fibrous collar)
- osteoblasts generate new bone
- procallus is replaces by bony callus
- remodeling of bone with return to use
what factors affect bone healing
- amount of local damage
- proximity of bone ends
- presence of foreign material or infection
- blood supply to fracture site
- age, nutrition, anemia
what are complications of fractures
- muscle spasms
- infections
- ischemia
- fat emboli
- nerve damage
- failure to heal or development of deformity during healing
- residual effects such as osteoarthritis
expand on compartment syndome when it comes to healing fracture
- tight cast can cause it
- ischemia and infraction of tissue may occue because of compression of arterial blood supply
- dead tissue may become gangrenous, requiring amputation
what are the 2 treatments for fractures….expand on them
closed reduction - pressure to restore bone position
open reduction - surgery to align and/or insert pins, screw rods or plates to align
expand on dislocations
- seperation of two bones at a joint, with loss of contact between articulating surfaces
- usually accompanies by significant soft tissue damage to ligaments and tendons
- distortion of joint usually evident
- may recur repeatedly, requiring surgery
what is a sprain
a tear in a ligament
what is a strain
a tear in a tendon
what is an avulsion
ligaments or tendons completely separates from bony attachments
what are other injures that can occur to joints
- overuse injuries
- repetitive strain injuries (injuries that develop over a period of time in which the same movement is repeated (massage, keyboard, running)
how do you diagnose joint injuries
- history of joint use and any trauma
- physical examination of joint, including range of motion
- radiography or MRI
- arthroscopy may be done, accompanied by treatment
what is the treatment for joint injuries
- rice (rest, immobilization, compression, elevation)
- nonsterioidal antiinflammatory drugs
- physiotherapy
- massage of surrounding tissue
expand on muscle tears
- can occue as a result of a trauma or overextension or overstressing of the muscle
- repeated injuried will result in fibrous scar tissue replacing normal structure
what are the 3 degrees of muscle tears…expand on each
- first degree (involves a small percentage of muscle fibers)
- second degree (involves much of the muscle but is not a complete tear)
- third degree (a complete tear across the width of the muscle)
what is osteoporosis
decrease in bone mass and density
what are the 2 forms osteoporosis appears
primary
- ideopathic (have a cause)
- age 50+
- decreased sex hormones
- decreased calcium intake
secondary
- as a complication of another disorder
what is the pathophysiology of osteoporosis
- bone resorption exceeds formation
- results in loss of compact bone
- diagnosed with bone density scans
- can cause compression fractures of vertebrae, wrist or hip
- can lead to kyphosis and scoliosis
what are the predisposing factors for osteoporosis
- age 50 +
- decreased mobility or sedentary lifestyle
- hormonal factors
- calcium, vitamin d or protein deficiency
- smoking
- small light bone structure
- excessive caffeine intake
what is the treatment for osteoporosis
- supplements
- bisphosphonates
- calcitonin
- human parathyroid hormone
- weight bearing exercise
- surgery to reduce kyphosis
expand on rickets and osteomalacia
- results from vitamin d and phosphate deficiency
- causes are dietary deficits, malabsorption, intake of phenobarbital, lack of sun exposure
- in children it leads to weak bones and other skeletal deformities
- in adults, it leads to soft bones, resulting in compression fractures
expand on paget disease
- occurs in adults 40+
- exact cause has not yet been established
- bone destruction replaced by fibrous tissue
- pathologic fractures are common
- in vertebrae it results in compression fractures and kyphosis
- in skull it leads to increased pressure resulting in headaches and compression of cranial nerves (severe pain)
what is osteomyelitis
bone infection caused by bacteria or fungi
what are the signs and symptoms of osteomyelitis
- local inflammation and bone pain
- fever and excessive sweating
- chills
- general malasise
what is the treatment for osteomyelitis
- antibiotics
- surgery may be required
what are the names of the 3 abnormal curvatures of the spine
lordosis
kyphosis
scoliosis
what is lordosis
swayback (curving inward at the lower back)
what are the causes of lordosis
achondroplasia
obesity
discitis
slipping forward of the vertebrae
what is kyphosis
hunchback or humpback (abnormally rounded upper back)
what are the causes of kyphosis
poor posture
spina bifida
congenital defects
spinal tumor or infections
scheuermann disease
what is scoliosis
S or C shaped - sideways curve to the spine
what is the treatment for abnormal curvatures of the spine
- medication for pain and inflammation
- weight loss
- wearing a brace
- exercises and physical therapy
- surgery
expand on bone tumors
- common site of secondary tumors from breast, lung or prostate tumors
- most primary tumors are termed sarcomas are malignant
what is the most common primary neoplasm of bone and expand on it
osteosarcoma
- occurs in the shaft of long bones of the leg
- common in children, adolscents and young adults
- bone pain at rest is a warning sign for this cancer
expand on chondrosarcomas
arise from cartiliage cells and most common in adults
expand on ewing sarcome
common in adolescents and usually occurs in the shaft of long bones
where do bone tumors merastasize to in the course of the disease
the lungs
what is the treatment for bone tumors
- excision of tumor
- surgical amputation
- chemotherapy
what is muscular dystrophy
- group of autosomal recessive disorders
- degeneration of skeletal muscle over time
what are the signs and symptoms of muscular dystrophy
- early motor weakness
- weakness in pelvic girdle
- gower maneuver (pushing up to erect position)
- tendon reflexes reduced
- deformities develop such as abnormal spine curvatures
- respiratory infections are common
- cardiac myopathy is common
what are the diagnostic tests you would run for someone with muscular dystrophy
- identification of common genetic abnormalities
