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Chapter 9

Musculoskeletal System Disorders

TermDefinition
long bones consist of a long, hollow shaft with 2 bulbous ends, such as the humerus & femur
short bones generally square-like in shape and found in the wrist & ankle
flat bones relatively thin & often curved such as the skull bones
irregular bones have many projections & vary in shape, are represented by the vertebrae & mandible
osteocytes mature bone cells that lie between the rings of matrix in spaces call lacunae
osteoblasts a cell that makes new bone
osteoclast reabsorption & removal of bone
2 types of bone tissue Compact bone Cancellous or spongy bone
Compact bone forms the outer covering of bones
Cancellous/spongy bone forms the interior structure of bones
diaphysis a thin shaft, between two larger ends or epiphyses
metaphysis area where the shaft broadens into the epiphysis
epiphysis made up of spongy bone covered by compact bone
periosteum a fibrous connective tissue containing osteoblasts, blood vessels, nerves, & lymphatics
medullary cavity The medullary cavity (medulla, innermost part) is the central cavity of bone shafts where red bone marrow and/or yellow bone marrow (adipose tissue) is stored
endosteum is a thin layer of connective tissue that lines the surface of the bony tissue that forms the medullary cavity of long bones.
4 basic functions of skeletal muscle 1. Facilitate body movement 2. Maintain body position 3. Stabilize joints 4. Maintain body temperature
Epimysium surrounding the entire muscle
Perimysium surrounding the fascicles
Endomysium surrounding the individual muscles fibers (cells)
motor unit the motor neuron of the spinal cord & all the muscle fibers it stimulates
neuromuscular junction where the synapse between the end of the motor nerve & the receptor site in the muscle fiber is located
aerobic exercise increases the muscles capacity to work for a longer time without causing marked hypertrophy of the muscle; swimming or running
anaerobic exercise focuses on increasing muscle strength by increasing muscle mass; weight lifting or bodybuilding
hypertrophy increased size of the muscle cell
anabolic steroids synthetic hormones used for changing the body image to build up muscle strength and mass; used by some athletes, bodybuilders, etc
atrophy muscle cell sized is decreased
Synarthroses represented by the sutures in the skull, are immovable joints
Amphiarthroses slightly moveable joints, are joints in which the bones are connected by fibrocartilage or hyaline cartilage
Diarthroses or synovial joints freely movable joints and are the most common type of joint in the body
hinge joint provides flexion & extension, is found at the elbow
ball-and-socket joint provides a wide range of motion, including rotation, is found at the shoulder
temporormandibular joint provides both hinge & gliding movements, controlling the opening of the mouth
synovial fluid prevents the articular cartilage on the two surfaces from damaging each other & also provides nutrients to the articular cartilage
articular (hyaline) cartilage found in synovial joints at the ends of the bone, provides a smooth surface & slight cushion during movement
synovial membrane lines the joint capsule to the edge of the articular cartilages
articular capsule composed of the synovial membrane and its outer covering
fibrous capsule a tough protective material that extend into the periosteum of each articulating bone
Bursae fluid-filled sacs composed of synovial membrane & located between structures such as tendons & ligaments
proprioceptors pain receptors
Electromyograms (EMGs) measure the electrical charge associated with muscle contraction & are helpful in differentiating muscle disorders from neurologic disease
Arthroscopy insertion of a lens directly into a joint
Complete fracture bone is broken to form 2 or more separate pieces
Incomplete fracture bone is only partially broken
Open or compound fracture bone fragments protrude through the skin
Simple fracture a single break in the bone in which the bone ends maintain their alignment & position
Comminuted fracture in which there are multiple fracture lines & bone fragments
Compression fracture common in the vertebrae, occurring when a bone is crushed or collapses into small pieces
Impacted fracture occurs when one end of the bone is forced or telescoped into the adjacent bone; for example, the neck of the femur is crushed against the pelvis
Pathologic fracture results from a weakness in the bone structure due to conditions such as a tumor or osteoporosis
Stress fracture result from repeated excessive stress
Depressed fracture occurs in the skull when the broken section is forced inward on the brain
transverse fracture a fracture across the bone
linear fracture a break along the axis of a bone
oblique fracture a break at an angle to the diaphysis of the bone
