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Pathophysiology > Week 6: Musculoskeletal > Flashcards

Week 6: Musculoskeletal Flashcards

1
Q

skeletal trauma

A

fractures & dislocations

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2
Q

support structure trauma

A

sprains and strains
tendinopathy and bursitis
muscle strains

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3
Q

a fracture is a

A

break in the continuity of a bone

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4
Q

incidence for specific bones varies by

A

age and gender

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5
Q

fractures are classified as

A 
complete 
incomplete
open
closed
comminuted
linear
oblique
spiral
transverse
greenstick
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6
Q

pathologic fracture

A

break at the site of a preexisting abnormality

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7
Q

stress fracture

A

d/t being subjected to repeated stress – e.g. athletics

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8
Q

transchondral fracture

A

fragmentation and separation of portion of articular cartilage

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9
Q

steps in fracture healing

A

Periosteum and blood vessels disrupted
Bleeding from ends and neighbouring soft tissue
Clot forms in medullary canal
Adjacent bone tissue dies – stimulates intense inflammatory response
Within 48 hours vascular tissue invades area – blood flow to bone
Bone-forming cells activated to produce subperiosteal procallus along bone shaft and over break
Osteoblasts synthesize collagen and matrix
This forms callus
Remodeling occurs, trabeculae formed along lines of stress

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10
Q

fracture clinical manifestations

A
  • S & S include impaired function, unnatural alignment, swelling, muscle spasm, tenderness, pain and impaired sensation
  • Position of bone affected by pull of attached muscles, gravity, direction and magnitude of fracture force
  • Immediate pain d/t trauma, secondary pain d/t soft tissues or muscles
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11
Q

tx of fractures

A
  • Must realign the bone fragments (reduction) & hold fragments in place (immobilization)
  • Most done by closed reduction
  • Traction to accomplish or maintain reduction (skin or skeletal)
  • External fixation used external frame of clamps
  • Open reduction – a surgical procedure
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12
Q

dislocation

A

a temporary displacement of 2 bones in which the bone surfaces lose contact entirely

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13
Q

subluxation

A

the contact bw two bones is partially lost

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14
Q

most commonly dislocated

A

shoulder, elbow, wrist, finger, hip, and knee

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15
Q

dislocation and subluxation cm

A
  • bruise nerves, vessels, ligaments, supporting structure, soft tissues occurs as well
  • Pain, edema, limitation in motion, deformity
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16
Q

ligament

A

band of fibrous ct that connects bones at a joint

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17
Q

tendon

A

fibrous ct that attaches skeletal muscle to bone

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18
Q

strain

A

tear in tendon

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19
Q

sprain

A

tear in ligament

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20
Q

sprain and strain steps in healing

A

Inflammation exudate develops between the torn ends
Granulation tissue forms containing macrophages, fibroblasts, and capillary buds
Within 5 days, collagen forms unorganized and then later interweave with existing fibres
A healing tendon in unable to withstand pull for 5 weeks
The entire process could take years to repair a tendon or ligament (longer than a break)

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21
Q

sprains and strains cm

A 
pain
 edema 
changes in tendon or ligament contour
dislocation and subluxation of bones
tenderness
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22
Q

muscle tears

A

muscle fibres are torn resulting in bleeding

fibres do heal but other fibres compensate

23
Q

idiopathic oa

A

no known cause but may be inherited

24
Q

secondary oa

A

associated with joint stress, congenital abnormalities or joint instability caused by trauma

