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Pathophysiology > Unit 2 - Chapter 9 - Musculoskeletal System Disorders > Flashcards

Unit 2 - Chapter 9 - Musculoskeletal System Disorders Flashcards

1
Q

what are the 4 different types of bones

A

long bones
short bones
flat bones
irregular bones

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2
Q

what does bone tissue consist of

A
  • matrix
  • mature bone cells (osteocytes)
  • bone producing cells (osteoblasts)
  • bone reabsorbing cells (osteoclasts)
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3
Q

what are the 2 types of bone structure and expand on both

A

compact - outer covering of bone

cancellous (spongy) - interior of bone

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4
Q

what is the periosteum

A

connective tissue covering over the bone

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5
Q

what is the endosteum

A

osteoblast-rich lining of medullary cavity

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6
Q

what are the 4 functions of skeletal muscle

A
  • facilitate body movement
  • maintain body position
  • stabilize joints
  • produce heat
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7
Q

what are some characteristics of skeletal muscle

A
  • 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
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8
Q

what are the 3 types of connective tissue coverings of skeletal muscle

A

epimysium
perimysium
endomysium

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9
Q

where does the epimysium surround

A

the entire muscle

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10
Q

what does the perimysium surround

A

muscle fascicles

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11
Q

what does the endomysium surrond

A

individual muscle fibers

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12
Q

expand on the motor unit

A

motor neuron in the spinal cord and all muscle fibers innervated by the neurons

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13
Q

expand on the neuromuscular junction

A

synapse between the motor neuron nerve fiber and muscle fiber

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14
Q

what is the step by step process of neuromuscular transmission and muscle contraction

A
  • 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)
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15
Q

expand on joints

A
  • connection between bones
  • accomplished by tendons and ligaments
  • little blood supply (healing is slow and difficult)
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16
Q

what are the 3 different types of joints and expand on each of them

A
  • synarthroses, immovable joints
  • amphiarthroses, slightly movable
  • diarthroses, freely moveable
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17
Q

what is articular cartilage in the synovial joint

A

coverring over ends of bones

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18
Q

what isthe synovial membrane in the synovial joint

A
  • produces synovial fluid that fills space between ends of bones
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19
Q

what is articular capsule in the synovial joint

A

consists of synovial membrane, a fibrous capsule

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20
Q

what are ligaments in the synovial joint

A

reinforce capsule, links bones, supports joint

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21
Q

what is the menisci in the synovial joint

A

lateral pads in some joints to stabilize

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22
Q

what is bursae in the synovial joint

A

fluid filled sacs to add extra cushion

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23
Q

what tests would you do for suspected bone disorders

A

radiography and bone scan

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24
Q

what tests would you do for suspected muscular disorders

A

electromyography (EMG) and biopsy

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25
Q

what tests would you do for suspected joint disorders

A

radiography, arthoscopy, mri, examination of synovial fluid

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26
Q

what is a fracture and what can cause them

A
  • a break in the integrity of a bone
  • occur because of trauma, neoplasms, or increased stress on bones
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27
Q

what is a complete fracture

A

when the bone is broken and forming seperate pieces

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28
Q

what is a incomplete fracture

A

bone only partially broken

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29
Q

what is a open fracture

A

when the skin is open and broken

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30
Q

what is a closed fracture

A

when the skin is closed and not broken

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31
Q

what is a simple fracture

A

single break, maintaining alignment and position

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32
Q

what is a comminuted fracture

A

multiple fractures and bone fragments

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33
Q

what is a compression fracture

A

when the bone is crushed or collapsed into small pieces

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34
Q

what are other types of fracture

A
  • impacted (one end forced into adjacent bone)
    -pathologic (results from weakness)
  • stress, depressed, transverse, linear, oblique and spiral fracture
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35
Q

expand on the pathophysiology of a bone fracture

A
  • 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
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36
Q
A
  • 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
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37
Q

what factors affect bone healing

A
  • amount of local damage
  • proximity of bone ends
  • presence of foreign material or infection
  • blood supply to fracture site
  • age, nutrition, anemia
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38
Q

what are complications of fractures

A
  • muscle spasms
  • infections
  • ischemia
  • fat emboli
  • nerve damage
  • failure to heal or development of deformity during healing
  • residual effects such as osteoarthritis
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39
Q

expand on compartment syndome when it comes to healing fracture

A
  • 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
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40
Q

what are the 2 treatments for fractures….expand on them

A

closed reduction - pressure to restore bone position

open reduction - surgery to align and/or insert pins, screw rods or plates to align