spiral fracture a break that angles around the bone, usually due to a twisting injury
avulsion ligaments or tendons that completely separate from their bony attachments
1st Degree Muscle Tear involves small percentage of the muscle; pain is mild & doesn't result in any appreciable loss in strength or ROM
2nd Degree Muscle Tear involves much of the muscle but stops short of being a complete tear; pain is severe with a substantial loss of strength & ROM
3rd Degree Muscle Tear a complete tear across the width of the muscle; there will be a great deal of internal bleeding & may require surgery for proper healing
Osteoporosis common metabolic bone disorder characterized by a decrease in bone mass & density, combined with loss of bone matrix & mineralization
Rickets & Osteomalacia result from a deficit of Vitamin D & phosphates required for bone mineralization
Osteomyelitis a bone infection usually caused by bacteria & sometimes fungi
Lordosis spine curving significantly inward at the lower back
Kyphosis aka hunchback or humpback, is an abnormally rounded upper back
Scoliosis is an S- or C-shaped sideways curve to the spine
Osteosarcoma primary malignant neoplasm that usually develops in the metaphysis of the femur, tibia, or fibula in children or young adults
chrondrosarcomas arise from cartilage cells and develop more gradually in the pelvic bone or shoulder girdle & eventually metastasize to the lungs
Muscular Dystrophy a group of inherited disorders characterized by degeneration of skeletal muscle
Duchenne's muscular dystrophy a group of progressive degenerative muscle disorders, often inherited as an X-linked recessive trait, affecting boys
Osteoarthritis degenerative or "wear & tear" joint disease; affects weigh bearing joints (hips, knees)
Rheumatoid arthritis an autoimmune disorder causing chronic systemic inflammatory disease; remissions & exacerbations; causes inflammation of the synovial membrane
Rheumatoid factor (RF) an antibody against immunoglobulin G, as well as other immunologic factors, is present in the blood in the majority of persons with RA
ankylosis fixation or immobility at a joint
uveitis inflammation of the iris, ciliary body, and choroid (uveal tract) in the eye
Infectious or septic arthritis usually involves a single joint; the joint is red, swollen, & painful with decreased ROM; early treatment is required to prevent permanent damage
Gout results from deposits of uric acid & urate crystals in the joint that then cause an acute inflammatory response; colchicine may be used during an acute episode
hyperuricemia elevated levels of uric acid
Ankylosing Spondylitis a chronic progressive inflammatory condition that affects the sacroiliac joints, intervertebral spaces, & costovertebral joints of the axial skeleton
Bursitis an inflammation of the bursae associated with bones, muscles, tendons, ligaments, of various joints
Synovitis an inflammation of the synovial membrane lining the joint
Tendinitis the irritation or inflammation of the tendon
4 Stages of Fracture Healing 1. Hematoma 2. Fibrocartilaginous callus 3. Bony callus 4. Remodeling
Functions of bones -provide support for the body -provide protection of the visera (heart, lungs, spinal cord, & brain) -metabolizes & stores calcium -produces bone marrow where new blood cells are produced
Bone is made up of? connective tissue consisting of an intercellular matrix & bone cells
Complications that affect bone healing 1. Muscle spasms 2. Infections 3. Ischemia 4. Compartment Syndrome 5. Fat Emboli 6. Nerve damage 7.Failure to heal 8. Fractures
Emergency treatment for fractures 1.Cover open wounds with sterile or clean dressings 2.Splint for support 3.Elevate limb slightly & apply cold if possible 4.Keep patient warm 5.Check for signs of shock
Predisposing Factors to Osteoporosis -Aging -Decreased mobility or a sedentary lifestyle -Hormonal factors -Deficits of calcium, Vitamin D, or protein -Smoking -Small, light bone structure -Excessive caffeine intake
Treatment of osteomyelitis Antibiotics Surgery
Osteosarcoma a primary malignant neoplasm that usually develops in the metaphysis of the femur, tibia, or fibula in children or young adults, particularly males; grows quickly and metastasizes to the lungs in early stages
Ewing's Sarcoma a malignant neoplasm common in adolescents that occurs in the diaphysis of long bones; grows quickly and metastasizes to the lungs in early stages
Chondrosarcomas arise from cartilage cells & are common in adults older than 30 years old.
Fibromyalgia characterized by pain & stiffness affecting muscle, tendons, & surrounding soft tissues (not joints).
Pathologic changes of RA 1. Inflamed synovium 2. Loss of cartilage 3. Ankylosis (joint fixation & deformities)
Treatment for RA Physical therapy & occupational therapy Pain control (NSAIDs, glucocorticoids, DMARDs
Created by: mschumacher1