- elevated creatine kinase levels
- electromyography
- muscle biopsy
- blood test shows abnormal dystrophin levels
what is the treatment for muscular dystrophy
- no cure is available
- excercise to maintain motor function
- supportive appliances
- physiotherapy and occupational therapy
- massage
- ventilator
what is fibromyalgia
- group of disorders characterized by pain and stiffness
- affecting muscles and surrounding soft tissues
what is the pathophysiology of fibromyalgia
- no obvious signs of inflammation or degeneration
- unknown cause
- predisposing and aggravating factors
what are the symptoms of fibromyalgia
- generalized aching pain
- marked fatigue
- sleep distrubances
- depression
- in some individuals, irritable bowel syndrome or urinary symptoms due to interstital cystitis
what is the treatment for fibromyalgia
- stress avoidance or reduction
- morning excercise
- pace activity and rest
- applications of heat or massage
- analgesic drugs
what is osteoarthritis
- degenerative wear and tear joint disease
- may be the result of increased weight bearing or lifting
- incidence increasing
- genetic componenet identified in research with mice
what is the pathophysiology of osteoarthritis
- articular cartilage is damaged
- surface of cartilage becomes rough and worn
- subchondral bone may be exposed
- cysts, osteophytes or new bone spurs develop
- joint space becomes narrower
- loss of normal range of joint motion
- pain with weight bearing and use
what is the etiology of osteoarthritis
- primary form (weight bearing, obesity, aging)
- secondary form (follows trauma or repetitive use)
- genetic factors
what are the signs and symptoms of osteoarthirits
- aching pain
- limited joint movement
- walking is difficult
- ## predisposition to falls
what is the treatment for osteoarthirits
- minimize stress on joints
- pacing activity
- mild excercise
- supports
- shoe inserts
- massage, physiotherapy, acupuncture, occupational therapy
- supplements
- analegsecs
- surgical joint replacement
what is rheumatoid arthritis
- autoimmune disorder
- caused chronic systemic inflammatory disease
- higher incidence in women than in men
- affects all age groups
what is the pathophysiology of rheumatoid arthritis
- inflammation
- cartilage erosion
- fibrosis
- joint fixation and deformity develop if untreated
what are other changes that happen with rheumatoid arthritis
- frequently occur around the jounts
- atrophy of muscles
- bone alignment shifts
- muscle spasms caused by inflammation and pain
- contractures and deformity develop
what is the etiology of rheumatoid arthritis
- exact cause not known
- fenetic factirs
- family predisposition
- some links to viral infections
what are the signs and symptoms of rheumatoid arthirits
- inflammation
- red swollen joints
- sensitive to touch
- joint stiffness
- joint movement impaired
what are the systemic effects of rheumatoud arthritis
- fatigue
- depression
- malaise
- anorexia
- low grade fever
- iron defiviency anemia
what is the treatment for rheumatoid arthritis
- Balance between rest and moderate activity
- Heat and cold applications
- Physical and occupational therapy
- NSAIDs
- Glucocorticoids for severe inflammation
- Analgesia for pain
- Disease-modifying antirheumatic drugs, such as gold salts, methotrexate, hydroxychloroquine
- Biologic response–modifying agents, such as infliximab, rituximab, anakinra
what is juvenile rheumatoid arthritis
- onset more acute than adult form
- large joint s frequently affected
expand on the 3 forms of juvenile rheumatoid arthritis
- still disease (systemic form) —fever, rash, lymphadenopathy, hepatomegaly, joint involvement
- second form causes polyarticular inflammation
- third form involves fewer joints but causes inflammation of the eye
what is infectious arthritis
- also known as septic arthritis
- develops in a single joint
- joint is red, swollen, painful with decreased movement
what are the causes of infectious arthritis
- direct introduction of bacteria into joint such as trauma, nonsterile injection, surgery
what is the treatment for infectious arthritis
- antimicrobials over sustaines period, often requires IV administration
expand on gout
- also known as gouty arthritis
- results from deposits of uric acid and crystals in the joint, causing inflammation
- formation of large hard nodule of urate crystals which causes local inflammation and occurs after the first attack of gout
how is gout diagnosed and how is it treated
- diagnosed by examination of synovial fluid and blood tests
- reated by reducing uric acid levels with drugs and dietary changes
what is ankylosing spindylitis
- chronic, progressive, inflammatory condition
- affects sacroiliac joints, intervertebral spaces, costovertebral joints
- cause has not been determined
what is the pathophysiology of ankylosing spindylitis
- the vertebral joints first become inflamed
- fibrosis and calcification or fusion of the joints
- inflammation begins in the lower back
- kyphosis develops
- osteoporosis is common
- lung expansion may be limited at this stage
what are the signs and symptoms of ankylosing spindylitis
- low back pain
- morning stiffness
- as calicfication develops, the spine becomes more rigid and flexion, extension and rotation of the spine are impaired
- ## some individuals develop systemic signs such as fatigue, fever, and weight loss
expand on bursitis
- inflamation of the bursae
- cause is repetitive motion on a particular joint
- diagnosis requires physical examination, ultrasound or MRI
- treatment options include rest, antiinflammatory drugs
expand on synovitis
- inflammation of the synovial membrabe
- movement of joint is restricted and painful
- diagnosis requires a swollen, red and warm joint and analysis of synovial fluid
what is the treatment for synovitis
- antiinflammatory drugs
- identification and treatment of underlying cause
expand on tendinitis
- irritation or inflammation of tendon
- manifestation is dull ache and mild swelling
- cause is a single trauma or repetitive motion
- diagnosis is made by physical examination
- treatment is rest, application of ice, pain relievers and physical therapy