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41
Q

expand on dislocations

A
  • 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
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42
Q

what is a sprain

A

a tear in a ligament

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43
Q

what is a strain

A

a tear in a tendon

44
Q

what is an avulsion

A

ligaments or tendons completely separates from bony attachments

45
Q

what are other injures that can occur to joints

A
  • overuse injuries
  • repetitive strain injuries (injuries that develop over a period of time in which the same movement is repeated (massage, keyboard, running)
46
Q

how do you diagnose joint injuries

A
  • 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
47
Q

what is the treatment for joint injuries

A
  • rice (rest, immobilization, compression, elevation)
  • nonsterioidal antiinflammatory drugs
  • physiotherapy
  • massage of surrounding tissue
48
Q

expand on muscle tears

A
  • 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
49
Q

what are the 3 degrees of muscle tears…expand on each

A
  • 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)
50
Q

what is osteoporosis

A

decrease in bone mass and density

51
Q

what are the 2 forms osteoporosis appears

A

primary
- ideopathic (have a cause)
- age 50+
- decreased sex hormones
- decreased calcium intake

secondary
- as a complication of another disorder

52
Q

what is the pathophysiology of osteoporosis

A
  • 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
53
Q

what are the predisposing factors for osteoporosis

A
  • age 50 +
  • decreased mobility or sedentary lifestyle
  • hormonal factors
  • calcium, vitamin d or protein deficiency
  • smoking
  • small light bone structure
  • excessive caffeine intake
54
Q

what is the treatment for osteoporosis

A
  • supplements
  • bisphosphonates
  • calcitonin
  • human parathyroid hormone
  • weight bearing exercise
  • surgery to reduce kyphosis
55
Q

expand on rickets and osteomalacia

A
  • 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
56
Q

expand on paget disease

A
  • 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)
57
Q

what is osteomyelitis

A

bone infection caused by bacteria or fungi

58
Q

what are the signs and symptoms of osteomyelitis

A
  • local inflammation and bone pain
  • fever and excessive sweating
  • chills
  • general malasise
59
Q

what is the treatment for osteomyelitis

A
  • antibiotics
  • surgery may be required
60
Q

what are the names of the 3 abnormal curvatures of the spine

A

lordosis
kyphosis
scoliosis

61
Q

what is lordosis

A

swayback (curving inward at the lower back)

62
Q

what are the causes of lordosis

A

achondroplasia
obesity
discitis
slipping forward of the vertebrae

63
Q

what is kyphosis

A

hunchback or humpback (abnormally rounded upper back)

64
Q

what are the causes of kyphosis

A

poor posture
spina bifida
congenital defects
spinal tumor or infections
scheuermann disease

65
Q

what is scoliosis

A

S or C shaped - sideways curve to the spine

66
Q

what is the treatment for abnormal curvatures of the spine

A
  • medication for pain and inflammation
  • weight loss
  • wearing a brace
  • exercises and physical therapy
  • surgery
67
Q

expand on bone tumors

A
  • common site of secondary tumors from breast, lung or prostate tumors
  • most primary tumors are termed sarcomas are malignant
68
Q

what is the most common primary neoplasm of bone and expand on it

A

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
69
Q

expand on chondrosarcomas

A

arise from cartiliage cells and most common in adults

70
Q

expand on ewing sarcome

A

common in adolescents and usually occurs in the shaft of long bones

71
Q

where do bone tumors merastasize to in the course of the disease

A

the lungs

72
Q

what is the treatment for bone tumors

A
  • excision of tumor
  • surgical amputation
  • chemotherapy
73
Q

what is muscular dystrophy

A
  • group of autosomal recessive disorders
  • degeneration of skeletal muscle over time
74
Q

what are the signs and symptoms of muscular dystrophy

A
  • 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
75
Q

what are the diagnostic tests you would run for someone with muscular dystrophy

A
  • identification of common genetic abnormalities
  • elevated creatine kinase levels
  • electromyography
  • muscle biopsy
  • blood test shows abnormal dystrophin levels
76
Q

