Week 9: Musculoskeletal Flashcards
1
Q
What are fractures?
A
The discontinuity of the shape and structure of bones.
2
Q
What are the 3 most common type of fractures?
A
- Open
- Pathologic
- Impacted
3
Q
What is an open fracture?
A
Bone breaks through the skin, exposing it to its external environment
4
Q
Why are open fractures risky?
A
High infection risk; bacteria enter, can cause osteomyelitis.
5
Q
How do you treat an open fracture?
A
Rapid cleaning and asepsis of the fragments.
6
Q
What is a pathologic fracture?
A
Break in a bone weakened by disease (osteoporosis, bone cancer).
7
Q
Who often gets pathologic fractures?
A
Post-menopausal women with osteoporosis.
8
Q
What’s an impacted fracture?
A
Fractured surfaces driven into each other (common in hip fractures).
9
Q
What causes impacted fractures?
A
Weight of trunk + hip muscle contractions.
10
Q
How are impacted fractures treated?
A
Traction for proper healing.
11
Q
Why is alignment important in fracture healing?
A
Misalignment causes deformities.
12
Q
Who aligns the bones?
A
Orthopedic surgeons.
13
Q
What forms after bones are aligned?
A
Connective tissue.
14
Q
What happens if bones aren’t aligned?
A
Big scar tissue/callus forms, which can calcify and cause clinical issues
15
Q
What do osteoblasts do?
A
Make osteoid → becomes bone.
16
Q
What do osteoclasts do?
A
Break down bone for shaping/remodeling.
17
Q
What’s the balance in bone healing?
A
Osteoblasts (build) vs. osteoclasts (breakdown).
18
Q
What’s the first step of fracture healing?
A
Hematoma Formation
Bleeding occurs immediately after the fracture, leading to clot formation
19
Q
What organizes the fibrous network? (2nd step of fracture healing)
A
Fibroblasts help organize a fibrous network.
Periosteal arteries are key for this process.
20
Q
What forms after the fibrous network?
A
Callus Formation: Osteoblasts form new bone, creating a callus
21
Q
What happens last in fracture healing?
A
Bone remodeling by osteoclasts.
22
Q
What’s a joint dislocation?
A
Complete bone separation in a joint.
23
Q
What’s subluxation?
A
Partial bone separation in a joint.
24
Q
What’s a strain?
A
Injury to tendons.
25
What’s a sprain?
Injury to ligaments.
26
Why do tendons/ligaments heal slowly?
Tendons and ligaments are high in collagen and have poor vasculature, leading to slow healing.
27
What’s rhabdomyolysis?
Breakdown of skeletal muscle due to trauma
28
What does the breakdown of skeletal muscle in rhabdomyolysis lead to?
lead to the release of myoglobin
29
Why is rhabdomyolysis dangerous?
Myoglobin harms kidneys which can cause kidney failure.
30
How do you detect rhabdomyolysis?
Myoglobin levels in serum are measured to detect muscle death.
31
How to treat rhabdomyolysis?
Dialysis if severe (prevents kidney failure).
32
What is osteoporosis?
Progressive bone matrix loss, occurring progressively with age.
33
What makes up bones?
Consist of cortical (compact) and trabecular (spongy) bone
34
What is osteopenia?
Early bone loss before osteoporosis.
35
What fractures happen with osteoporosis?
Pathologic fractures due to weakened bones.
36
What spine issue happens in osteoporosis?
Vertebral compression fractures leading to loss of height and potential spinal cord damage
37
What fracture is common in hips?
Weakened femoral neck increases the risk of hip fractures.
38
What test measures bone loss?
Bone mineral density.
39
What happens to calcium balance after age 35?
Often a negative calcium balance, where calcium is not effectively incorporated into bones.
40
What cells are hyperactive in osteoporosis?
Osteoclasts.
41
What hormone slows osteoclasts?
Estrogen.
42
What happens after menopause?
Menopause accelerates osteoporosis in women due to decreased estrogen levels.
43
What is osteomyelitis?
Inflammation of the bone and bone marrow, most commonly caused by infection.
44
Most common cause of osteomyelitis?
Open fractures
45
What happens to infected bone?
Bacteria destroy bone, forming abscesses and cavities.
46
How does the body fight off the infected bone in osteomyelitis?
Limited vasculature in bone makes it difficult for immune cells to fight infection.
47
Why is it hard to treat osteomyelitis?
Poor blood supply, antibiotics can’t reach well.
48
What may treatment include for osteomyelitis?
Surgical cleaning and strong antibiotics.
49
What happens to blood supply in infection?
Initial site of infection blocks blood supply, damaging the periosteum
Can lead to sequestrum formation (dead bone tissue)..
50
How does infection spread to bone?
Open fracture, sepsis, nearby tissue infections, injections, trauma.
51
Common bacteria in osteomyelitis?
