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Patho 3 Mus/Skel

Patho 3 Mus/Skel Barry

QuestionAnswer
FRACTURES ARE DEFINED AS: A BREAK IN THE CONTINUITY OF A BONE.
FRACTURES TYPICALLY OCCUR WHEN: THE FORCE APPLIED EXCEEDS THE TENSILE OR COMPRESSIVE STRENGTH OF THE BONE.
THE HIGHEST INCIDENCE OF FRACTURES IS IN WHAT TWO GROUPS? YOUNG MALES (15-24 yrs.) AND ADULTS (65 yrs AND OLDER).
FRACTURES IN HEALTHY <BLANK> (TIBIA, CLAVICLE AND LOWER HUMERUS) USUALLY HAPPEN IN YOUNG PERSONS AS A RESULT OF <BLANK>. LONG BONES, TRAUMA.
TRUE OR FALSE: FRACTURES OF THE HANDS AND FEET ARE USUALLY CAUSED BY TRAUMA. FALSE. FRACTURES OF THE HANDS AND FEET ARE USUALLY CAUSED BY ACCIDENTS IN THE WORKPLACE.
THE INCIDENCE OF FRACTURES OF THE UPPER FEMUR, UPPER HUMERUS, VERTEBRAE AND PELVIS IS HIGHER IN OLDER OR ELDERLY ADULTS AND OFTEN ASSOCIATED WITH WHAT? OSTEOPOROSIS.
WHAT COMMON FRACTURES IN THE ELDERLY ARE OFTEN ASSOCIATED WITH OSTEOPOROSIS? FRACTURES OF THE UPPER FEMUR, UPPER HUMERUS, VERTEBRAE AND PELVIS.
THREE CLASSIFICATIONS OF FRACTURES: PATHOLOGIC, STRESS, TRANSCHONDRAL.
DEFINE PATHOLOGIC FRACTURE: A BREAK AT THE SITE OF A PRE-EXISTING ABNORMAL CONDITION, BY A FORCE THAT WOULDN’T DO IT TO A NORMAL BONE.
EXAMPLES OF CONDITIONS THAT COULD PRECIPITATE A PATHOLOGIC FRACTURE: TUMORS, OSTEOPOROSIS, INFECTIONS AND METABOLIC BONE DISORDERS.
DEFINE STRESS FRACTURE: OCCURS IN NORMAL OR ABNORMAL BONE SUBJECTED TO REPEATED STRESS (ATHLETIC EVENTS). THE STRESS IS LESS THAN THE ONE USUALLY CAUSING THE FRACTURE.
TWO TYPES OF STRESS FRACTURE: FATIGUE, INSUFFICIENCY.
DEFINE FATIGUE FRACTURE: CAUSED BY ABNORMAL STRESS OR TORQUE APPLIED TO A BONE WITH NORMAL ABILITY TO DEFORM AND RECOVERY (JOGGERS, DANCERS).
DEFINE INSUFFICIENCY FRACTURE: OCCURRING IN BONES LACKING NORMAL ABILITY TO DEFORM AND RECOVERY (NORMAL WEIGHT BEARING AND ACTIVITY)
DEFINE TRANSCHONDRAL FRACTURE: FRAGMENTATION AND SEPARATION OF A PORTION OF THE ARTICULAR CARTILAGE THAT COVERS THE END OF A BONE AT A JOINT (HEAD OF THE FEMUR, ANKLE, PATELLA, ELBOW, WRIST).
ANOTHER WORD FOR TRANSCHONDRAL FRACTURE? OSTEOCHONDRITIS DISSECANS
COMPLETE: THE BONE IS BROKEN ALL THE WAY THROUGH.
INCOMPLETE: INCOMPLETE: BONE DAMAGED BUT STILL IN ONE PIECE.
OPEN: THE SKIN IS BROKEN.
CLOSED: THE SKIN IS INTACT.
COMMINUTED: BONE BREAKS INTO TWO OR MORE FRAGMENTS.
LINEAR: RUNS PARALLEL TO THE LONG AXIS OF THE BONE.
OBLIQUE: 45 DEGREE ANGLE TO THE SHAFT OF THE BONE.
SPIRAL: ENCIRCLES THE BONE.
TRANSVERSE: ACROSS THE BONE.
INCOMPLETE FRACTURES CAN BE OF THREE TYPES: GREENSTICK, TORUS, BOWING.