what is the treatment for muscular dystrophy

A
  • no cure is available
  • excercise to maintain motor function
  • supportive appliances
  • physiotherapy and occupational therapy
  • massage
  • ventilator
77
Q

what is fibromyalgia

A
  • group of disorders characterized by pain and stiffness
  • affecting muscles and surrounding soft tissues
78
Q

what is the pathophysiology of fibromyalgia

A
  • no obvious signs of inflammation or degeneration
  • unknown cause
  • predisposing and aggravating factors
79
Q

what are the symptoms of fibromyalgia

A
  • generalized aching pain
  • marked fatigue
  • sleep distrubances
  • depression
  • in some individuals, irritable bowel syndrome or urinary symptoms due to interstital cystitis
80
Q

what is the treatment for fibromyalgia

A
  • stress avoidance or reduction
  • morning excercise
  • pace activity and rest
  • applications of heat or massage
  • analgesic drugs
81
Q

what is osteoarthritis

A
  • 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
82
Q

what is the pathophysiology of osteoarthritis

A
  • 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
83
Q

what is the etiology of osteoarthritis

A
  • primary form (weight bearing, obesity, aging)
  • secondary form (follows trauma or repetitive use)
  • genetic factors
84
Q

what are the signs and symptoms of osteoarthirits

A
  • aching pain
  • limited joint movement
  • walking is difficult
  • ## predisposition to falls
85
Q

what is the treatment for osteoarthirits

A
  • minimize stress on joints
  • pacing activity
  • mild excercise
  • supports
  • shoe inserts
  • massage, physiotherapy, acupuncture, occupational therapy
  • supplements
  • analegsecs
  • surgical joint replacement
86
Q

what is rheumatoid arthritis

A
  • autoimmune disorder
  • caused chronic systemic inflammatory disease
  • higher incidence in women than in men
  • affects all age groups
87
Q

what is the pathophysiology of rheumatoid arthritis

A
  • inflammation
  • cartilage erosion
  • fibrosis
  • joint fixation and deformity develop if untreated
88
Q

what are other changes that happen with rheumatoid arthritis

A
  • frequently occur around the jounts
  • atrophy of muscles
  • bone alignment shifts
  • muscle spasms caused by inflammation and pain
  • contractures and deformity develop
89
Q

what is the etiology of rheumatoid arthritis

A
  • exact cause not known
  • fenetic factirs
  • family predisposition
  • some links to viral infections
90
Q

what are the signs and symptoms of rheumatoid arthirits

A
  • inflammation
  • red swollen joints
  • sensitive to touch
  • joint stiffness
  • joint movement impaired
91
Q

what are the systemic effects of rheumatoud arthritis

A
  • fatigue
  • depression
  • malaise
  • anorexia
  • low grade fever
  • iron defiviency anemia
92
Q

what is the treatment for rheumatoid arthritis

A
  • 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
93
Q

what is juvenile rheumatoid arthritis

A
  • onset more acute than adult form
  • large joint s frequently affected
94
Q

expand on the 3 forms of juvenile rheumatoid arthritis

A
  • 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
95
Q

what is infectious arthritis

A
  • also known as septic arthritis
  • develops in a single joint
  • joint is red, swollen, painful with decreased movement
96
Q

what are the causes of infectious arthritis

A
  • direct introduction of bacteria into joint such as trauma, nonsterile injection, surgery
97
Q

what is the treatment for infectious arthritis

A
  • antimicrobials over sustaines period, often requires IV administration
98
Q

expand on gout

A
  • 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
99
Q

how is gout diagnosed and how is it treated

A
  • diagnosed by examination of synovial fluid and blood tests
  • reated by reducing uric acid levels with drugs and dietary changes
100
Q

what is ankylosing spindylitis

A
  • chronic, progressive, inflammatory condition
  • affects sacroiliac joints, intervertebral spaces, costovertebral joints
  • cause has not been determined
101
Q

what is the pathophysiology of ankylosing spindylitis

A
  • 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
102
Q

what are the signs and symptoms of ankylosing spindylitis

A
  • 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
103
Q

expand on bursitis

A
  • 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
104
Q

expand on synovitis

A
  • 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
105
Q

what is the treatment for synovitis

A
  • antiinflammatory drugs
  • identification and treatment of underlying cause
106
Q

expand on tendinitis

A
  • 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

Pathophysiology (11 decks)

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