Staph aureus (MRSA), Streptococcus, Haemophilus, E. coli.
52
What happens if infection spreads to joints?
Septic arthritis.
53
What can septic arthritis result from?
Spread from adjacent soft tissue infections or contaminated injections.
54
What causes osteoarthritis?
Mechanical injury and lack of joint protection
55
What is osteoarthritis?
By inflammation in the joint
56
What happens to cartilage in osteoarthritis ?
Damage → inflammation → neutrophils destroy cartilage.
57
Is osteoarthritis chronic?
Yes, takes years.
58
Which joints are affected in osteoarthritis?
Weight-bearing (knees)
59
What happens when cartilage is gone in osteoarthritis?
Exposes the bone underneath, leading to cracks and subchondral bone damage
60
What are osteophytes in osteoarthritis?
Bone spurs formed during “healing” attempts.
61
What happens to joint space in osteoarthritis?
Joint space narrows, leading to loss of mobility and chronic pain.
62
What is the treatment for osteoarthritis?
Initially, exercise to build muscle strength.
Eventually, knee replacement may be necessary.
63
What is rheumatoid arthritis?
An arthritis with an immunologic origin, involving an immune response against the joint.
64
What kind of disease is RA?
Autoimmune.
65
What does RA attack?
Synovial membrane + joints.
66
What forms in RA?
Formation of pannus (scar tissue) that deforms the joint.
67
What joint deformity is common?
Ulnar deviation (ulnar drift)
68
Which joints are most affected in RA?
Small joints (hands).
69
What is a joint deformity?
When a joint loses its anatomical shape
70
What are rheumatoid factors?
Immune complexes damaging joints.
71
What’s ankylosis?
Joints become rigid and lose their ability to function.
72
What is gout?
A joint disorder caused by inflammation due to uric acid crystals.
73
Where does gout often hit?
In small joints, especially the big toe
74
What is uric acid?
Waste from purine breakdown (nucleic acids).
75
How is uric acid excreted?
By the kidneys + intestines.
76
What increases uric acid?
High purine diet (meat)
kidney failure as it causes under-excretion of uric acid.
77
What is hyperuricemia?
Accumulation of uric acid leads to crystal formation and tissue damage in joints.
78
What is hip dysplasia?
Abnormal hip joint formation in kids.
79
What doesn’t form right in hip dysplasia?
Acetabulum (hip socket)
80
What happens to the femoral head in hip dysplasia?
Partially exposed causing dislocation/subluxation.
81
When is hip dysplasia detected and how is it treated?
Its detected a birth, and is treated with orthopedic methods in the first few months.
82
What are the 2 types of bone tumors?
Primary or secondary (metastatic).
83
What are secondary bone tumors?
Common from primary cancers like prostate, breast, and kidney
84
What can tumors cause?
Pain + pathologic fractures.
85
What’s the seed and soil hypothesis?
Some cancers favor bone metastasis due to the bone providing a favorable environment
86
What are 2 types of common primary bone tumors?
Osteosarcoma: Malignant bone tumor in young adults
Osteoma: Benign bone tumor.
87
Osteoid Osteoma
A benign bone tumor, less aggressive than osteosarcoma.
88
Ewing Sarcoma
malignant bone tumor, more commonly seen in pediatric patients.
89
Where does Osteosarcoma happen?
Long bones near growth plates (femur, tibia, humerus).
90
Why do osteosarcomas grown on the growth plates, what's so special?
Areas of active bone growth in children. Osteoblasts are highly active in these regions, making them susceptible to tumor development.
91
Why does osteosarcoma predominantly occur in children?
Due to their growth plates being highly active.
92
What famous Canadian person had osteosarcoma?
Terry fox
93
What imaging is used first?
X-rays
94
What can x-rays show?
Tumor extent + features.
95
What kind of pain, should prompt an X-ray examination.
Persistent bone pain in young adults, especially in the (knee, hip, shoulder, or jaw)
96
What pattern on X-ray for osteosarcoma?
Patchy areas of mineralized bone that resemble popcorn. This pattern is easily recognizable
97
What other test can detect osteosarcoma?
Nuclear medicine scan but x ray is still the first option
98
What happens to osteoblasts in osteosarcoma?
Uncontrolled growth.
99
What happens to the bone cortex?
Tumor can erode and destroy the bone cortex (the dense outer layer of the bone)
100
What forms around the bone in osteosarcoma?
form a large, palpable mass around the affected bone.
101
What animals get sarcomas a lot?
Large dog breeds such as Great Danes due to rapid bone growth
102
What is the primary treatment for osteosarcoma?
Surgical removal of the tumor AND Chemotherapy to kill cancer cells and prevent metastasis.
103
When is amputation done for osteosarcoma?
If the tumor is extensive or has spread to nearby tissues
104
What affects prognosis?
Tumor stage, age, treatment response.