GREENSTICK (A TYPE OF INCOMPLETE FRACTURE): PERFORATES ONE CORTEX AND SPLINTERS THE SPONGY BONE (PROXIMAL DYAPHISIS OF TIBIA, RADIUS AND ULNA)
TORUS (A TYPE OF INCOMPLETE FRACTURE): CORTEX BUCKLES BUT DOES NOT BREAK (OSTEOPOROSIS)
BOWING (A TYPE OF INCOMPLETE FRACTURE): LONGITUDINAL FORCE APPLIED. COMMON IN RADIUS-ULNA AND TIBIA FIBULA. ONE BONE SUFFERS COMPLETE FRACTURE AND THE OTHER BOWS.
CLINICAL MANIFESTATIONS OF FRACTURE INCLUDE: -IMPAIRED FUNCTION AND SENSATION -DEFORMITY -SWELLING -MUSCLE SPASM -TENDERNESS -PAIN
FRACTURE TREATMENT INVOLVES REDUCTION AND IMMOBILIZATION.
WHAT IS REDUCTION? REALIGNING THE BONE FRAGMENTS CLOSE TO THEIR ANATOMICAL POSITION, WHICH SOMETIMES MUST BE OPEN (SURGICAL)
WHAT IS IMMOBILIZATION? HOLDING THE ALREADY REDUCED BONE FRAGMENTS IN PLACE BY USING SPLINTS AND PLASTER CASTS.
ARTHROPATHIES: A GROUP OF DISEASES AFFECTING THE JOINTS.
HOW ARE ARTHROPATHIES CATEGORIZED? INFLAMMATORY AND NON-INFLAMMATORY.
NON-INFLAMMATORY ARTHROPATHIES: NO SYNOVIAL MEMB. INFLAMMATION, SYSTEMIC SIGNS AND SYMPT. OR ABNORMAL SYNOVIAL FLUID.
INFLAMMATORY ARTHROPATHIES (ARTHRITIS): : --INFLAMMATORY DAMAGE OR DESTRUCTION IN THE SYNOVIAL ARTICULAR CARTILAGE OR MEMB. --SYSTEMIC SIGNS OF INFLAMMATION (FEVER, LEUKOCYTOSIS, ANOREXIA).
WHAT IS THE MOST PREVALENT NON-INFLAMMATORY JOINT DISEASE? OSTEOARTHRITIS (DEGENERATIVE JOINT DISEASE)
OSTEOARTHRITIS (DEGENERATIVE JOINT DISEASE) IS THE MOST PREVALENT NON-INFLAMMATORY JOINT DIS. CHARACTERIZED BY: DEGENERATION AND LOSS OF ARTICULAR CARTILAGE IN SYNOVIAL JOINTS.
SOME CASES OF OSTEOARTHRITIS RESULT FROM JOINT STRESS, CONGENITAL ABNORMALITIES OR JOINT INSTABILITY CAUSED BY TRAUMA AND ARE KNOWN AS... SECONDARY.
WHAT ARE CONDITIONS THAT CAUSE SECONDARY OSTEOARTHRITIS? RESULT FROM JOINT STRESS, CONGENITAL ABNORMALITIES OR JOINT INSTABILITY CAUSED BY TRAUMA.
THE <BLANK> OR <BLANK> TYPE OF OA IS NOT ASSOCIATED TO ANY OF THESE RISK FACTORS AND IS THE MOST COMMON TYPE OF NON-INFLAMMATORY JOINT DISEASE.. PRIMARY OR IDIOPATHIC.
THE PATHOLOGICAL CHARACTERISTICS ARE THE SAME FOR BOTH PRIMARY AND SECONDARY OA AND INCLUDE: --EROSION AT THE ARTICULAR CARTILAGE. --SCLEROSIS OF BONE UNDERNEATH THE CARTILAGE. --FORMATION OF BONE SPURS (OSTEOPHYTES).
CLINICAL MANIFESTATIONS OF OA INCLUDE: --PAIN (PREDOMINANT SYMPTOM) --STIFFNESS --SWELLING OR ENLARGEMENT --TENDERNESS --LIMITED RANGE OF MOTION --MUSCLE WASTING --PARTIAL DISLOCATION --DEFORMITY
DIAGNOSIS OF OA IS ESTABLISHED BY: CLINICAL EXAM, SIMPLE BONE X-RAY, CAT-SCAN, MRI AND ARTHROSCOPY.
CONSERVATIVE TREATMENT FOR OA: REST, ANALGESIC AND INFLAMMATORY DRUG THERAPY, WEIGHT LOSS IF OBESITY.
SURGICAL TREATMENT FOR OA: USED TO IMPROVE JOINT MOV., CORRECT DEFORMITY OR CREATE A NEW JOINT WITH ARTIFICIAL IMPLANTS.
