Pathofinal: Musculoskeletal Disorders

Front 1

Humans have how many bones?

Back 1

206

Front 2

Because they contain various types of _____, bones are considered organs

Back 2

tissue

Front 3

What are the two major groups of bones?

Back 3

Axial

Appendicular

Front 4

Long Bones, which are longer than they are wide, are classified by ______ rather than _______

Back 4

Shape

Size

Front 5

Cube-shaped bones of the wrist and ankle

Back 5

Short bones

Front 6

Bones that form within tendons (e.g., patella)

Back 6

Short bones

Front 7

The sternum and most of the skull bones would be considered _______ bones.

Back 7

Flat

Front 8

Vertebrae are considered to be ______ bones based on shape.

Back 8

Irregular

Front 9

Dense outer layer that looks smooth and solid to the naked eye

Back 9

Compact Bones

Front 10

Honeycomb of trabeculae filled with yellow or red bone marrow

Back 10

Spongy bone

Front 11

What is the structural unit of a compact bone?

Back 11

Haversian system or osteon

Front 12

Each ______ is an elongated cylinder oriented parallel to the long axis of the bone
A group of hollow tubes, one placed inside the other.

Back 12

osteon

Front 13

Bone forming cells that synthesize extracellular matrix of bone tissue

Back 13

Osetoblasts

Front 14

Mature bone cells that exchange nutrients and waste with the blood

Back 14

Osteocytes

Front 15

Large cells the resorb or break down bone matrix

Back 15

Osteoclasts

Front 16

Unmineralized bone matrix composed of proteoglycans, glycoproteins, and collagen

Back 16

Osteoid

Front 17

Occurs where bone is injured or added strength is needed
Requires a diet rich in protein, vitamins C, D, and A, calcium, phosphorus, magnesium, and manganese

Back 17

Bone deposition

Front 18

_______ ___________ is essential for mineralization of bone

Back 18

Alkaline phosphatase

Front 19

_________ ____ – grooves formed by osteoclasts as they break down bone matrix

Back 19

Resorption bays

Front 20

Osteoclasts release ________ enzymes that digest organic matrix

Back 20

Lysosomal

Front 21

Bone Resorption:

Dissolved matrix is __________ across the osteoclast’s cell where it is secreted into the ________ _____ and then into the blood.

Back 21

transcytosed

interstitial fluid

Front 22

Calcium is necessary for: (5)

Back 22

Transmission of nerve impulses
Muscle contraction
Blood coagulation
Secretion by glands and nerve cells
Cell division

Front 23

Bone fractures are classified by? (4)

Back 23

The position of the bone ends after fracture
The completeness of the break
The orientation of the bone to the long axis
Whether or not the bones ends penetrate the skin

Front 24

Bone is broken all the way.

Back 24

Complete bone fracture

Front 25

Bone is not broken all the way?

Back 25

Incomplete bone fracture

Front 26

The fracture is parallel to the long axis of the bone.

Back 26

Linear bone fracture

Front 27

The fracture is perpendicular to the long axis of the bone.

Back 27

Transverse bone fracture

Front 28

The fracture has open bone ends that penetrate the skin.

Back 28

Compound (open) bone fracture

Front 29

The fracture has bone ends that do not penetrate the skin.

Back 29

Simple (closed) bone fracture

Front 30

Bone fragments into three or more pieces; common with elderly

Back 30

Comminuted fracture

Front 31

Bone is crushed; common in porous bones

Back 31

Compression fracture

Front 32

Ragged break occurs when excessive twisting force is applied to a bone; common sports fracture.

Back 32

Spiral fracture

Front 33

Epiphysis separates from the diaphysis along the epiphyseal plate; common when cartilage is dying

Back 33

Epiphyseal fracture

Front 34

Typical with skull fractures, the broken bone portion is pressed inward.

Back 34

Depressed fracture

Front 35

Bone breaks incompletely much like the way a green twig breaks on one side and bends on the other.

Back 35

Greenstick fracture

Front 36

4 steps in repairing a bone fracture.

