9.1 Pathophysiology - Musculoskeletal Function

Front 1

undifferentiated cells that differentiate into osteoblasts during growth and healing

Back 1

Osteogenic

Front 2

bone building cells

Back 2

Osteoblasts

Front 3

mature bone cells active in maintaining the bony matrix

Back 3

Osteocytes

Front 4

cells that function in the resorption of bone

Back 4

Osteoclasts

Front 5

membrane that covers bones (except articular ends)

Back 5

Periosteum

Front 6

membrane lining spaces of spongy bone, marrow cavities

Back 6

Endosteum

Front 7

irregularly shaped bones located in ankles

Back 7

Short Bones

Front 8

layer of spongy bone between layers of compact bone

Back 8

Flat Bones

Front 9

shaft of the long bone - compact bone

Back 9

Diaphysis

Front 10

ends of long bones - covered with articular cartilage

Back 10

Epiphysis

Front 11

part of bone shaft that funnels out - bony trabeculae

Back 11

Metaphysis

Front 12

Hormonal action of bone & calcium:
Intestinal absorption of calcium

Back 12

Parathyroid increases
Calcitonin unaffected
Vitamin D increases

Front 13

Hormonal action of bone & calcium:
Renal Excretion of calcium

Back 13

Parathyroid increases
Calcitonin unaffected
Vitamin D increases

Front 14

Hormonal action of bone & calcium:
Serum calcium

Back 14

Parathyroid increases
Calcitonin decreases
Vitamin D unaffected

Front 15

Hormonal action of bone & calcium:
Bone resorption

Back 15

Parathyroid increases
Calcitonin decreases
Vitamin D increases

Front 16

Hormonal action of bone & calcium:
Bone formation

Back 16

Parathyroid increases
Calcitonin uncertain
Vitamin D increases

Front 17

Types of Fractures

Back 17

1. Complete or incomplete
2. Open(compound) or closed(simple)
3. Comminuted (2 or more fragments)

Front 18

Types of fracture lines

Back 18

1. linear
2. oblique
3. spiral & transverse

Front 19

4 steps of bone healing

Back 19

1. hematoma
2. callus
3. ossification
4. remodeling

Front 20

stretching injury to muscle or tendons

Back 20

Strain

Front 21

ligament involvement, abnormal or excessive movement of a joint

Back 21

Sprain

Front 22

Degenerative joint disease leading cause of disability & pain in the elderly.
Problem with homeostatic mechanisms that maintain articular cartilage

Back 22

Osteoarthritis

Front 23

Causes of ________ ?

- Idiopathic
- Trauma
- Repeated stress
- Congenital deformity
- Hemophilia (or other conditions with chronic joint swelling)
- Common in elderly
- Obesity

Back 23

Osteoarthritis

Front 24

Manifestations of ________ ?

- pain(hips, knees and lumbar)

Back 24

Osteoarthritis

Front 25

Systematic inflammatory disease that affects 0.3 - 1.5% of the population(women 2-3x more than men)
aberrant immune response that leads to synovial inflammation and destruction of the joint architecture

Back 25

Rheumatoid Arthritis (RA)

Front 26

Causes of ________ ?

- Autoimmune disease; Develops after an immune response Bacterium, mycoplasm or virus
- Original response is IgG mediated - may destroy microorganism; Other antibodies produced (IgM or IgG); Self-directed antibodies called rheumatoid factors (RF)
- Genetic predisposition; Women affected more
- Various cytokines contribute

Back 26

Rheumatoid Arthritis (RA)

Front 27

Manifestation of ________ ?

- symmetric, any diarthroidal joint, and polyarticular, joint pain and swelling, "spindle-shaped" appearance (esp. fingers)
- Extracellular symptoms: fatigue, weakness, anorexia, weight loss, low-grade fever, rheumatiod nodules
labs: elevated ESR, anemia

Back 27

Rheumatoid Arthritis (RA)

Front 28

Complications of ________ ?

- Extrasynovial rheumatoid nodules develop on: Cardiac valves; Lungs; Eyes; Spleen
- Vasculitis -> thrombosis & infarction

Back 28

Rheumatoid Arthritis (RA)

Front 29

Causes of ________ ?