THE INFLAMMATORY JOINT DISEASE (ARTHRITIS) PRESENTS: --INFLAMMATORY DAMAGE OR DESTRUCTION IN THE SYNOVIAL ARTICULAR CARTILAGE OR MEMB. --SYSTEMIC SIGNS OF INFLAMMATION (FEVER, LEUKOCYTOSIS, ANOREXIA).
INFLAMMATORY JOINT DISEASE CAN BE INFECTIOUS WITH INVASION HAPPENING... THROUGH A TRAUMATIC OR SURGICAL WOUND, CONTAMINATED NEEDLE OR BLOODSTREAM (FROM SEPTIC FOCI).
INFLAMMATORY JOINT DISEASE CAN BE NON-INFECTIOUS (MOST COMMON) RESULTING FROM... NON-INFECTIOUS (THE MOST COMMON) RESULTING FROM IMMUNE REACTIONS (RHEUMATOID ARTHRITIS AND ANKYLOSING SPONDYLITIS) OR DEPOSITION OF CRYSTALS OF URATE IN AND AROUND THE JOINT (GOUTY ARTHRITIS).
TRUE OR FALSE: RHEUMATOID ARTHRITIS IS A LOCALIZED AUTOIMMUNE DISEASE WHICH CAUSES CHRONIC INFLAMMATION OF CONNECTIVE TISSUE, PRIMARILY IN THE JOINTS. FALSE. RHEUMATOID ARTHRITIS IS A SYSTEMIC AUTOIMMUNE DISEASE WHICH CAUSES CHRONIC INFLAMMATION OF CONNECTIVE TISSUE, PRIMARILY IN THE JOINTS.
MOST COMMON JOINTS AFFECTED BY RH? FINGERS, FEET, WRISTS, ELBOWS, ANKLES AND KNEES.
RA LEADS TO DEFORMITY WHICH LEADS TO... LOSS OF FUNCTION.
WHAT COHORT MORE FREQUENTLY SUFFERS FROM RA? WOMEN.
CLINICAL MANIFESTATIONS OF RA INCLUDE: FEVER, FATIGUE, WEAKNESS, ANOREXIA, WEIGHT LOSS AND GENERALIZED ACHING AND STIFFNESS AS WELL AS PAINFUL, TENDER AND STIFF JOINTS, GRADUALLY LEADING TO DEFORMITY WHICH IS RESPONSIBLE FOR THE PHYSICAL LIMITATIONS.
RA DIAGNOSIS IS ESTABLISHED BY: PHYSICAL EXAM, X-RAY OF THE JOINT AND SEROLOGIC TESTS FOR RHEUMATOID FACTOR AND CIRCULATING IMMUNE COMPLEXES.
RA TREATMENT? CONSERVATIVE: REST, HOT AND COLD PACKS, CORTICOSTEROIDS, PHYSICAL THERAPY, ANTINEOPLASTIC DRUGS, ANTI-INFLAMMATORY DRUGS (ORALLY OR INJECTED INTO THE JOINT), SURGICAL.
THE MUSCULAR DYSTROPHIES ARE A GROUP OF FAMILIAL DISORDERS WHICH CAUSE... DEGENERATION OF SKELETAL MUSCLE FIBERS.
THE MUSCULAR DYSTROPHIES ARE THE MOST PREVALENT OF THE MUSCULAR DISEASES IN CHILDHOOD AND ARE CHARACTERIZED BY: PROGRESSIVE, SYMMETRIC WEAKNESS AND WASTING OF SKELETAL MUSCLE GROUPS WITH INCREASING DISABILITY AND DEFORMITY.
FIVE MAIN TYPES OF MUSCULAR DYSTROPHIES: --PSEUDOHYPERTROPHIC (DUCHENNE) --FACIOSCAPULOHUMERAL --LIMB GIRDLE --OCULOPHARYNGEAL --MYOTONIC MUSCULAR
CLINICAL FINDINGS AND GENETIC INHERITANCE PATTERNS ARE CONSISTENT FOR EACH TYPE OF MUSCULAR DYSTROPHY BUT THE PHYSIOLOGY IS... ABOUT THE SAME FOR ALL TYPES.
PHYSIOLOGY OF MUSCULAR DYSTROPHIES: NECROSIS AND PHAGOCYTOSIS OF MUSC. CELLS AND EARLY FRAGMENTATION AND DISSOLUTION OF MYOFILAMENTS.
WHAT HAPPENS TO MUSCLE FIBERS IN MUSCULAR DYSTROPHIES? THE MUSCLE FIBERS MAY BE SWOLLEN, SOME OF THEM HYPERTHROPHIC AND OTHERS ATROPHIC AND EVENTUALLY REPLACED BY FAT (FATTY INFILTRATION) AND CONNECTIVE TISSUE (FIBROSIS).