Back 36

Formation of fracture hematoma
Fibrocartilaginous callus formation
Bony callus formation
Bone remodeling

Front 37

Fibrocartilaginous callus:
_________ tissue (soft callus) forms a few days after the fracture

Back 37

Granulation

Front 38

After a bone fracture and hematoma formation, granulation tissue forms, what is the next step before bony callus formation?

Back 38

Capillaries grow into the tissue and phagocytic cells begin cleaning debris

Front 39

Bony callus formation:

Bone callus begins __-__ weeks after injury, and continues until firm union is formed __-__ months later

Back 39

3-4 weeks

2-3 months

Front 40

Excess material on the bone shaft exterior and in the medullary canal is removed
Compact bone is laid down to reconstruct shaft walls

This is termed? and occurs after?

Back 40

Remodeling

after bony callus formation

Front 41

Separation of two bones at the joint?

Back 41

Dislocation

Front 42

During a dislocation bone is most often broken.

True or False

Back 42

False

no break

Front 43

Treatment for a dislocation?

Back 43

Ice, immobilization, surgery

Front 44

A tear in a ligament is otherwise known as a ?

Back 44

Sprain

Front 45

A tear in a tendon.

Back 45

Strain

Front 46

Occurs most often in postmenopausal women:
Due to a ↓ in estrogen production

Back 46

Osteoporosis

Front 47

In osteoporosis bone_________outpaces bone ______

Back 47

reabsorption

deposit

Front 48

What is the most vulnerable area for osteoporosis?

Back 48

Spongy bone of the spine

Front 49

True or False

Osteoporosis: Bones become so fragile that sneezing or stepping off a curb can cause fractures

Back 49

True

Front 50

About how many fractures a year are caused by osteoporosis?

Back 50

1.5 million

Front 51

Prevalence of osteoporosis?

Back 51

10 million americans (8 million women)

Front 52

Weighing less than ___ lbs, and what ethnicity's are most at risk for osteoporosis.

Back 52

127

Caucasian Asian

Front 53

True or False

Osteoporosis has obvious symptoms.

Back 53

False

silent

Front 54

How is osteoporosis diagnosed?

Back 54

Bone density scan: dual-energy x-ray absorptiometry (DXA) on lower spine or hips

Front 55

Treatment of osteoporosis?

Back 55

Vitamin D + Calcium supplements

Calcitonin nasal spray

Bisphosphonates - inhibit osteoclasts

SERMS - selective estrogen receptor modulators

Front 56

Bones of children are inadequately mineralized causing softened, weakened bones
Bowed legs and deformities of the pelvis, skull, and rib cage are common

Back 56

Rickets

Front 57

What causes rickets?

Back 57

Caused by insufficient calcium in the diet, malabsorption, or by vitamin D deficiency

Front 58

Bones in adults are inadequately mineralized causing softened, weakened bones
Compression fractures
Main symptom is pain when weight is put on the affected bone

Back 58

Osteomalacia

Front 59

Early sign of osteomalacia?

Back 59

Muscle weakness

Front 60

Cause of osteomalacia?

Back 60

Caused by insufficient calcium in the diet, malabsorption, or by vitamin D deficiency

Front 61

A form of osteomalacia that happens in patients with chronic renal failure

Back 61

Renal Rickets

Front 62

People with renal rickets, kidneys cannot activate vitamin ___

Back 62

D

Front 63

Treatment of renal rickets

Back 63

Treatment= giving active form of vit D, and using drugs to bind and help excrete phosphate

Front 64

Osteitis deformans
Progressive bone disease in people >40 yrs old
Results in excessive bone destruction, replacement of bone with fibrous tissue, and pain
Also causes heart disease

Back 64

Paget's Disease

Front 65

Pagets symptoms

Back 65

Symptoms:
May be asymptomatic
Pain, deformed bones, frequent fractures
Headaches and hearing loss

Front 66

Pagets diagnosis

Back 66

Diagnosis:
Alkaline phosphatase blood levels ↑ further tests needed
Bone specific alkaline phosphatase levels
Bone scan
X-rays

Front 67

Two types of primary bone tumors:

Back 67

Osteosarcoma
Ewing’s sarcoma

Front 68

True or False

Majority of bone tumors are benign

Back 68

False

malignant

Front 69

Tumors of cartilage
People >30 yrs old
Pain is the only symptom

Back 69

Chondrosarcomas

Front 70

Group of inherited muscle-destroying diseases
Skeletal muscles enlarge due to fat and fibrous connective tissue deposits, but muscle fibers atrophy

Back 70

Muscular Dystrophy

Front 71

Results in muscle weakness, lack of muscle coordination, and usually results in death from respiratory failure

Back 71

Muscular Dystrophy

Front 72

The most common and most devastating form of muscular dystrophy
Inherited, sex-linked disease carried by females (in one of their X chromosomes), but expressed in males (3/100,00)

Back 72

Duchenne Muscular Dystrophy

Front 73

Duchenne Muscular Dystrophy is diagnosed between what ages?

Back 73

2-10

Front 74

Duchenne muscular dystrophy (DMD)

Progresses from the _________ upward, and victims die of respiratory or cardiac failure in their ___

Back 74

extremities

20’s

Front 75

DMD is caused by the lack of the cytoplasmic protein _______ (which regulates _______ flow into muscle cells)

Back 75

dystrophin

calcium

Front 76

Autoimmune disease where the body develops antibodies against the acetylcholine receptors in the neuromuscular junction

Back 76

Myasthenia Gravis

Front 77

Treatment of myasthenia gravis?

Back 77

acetylcholinesterase inhibitors

Front 78

Controversial group of disorders resulting in pain and stiffness of muscles, tendons, and surrounding soft tissue
No joint pain
More common in women than in men

Back 78

Fibromyalgia

Front 79

Fibromyalgia may be due to increased sensitivity to _______ __

Back 79

substance p

Front 80

What are the symptoms of fibromyalgia?

Back 80

Symptoms include fatigue, sleep disturbances, depression, as well as muscle aches, irritable bowel

Front 81

How to treat fibromyalgia?

Back 81

Antidepressants
NSAIDS

Front 82

Non-inflammatory, non-systemic
Progressive wearing off of weight bearing joints
Affects men more than women

Back 82

Osteoarthritis

Front 83

Treatment for osteoarthritis?

Back 83

Canes
NSAIDS for pain
Rest
Synovial injections
Knee or hip replacement

Front 84

Autoimmune progressive joint damage and deformity.
Pts develop Rheumatoid factor (RF) antibody against immunoglobulin G

Back 84

Rheumatoid Arthritis

Front 85

5 stages of rheumatoid arthritis

Back 85

Synovitis inflammation of synovial cells

Pannus formation deposit of granulation tissue which releases enzymes and inflammatory mediators

Cartilage erosion by the pannus enzymes

Fibrosis limits movement

Ankylosis joint fixation and deformity

Front 86

Juvenile rheumatoid arthritis occurs in children under __ years

Back 86

16

Front 87

Rheumatoid arthritis treatment

Back 87

Treatment:
NSAIDS and other pain relievers
Anti-inflammatory agents
Immunosuppressants
Surgery

Front 88

Chronic, inflammatory condition that affects the spine and the pelvis
Eventually causes fusion of the vertebrates in the spine stiffness of the spine
Men> women

Back 88

Ankylosing Spondylitis

Front 89

_____ antigen is present in most patients with ankylosing spondylitis

Back 89

HLA-B27

Front 90

What age group is usually affected by ankylosing spondylitis?

Back 90

20-30

Front 91

Symptoms of ankylosing spondylitis

Back 91

Symptoms:
Lower back pain
Morning stiffness
Pain is worse when lying down may radiate to legs

Front 92

True or False

Treatment of ankylosing spondylitis is the same as treatment for rheumatoid arthritis.

Back 92

True

Front 93

Recurrent arthritis due to uric acid crystal deposition in joints (usually the lower extremeties)
Also renal stone formation, and may progress to renal failure overtime
Familial
Men>Women
Pts > 40 yrs old

Back 93

Gout

Front 94

Uric acid is ______ soluble

Back 94

poorly

Front 95

Uric acid deposits may result in inflammatory bulges called _____(usually around joints)

Back 95

tophi

Front 96

Treatment of gout?

Back 96

Pain control
Anti-inflammatory agents
↑fluid intake and ↑ urine pH helps excrete uric acid