- inflammatory response to uric acid which results if increased levels of uric acid in body & body fluids, including synovial fluids

Back 29

Gout

Front 30

Syndrome caused by inflammatory response to uric acid which results if increased levels of uric acid in body &* body fluids, including synovial fluids

Back 30

Gout

Front 31

Manifestations of ________ ?

- Monoarticular and usually affects the first metatarsophalangeal joint, begins at night with pain in affected joint.

Back 31

Gout

Front 32

Causes of ________ ?

- Congenital structural deformity
- Neuromuscular disease
- Idiopathic
- Poor posture causing deformity and pain
- May compromise pulmonary function

Back 32

Scoliosis

Front 33

Complications of ________ ?

- back pain
- respiratory, cardiac, and GI complications

Back 33

Scoliosis

Front 34

Density or mass of bone is reduced; spongy & compact bone are lost; involves major portions of axial skeleton

Back 34

Osteoporosis

Front 35

Causes of ________ ?

- Inadequate dietary calcium & magnesium intake
- Lack of exercise
- Lack of vitamin D
- Decreased levels of estrogen
- Family history
- Excessive phosphorus (sodas & junkfood)

Back 35

Osteoporosis

Front 36

Patho of _______

Imbalance between bone resorption and formation such that bone resorption exceeds formation

Back 36

Osteoporosis

Front 37

Manifestations of ________ ?

- Silent disorder
- first symptom usually a fracture
- height loss with kyphosis (Dowager's hump)

Back 37

Osteoporosis

Front 38

inadequate & delayed mineralization of osteoid in mature compact and spongy bone

Back 38

Osteomalacia

Front 39

Causes of ________ ?

- Deficiency of vitamin D & Ca
- Rare in USA
- Disorders of small bowel
- hepatobiliary system & pancreas; Anticonvulsant drug therapy; Renal osteodystrophy; phosphate deficiency due to renal loss or decreased intestinal absorption

Back 39

Osteomalacia

Front 40

Manifestations of ________ ?

- Bone pain
- tenderness
- fractures

Back 40

Osteomalacia

Front 41

Bone infection caused by bacteria (Staph aureus*, B streptococci*, fungi, parasites & viruses)

Back 41

Osteomyelitis

Front 42

Patho of _______

Different in children & adults
Children - long bones / growth plate
Adults - vertebrae, sacroiliac joints

Back 42

Osteomyelitis

Front 43

Manifestations of ________ ?

- symptoms of bacteremia
- pain, swelling, redness

Back 43

Osteomyelitis

Front 44

Three major symptoms:
pain, presence of a mass, impairment of function.
(can be present anywhere)

Back 44

Bone cancer

Front 45

Three types of RA in children

Back 45

1. Systemic onset (10%)
2. Pauciarticular arthritis (50%)
3. Polyarticular onset disease (40%)

Front 46

Manifestations of ________ ?

- daily intermittent high fever, usually accompanied by a rash
- generalized lymphadenopathy
- hepatosplenomegaly
- leukocytosis & anemia
- Symptoms usually subside in 6 to 12 months (can also make appearance in adulthood)

Back 46

Systemic onset JRA

Front 47

Affects no more that 4 joints. Affects girls younger than 6 and boys with late-onset arthritis

Back 47

Pauciarticular JRA

Front 48

Affects 5 or more joints during the first 6 months. Systemic feature adds low-grade fever, weight loss, malaise, anemia, stunted growth, slight organomegaly (hepatsplenomegaly) and adenopathy

Back 48

Polyarticular JRA

Front 49

devascularized bone fragments

Back 49

sequestra

Front 50

long bone / growth plate bone infection. adjacent joint involved; periosteal new bone formation and reactive bone formation in the marrow tend to wall in the infection

Back 50

Child Osteomyelitis

Front 51

Vertebral / sacroiliac joint infection. first involves subchondral bone, then spreads to the joint space. In vertebrae sequential destruction of end plate, adjoining disk, and contiguous vertebral body.

Back 51

Adult Osteomyelitis