IF YOU OBSERVED UNDER THE MICROSCOPE A MUSCLE SAMPLE FROM A PATIENT WITH A MUSCULAR DYSTROPHY YOU WOULD SEE.. THE INVOLVED MUSCLE FIBERS ARE RANDOMLY DISTRIBUTED, WITH NO DISTINCT PATTERN.
MOST COMMON OF THE MUSCULAR DYSTROPHIES: DUCHENNE MUSCULAR DYSTROPHY.
DUCHENNE MUSCULAR DYSTROPHY IS THE MOST COMMON OF THE MUSCULAR DYSTROPHIES, DESCRIBED AS A... PSEUDOHYPERTROPHIC MUSC. PARALYSIS.
CLASSIC DUCHENNE OCCURS ONLY IN <BLANK>, WITH HALF THE CASES SHOWING <BLANK> INHERITANCE. BOYS, X-LINKED.
DUCHENNE MUSCULAR DYSTROPHY PATIENTS LACK <BLANK>, CAUSING CELL DEATH AND FIBER NECROSIS? DYSTROPHIN.
CLINICAL MANIFESTATIONS OF DUCHENNE MUSCULAR DYSTROPHY? THE DIS. IS USUALLY IDENTIFIED IN CHILDREN OF ABOUT 3 YRS OF AGE. SHOWING SLOW MOTOR DEVELOPMENT WITH PROGRESSIVE WEAKNESS AND MUSC. WASTE.
MOTOR DEVELOPMENT PROBLEMS IN CHILDREN WITH DUCHENNE MUSCULAR DYSTROPHY? SITTING, STANDING AND WALKING ARE DELAYED AND THE CHILD IS CLUMSY, FALLS FREQUENTLY AND HAS PROBLEMS CLIMBING STAIRS.
IN DUCHENNES MUSCULAR DYSTROPHY, WEAKNESS ALWAYS BEGINS IN THE... PELVIC GIRDLE.
IN DUCHENNES MUSCULAR DYSTROPHY, <BLANK> IS EVIDENCED IN 80 PERCENT OF THE CASES. CALF MUSCLE HYPERTROPHY.
IN DUCHENNES MUSCULAR DYSTROPHY, CONTRACTURES AND WASTING OF MUSCLES CONTRIBUTE TO... MUSC. ATROPHY AND DEFORMITY OF THE SKELETON.
PATIENTS WITH DUCHENNES MUSCULAR DYSTROPHY SUFFER: -PULMONARY COMPLICATIONS -CARDIAC FAILURE -MENTAL RETARDATION -SMOOTH MUSC. DYSFUNCTION
PERCENTAGE OF CHILDREN WITH DUCHENNE MUSCULAR DYSTROPHY WHO HAVE CARDIAC FAILURE, PERCENTAGE WHO HAVE SOME CARDIAC INVOLVEMENT: 50 PERCENT OF CHILDREN WITH CARDIAC FAILURE; SOME CARDIAC INVOLVEMENT IN UP TO 95 PERCENT OF THE CHILDREN.
IN CHILDREN WITH DUCHENNE MUSCULAR DYSTROPHY, SMOOTH MUSCLE DYSFUNCTION MAY CAUSE... MEGACOLON, VOLVULUS, MALABSORPTION SYND. AND CRAMPING PAIN IN THE GI TRACT.
DIAGNOSIS OF DUCHENNE MUSCULAR DYSTROPHY IS CONFIRMED BY: -ELECTROMYOGRAPHY (EMG), -MEASUREMENT OF SERUM ENZYMES (CPK INCREASED MORE THAN 10 TIMES) -MUSCLE BIOPSY.
WHAT DOES CPK STAND FOR? CREATINE PHOSPHOKINASE.
WHAT DO WE DO FOR CHILDREN WITH DUCHENNE MUSCULAR DYSTROPHY? THERE’S NO EFFECTIVE TREATMENT FOR THE DISEASE AND MAINTAINING FUNCTION IN UNAFFECTED MUSC. GROUPS FOR AS LONG AS POSSIBLE IS THE MAIN GOAL.
WHAT PERCENTAGE OF CHILDREN WITH DUCHENNE MUSCULAR DYSTROPHY REACH ADULTHOOD? WHAT DO THEY USUALLY DIE FROM? ONLY 25% OF AFFECTED CHILDREN REACH THE AGE OF 21 YEARS, WITH DEATH USUALLY RESULTING FROM RESP. OR CARDIAC MUSCLE WEAKNESS.
Created by: Chelsea Leigh Jones Chelsea Leigh Jones on 2010-10-08



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