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44 Cards in this Set
- Front
- Back
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What are the risks for Musculoskeletal Disorders?
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- trauma
- osteoporosis - poor nutrition - bone disease - age (depends on type) |
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What is the pathology of musculoskeletal disorders (steps)?
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Fracture ->
1) causes damage to periosteum, vessels & soft tissue 2) causes bleeding & inflammatory mediators 3) causes phagocytosis, angiogenesis & remodeling of new bone (activated osteoblasts) 4) pro-callus layer -> collagen & Ca deposits -> new callus bone + osteoclasts remove unnecessary callus -> trabeculae formed |
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Type of Fracture: Complete
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broken through
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Type of Fracture: incomplete
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not broken all the way through
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Type of Fracture: Open (aka compound)
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skin broken through
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Type of Fracture: Closed
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skin not broken through
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Type of Fracture: comminuted
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fracture in two or more fragments
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Type of Fracture: linear (longitudinal)
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fracture parallel to long axis of bone
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Type of Fracture: Oblique
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fracture at 45 degrees to bone shaft
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Type of Fracture: transverse
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fracture at right angle to bone shaft
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Type of Fracture: greedstick
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one-sided bone broken with splintering with other side bent
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Type of Fracture: compression (impacted)
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fracture of bones wedged together
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Types of Fracture: Stress
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from repeated stress
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Type of Fracture: pathological
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weakened bone-minimal force breaks bones
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What are the S/S of fractures?
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S/S: deformity, swelling, spasm, tenderness, pain, decreased sensation, & decreased mobility
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What are the complications of fractures?
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- nonunion, delayed union (> 6mos), malnutrition (non-anatomic position)
- fat emboli = release of fat globules from long bones - compartment syndrome = compression of underlying vessels/nerves due to limited ability of surrounding tissue to expand (eg: soft tissue injury, burns, cast) |
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Common MS injuries: Subluxation
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- temporary displacement of 1 or more bones in joint; opposing bones lose partial contact
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Common MS injuries: dislocation
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- temporary displacement of 1 or more bones in joining; opposing bones lose complete contact (more serious)
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Common MS injuries: strains
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- tendon/muscle, mild stretching to severe tear -> causes inflammatory response
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Common MS injuries: sprains
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- ligament, mild stretching to severe tear -> causes inflammatory response
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Commone MS injuries: repetitive motion disorders
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- repetitive motion disorders -> causes injury -> which causes inflammation -> "point of tenderness" -> increase pain with motion, decreases wtih mobility
- eg: tendinitis (tendon) & bursitis (bursae) |
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What is osteoporosis?
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- abnormal loss of bony tissue resulting in fragile porous bones attributable to a lack of calcium; most common in postmenopausal women
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Who's at risk?
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Risks: family history; postmenopausal women b/c of decrease estrogen levels; active young athletes; anorectics or bulemics with amenorrhea; low body fat (fat cells secrete estrogen); decrease stress long bones (immobility); decrease intake/malabsorption of Ca, protein, Vit C & D; smoking, caffeine/ETOH intake; excess Na; excess PO4 intake (soft drinks); steroids; decrease testerone (elderly men have decrease Vit D absorption); uncontrolled Rheumatoid Arthritis/inflammatory bowel disease; Whites; Asians; COPD; hyperparathyroidism; hyperthyroidism; renal/liver disease; hyperglyemia
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Bone Mass characteristics?
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- Normal healthy women gain bone mass up to age 30 (greatest gain up to about 20)
- rate of resoprtion & new bone formation relatively constant during remodeling - estrogen inhibits bone resorption by decreasing sensitivity of osteoclasts to PTH - post-menopausal osteoporosis: increases of pro-osteoclastic cytokines (IL-1, IL-6, TNFa) + other cytokines |
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Pathology of osteoporosis (in steps)
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1) decrease estrogen (lask of inhibitory control over PTH)
2) increase PTH activation of osteoclasts 3) increased # & frequency of multicellular units activated 4) increased osteoclast activity 5) increased rate of resorption (1st year post-menopause greatest loss) therefore decreased osteoblasts & bone formation 6) decrease # of cells in multicellular units (osteocytes) 7) loss of spongy & cortical bone 8) bone mass density (DXA scan) = 2.5 SD below mean* = diagnosis of osteoporosis (* postmenopausal women) |
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What are the complications of fractures?
