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Ortho A&P 1
Orthopedics
| Question | Answer |
|---|---|
| Components of the MS System | Bone, Articular Tissue, Connective Tissue |
| Articular Tissue | Cartilage, Synovium |
| Connective Tissue | Muscle, Ligaments, Tendons |
| Bones: Numbers | 80 in axial skeleton; 126 in appendicular skeleton; 27 in the hand |
| Regions of long bones | Epiphysis; Physis; Metaphysis ; Diaphysis |
| Epiphysis = | above growth plate |
| Physis = | growth plate |
| Diaphysis = | shaft |
| Physis in children: | is open (i.e., growth plate) |
| Types of Bone | Cortical; Cancellous |
| Cortical bone = | Compact, makes up 80% of skeleton (e.g., diaphysis of long bones) |
| Cancellous bone = | Spongy or trabecular ; more prominent in spine & pelvis (e.g., metaphysis of long bones) |
| Periosteum = | Highly vascular membrane that covers bone; more prominent in children |
| Bone Marrow = | Source of hematopoietic progenitor cells |
| Highly vascular membrane that covers bone; more prominent in children | Periosteum |
| Source of hematopoietic progenitor cells Bone | Marrow |
| Organic Bone Matrix wrt weight | Organic matrix composes 40% of bone dry wt |
| Organic Bone Matrix = | Type I Collagen, Proteoglycans, Noncollagenous matrix proteins, GFs & cytokines |
| Type I Collagen = | 90% of organic matrix |
| Bone strength from: | Type I Collagen (tensile strength); Proteoglycans (compressive strength) |
| Noncollagenous matrix proteins promote: | mineralization & bone formation |
| Growth factors & cytokines = | Interleukins, transforming growth factor |
| Inorganic Bone Matrix = | Calcium hydroxyapatite; Osteocalcium phosphate (Brushite) |
| Mineral components wrt weight | Mineral components compose 60% of the dry wt of bone |
| Metaphyseal - Epiphyseal System | Arises from periarticular vascular plexus |
| Periosteal System | Low pressure capillary system supplies outer 1/3 of diaphyseal cortex |
| Bone maintained by metabolism of: | Ca & PO4 |
| Amount Ca & PO4 in bone | 99% of Ca & 85% of PO4 found in Bone |
| Needed for gut Ca absorption: | Vitamin D |
| Increases plasma Ca by increasing gut absorption & bone resorption: | PTH |
| Osteoblasts = | Cells that form bone, producing type I collagen |
| Osteoclasts = | Cells that resorb bone |
| Osteocytes = | Cells that maintain bone; make up 90% of mature skeleton |
| Fracture Healing: stages | Inflammation, Repair, Remodeling |
| Fracture Healing: Remodeling stage | Begins mid repair phase; continues for several months |
| Types of Cartilage | Fibrocartilage, Elastic cartilage, Fibroelastic cartilage, Articular cartilage |
| Fibrocartilage | Area for bone & tendon insertion |
| Elastic cartilage | Nose, auricle |
| Fibroelastic cartilage: | Menisci (functions to deepen articular surface & stabilize joint) |
| Articular cartilage: | Hyaline (aids in load distribution & decreasing joint friction) |
| Synovium = | Membrane lines the joint; mediates exchange of nutrients between blood & joint fluid |
| Synovial (Joint) Fluid: | Nourishes articular cartilage; lubricates articular surfaces |
| Bursa: | Fluid-filled potential space over areas of friction |
| Combine into myofibrils: | Actin & Myosin filaments |
| Myofibrils combine into: | muscle fibers |
| Muscle fibers combine into: | muscle fascicles |
| Blood supply to long bones | Nutrient Artery System; Metaphyseal-Epiphyseal System; Periosteal System |
| Nutrient Artery System: | Nutrient a. enters diaphyseal cortex thru nutrient foramen into medullary canal |
| Bone remodeling MOA | Osteoclasts resorb bone followed by new bone deposition by osteoblasts |
| Wolff’s law | Increase in external stress leads to bone formation; removal of external stress leads to bone resorption |
| Change in bone marrow with aging | Red (active) marrow changes to yellow (fatty, inactive) marrow |
| Peak bone mass at age: | 16 to 25 y.o. |
| Isotonic contraction: | Constant tension through ROM |
| Concentric contraction: | muscle shortens |
| Eccentric contraction: | muscle elongates |
| Isometric contraction: | Muscle tension with length constant |
| Isokinetic contraction: | Concentric or eccentric contraction at constant speed over ROM |
| Gait Analysis: Width of the gait: | Normal =2-4 in heel to heel; Wide based gaits = instability |
| Gait Analysis: Ctr of gravity: | Normal gait oscillates no more than 2 in. vertically; pain & mx weakness => pt shifts COG over affected hip |
| Gait Analysis: Pelvic shift: | pelvis & trunk shift laterally 1 in. to wt bearing side |
| Gait Analysis: Pelvic shift: in gluteus mx weakness: | lateral shift is accentuated to the side involved |
| Gait Analysis: Length of step: | Ave length is 15 in. With age/ fatigue/ pathology: step is shortened |
| Gait Analysis: Cadence: | Ave cadence is 90-120 steps/ min. With age/ fatigue/ pain: cadence is decreased to conserve energy |
| Gait Analysis: Pelvic rotation: | Normal during swing phase = 40 degrees in leg that is moving forward; if pain or stiffness in hip, pelvis will not rotate normally |
| Antalgic gait: | Limp from pain |
| Wide based gait = | Instability from cerebellar disease or peripheral neuropathy |
| Steppage gait = | Weak ankle dorsiflexors results in increase knee & hip flexion |
| Flat foot gait = | Gastrocnemius/ Soleus weakness (S1-S2 radiculopathy) |
| Back Knee gait = | Quadriceps weakness forces pt to push on thigh w/ hand to try to lock knee in stance phase |
| Trendelenberg (abduction lurch) gait = | Gluteus medius weakness (L5); pt lurches toward weak side to place COG over hip |
| Extensor lurch = | Gluteus max weakness (S1); pt thrusts thorax posteriorly to maintain hip extension |
| Foot Drop = | Weakness of tibialis anterior (L4) |
Created by:
Abarnard
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