25
Q

oa most often affects

A 
hands 
wrists
neck
lower back
hip
knees
ankles
feet
26
Q

loss of articular cartilage patho

A
  • Cartilage becomes yellow or brownish grey
  • Surface areas flake off
  • Becomes thin or may be absent in some areas
  • Bone is unprotected – becomes sclerotic
  • Cartilage-coated osteophytes may grow outwards
  • Pieces of spur break off- irritate synovial membrane
  • Joint capsule becomes thickened
27
Q

oa clinical manifestations

A 
pain and stiffness in joints
aggravated by weight bearing and relieved by rest
nocturnal pain not relieved by resting
limited ROM
crepitus
changes in ambulation and gait
28
Q

joint effusion, inflammatory exudate or blood in synovial cavity caused by

A
  • presence of osteophyte fragments in synovial cavity
  • drainage of cysts from diseased subchondral bone
  • acute trauma to joint structures
29
Q

oa dx

A

clinical assessment, xray, ct scan, mri

30
Q

oa tx

A

rest, ROM exercises, use of aids, weight loss, analgesics, antiinflammatories, and surgery

31
Q

rheumatoid arthritis

A

autoimmune disease, chronic inflammation of connective tissue that affects the synovial membrane

32
Q

RA joints most affected

A

fingers, feet, wrists, elbows, knees, ankles

may also affect lungs, heart, kidneys, and skin

33
Q

RA cm

A
  • Joints become painful, tender and stiff
  • Morning stiffness lasting more than 1 hour
  • Progresses from smaller joints -> weight-bearing joints
  • Joint swelling widespread and symmetric
  • Joint deformities -> loss of joint motion -> contractures -> muscle atrophy
  • formation of nodules
34
Q

RA dx

A

PE, xray, blood tests

35
Q

RA tx

A
  • rest of joints and body, heat and cold, PT, high calorie intake and vitamin rich diet
  • drugs - corticosteroids, antiinflammatories, and immunosuppressants
  • surgery
36
Q

ankylosing spondylitis

A

chronic inflammatory joint disease characterized by fusion of spine and sacroiliac joints

37
Q

genotype assoc. with ankylosing spondylitis

A

HLA B27

38
Q

gout

A

excess uric acid in blood that causes precipitation of urate crystals in joints

39
Q

physiologic contracture

A

d/t failure of calcium pump in presence of ATP - temporary if underlying pathology reversed
occurs in the absence of muscle action potential

40
Q

pathologic contracture

A

permanent - caused by muscle spasm or weakness

may be a response to pain or secondary to scar formation (burns)

41
Q

osteomyelitis

A

infectious bone disease caused by bacteria, viruses, fungi, and parasites

42
Q

osteomyelitis is difficult to treat bc

A

bone contains multiple channels that encourage proliferation of infectious cells - natural defenses do not penetrate
tiny vessels 1) are easily damaged, and 2) make obstruction by bacteria easy, leads to necrosis
bone cells destroyed by infection are not easily replaced, bone production lags behind bone resorption by osteoclasts

43
Q

exogenous osteomyelitis

A

infection from outside the body - spreads from soft tissues to bone

44
Q

endogenous osteomyelitis

A

infection carried in blood from other sites within the body - spreads from bone to soft tissues

45
Q

most common sources of bacteria in OM

A

cutaneous, sinus, ear, and dental infections

46
Q

OM dx

A

elevated WBC, bone scan, CT, and MRI

47
Q

OM tx

A

iv antibiotics, surgical debridement, hyperbaric O2 therapy, may need to remove any implants

48
Q

osteoporosis

A

present with a BMD -2.5 SD below the young adult mean

49
Q

osteoporosis symptoms

A

back pain, kyphosis, height loss, improper fit of clothing, protruding abdomen, negative body image

50
Q

osteoporosis risk factors

A

smoking, lack of physical activity, excess alcohol, low calcium and vitamin D intake, thinness, family hx, premature menopause

51
Q

bone generation is directly related to

A

physical activity, calcium intake, vitamin D, hormone levels

52
Q

osteoporosis dx

A

bone scan, xray, CT scan, serum tests

53
Q

osteoporosis tx

A

prevent bone loss with vitamin supplements (Ca & Vit. D) and fracture prevention, weight bearing exercises

54
Q

best way to test BMA

A

dual energy xray absorptiometry

Pathophysiology (12 decks)

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