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- nonunion, delayed union (> 6mos), malnutrition (non-anatomic position)
- fat emboli = release of fat globules from long bones - compartment syndrome = compression of underlying vessels/nerves due to limited ability of surrounding tissue to expand (eg: soft tissue injury, burns, cast) |
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Common MS injuries: Subluxaiton
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- temporary displacement of 1 or more bones in joint; opposing bones lose partial contact
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Common MS injuries: dislocation
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- temporary displeacment of 1 or more bones in joing; opposing bones lose complete contact (more serious)
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Common MS injuries: strains
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- tendon/muscle, mild strethcing to severe tear -> causes inflammatory response
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Common MS injuries: sprains
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- ligament, mild strethcing to severe tear -> causes inflammatory response
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Commone MS injuries: repetitive motion disorders
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- repetitive motion disorders -> causes injury -> which causes inflammation -> "point of tenderness" -> increase pain with motion, decrease mobility
- eg: tendinitis (tendon) & bursitis (bursae) |
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What is osteoporosis?
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- abnormal loss of bony tissue resulting in fragile porous bones attributable to a lack of calcium; most common in postmenopausal women
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Who's at risk?
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Risks: family history; postmenopausal women b/c of decrease estrogen levels; active young athletes; anorectics or bulemics with amenorrhea; low body fat (fat cells secrete estrogen); decrease stress long bones (immobility); decrease intake/malabsorption of Ca, protein, Vit C & D; smoking, caffeine/ETOH intake; excess Na; excess PO4 intake (soft drinks); steroids; decrease testerone (elderly men have decrease Vit D absorption); uncontrolled Rheumatoid Arthritis/inflammatory bowel disease; Whites; Asians; COPD; hyperparathyroidism; hyperthyroidism; renal/liver disease; hyperglyemia
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Bone Mass characteristics?
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- Normal healthy women gain bone mass up to age 30 (greatest gain up to about 20)
- rate of resoprtion & new bone formation relatively constant during remodeling - estrogen inhibits bone resorption by decreasing sensitivity of osteoclasts to PTH - post-menopausal osteoporosis: increases of pro-osteoclastic sytokines (IL-1, IL-6, TNFa) + other cytokines |
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Pathology of osteoporosis (in steps)
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1) decrease estrogen (lask of inhibitory control over PTH)
2) increase PTH activation of osteoclasts 3) increased # & frequency of mulitcellular units activated 4) increased osteoclast activity 5) increased rate of resorption (1st year post-menopause greatest loss) therefore decreased osteoblasts & bone formation 6) decrease # of cells in mulitcellular units (osteocytes) 7) loss of spongy & cortical bone 8) bone mass density (DXA scan) = 2.5 SD below mean* = diasgnosis of osteoporosis (* postmenopausal women) |
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What are some complications r/t Osteoporosis?
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- 1.5 mill fractures/year
- 50% Caucasians > age 50 will fracture in lifetime (#1 = spine) - Pulmonary Emboli = due to fat emboli if fracture long bone - pneumonia - hemorrhage -> can cause shock - Higher risk for death |
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What is osteomylitis?
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- endogenous or exogenous entry of bacteria into bone
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What is the pathology of osteomylitis?
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- Entry of bacteria into bone -> causes inflammatory response -> vascular engorgement, edema, phagocytes, abscesses -> cause vessel thrombosis & exucdate -> which walls off vascular supply -> leading to ischemia & increase risk of bone necrosis
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What is Rheumatoid Arthritis?
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A chronic and progressive disease in which the immune system attacks the joints. It is characterised by pain, inflammation and swelling of the joints, stiffness, weakness, loss of mobility and deformity. Tissues throughout the body can be affected, including the skin, blood vessels, heart, lungs, and muscles.
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What is osteoarthritis?
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- chronic breakdown of cartilage in the joints; can cause inflammation & joint "mice" which are little fragments of bone in joints
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What are other Musculoskeletal Disorders?
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- Pathological Contractures = permanent muscle shortening due to firbrotic changes
- Disuse atrophy - Fibromyalgia - chronic syndrome characterized by diffuse pain & tender points, absence of inflammation; fatigue & sleep disturbances = common |
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Othere kinds of MS Abnormalities?
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- Hip dysplasia
- Clubfoot - Scoliosis = lateral curvature of spine - Duchenne Muscular Dystrophy = genetic error; a muscle degenerative syndrome |
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Cancers that affect cells in the Bone Tissue?
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- Multiple myeloma = cancer of plasma cells in adults
- Osteosarcoma (bone cancer) = metaphyses of long bones near growth plates; children most affected; cancer of mesenchymal cells - Ewing's sarcoma (bone cancer) = in bone marrow of long bones/pelvis; children most affected |
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What is Carpal Tunnel Syndrome?
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- repetitive motion injuries/arthritis -> causes compression of median nerve w/n carpal tunnel -> pain, buring, paresthesias (fingers/hands) = + TINEL'S & PHALEN'S SIGNS
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