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Musculoskeletal
| Question | Answer |
|---|---|
| 5 Functions of bones | Structural support storage of minerals production of blood cells protect body organs provide leverage and movement |
| What minerals are stored in bones? | calcium, phosphorus, magnesium, sodium |
| Red bone marrow function | makes RBC's, WBS, and Platelets |
| Yellow bone marrow function | Fats, cartilage, and bone |
| osteogenesis | bone growth |
| Trabecular bone | Spongy, cancellous bone, more susceptible to osteoporosis ex: wrist, hip, and vertebrae |
| Cortical bone | dense bone ex: femur or tibia |
| Osteoblasts | Bone forming cells |
| Osteoclasts | cells that do bone remodeling and keep bone tissue from overgrowing |
| Osteocytes | mature osteoblasts that maintain the bone matrix |
| Bone remodeling | bone formation: osteoblasts, produces organic bone matrix Bone resorption: osteoclasts, dissolves bone |
| What factors affect bone maintenance? | - calcium+ vit d - physical activity, tobacco, alcohol - sex, size, age, race, fam history - PTH, calcitonin (parathyroid and thyroid) - nutrition - medication |
| Ligaments connect | bone--> bone stability |
| Tendons connect | Muscle --> bone motion |
| What is synovial fluid? | Fluid in the synovium of the joint capsule and lubricates movement |
| Tonus | state of muscle readiness (strength) |
| Flaccid | muscle limp and lacking tone |
| Spastic | Muscle with greater than normal tone |
| Atonic muscle | denervated muscle |
| Hypertrophy | increase in muscle size |
| Atrophy | decrease in muscle size |
| MS diagnostic tools | x-ray CT/MRI Bone scan electromyography biopsy |
| Sprain | overstretch of the ligament |
| Strain | overstretch of the muscle/tendon |
| Muscle contusion | bruised muscle |
| 1st stage of bone healing | Fracture and inflammation bleeding between edges of fractured bone (hematoma) |
| 2nd stage of bone healing | Granulation tissue formation fibroblasts are attracted to the area growth of vascular tissue |
| 3rd stage of bone healing | Callus formation consisting of osteoblasts and chondroblasts synthesis of extracellular organic matrix of woven bone and cartilage |
| 4th stage of bone healing | Lamellar bone deposition mesh like callus replaced by mineralized bone strengthening and ossification |
| 5th stage of bone healing | REMODELING final phase adequate strength at 3-6 mos |
| What is a fat embolism? | Fat globules from the (yellow) marrow of a fractured bone enter circulation - obstruct microvasculature (brain, pulmonary) |
| Delayed union | taking more than normal time for healing |
| Nonunion | permanent failure of bone healing |
| Malunion | healing of bone in an unacceptable position |
| What do you assess after a fracture in an extremity? | - vascular injury - infection - avascular necrosis |
| What are the 5 p's and what do they indicate? | - pain - pulse - pallor - paresthesia - paralysis Indicate poor perfusion and neurovascular changes when distal to injuries |
| What is compartment syndrome? | Swelling or bleeding causes high pressure which collapses A+V, fascial membrane cannot handle pressure - can lead to ischemia, necrosis, and functional impairment |
| What are the compartment syndrome symptoms and how would you diagnose? | assessment: weak distal pulse, pulselessness |
| What is rhabdomyolysis? | Muscle breakdown --> myoglobin filter through kidneys--> toxic to nephrons in large amounts--> AKI |
| Rhabdomyolysis triad | - myalgia, weakness, myoglobinuria diagnostic: creatinine kinase dark urine is first sign |
| How does an MS injury put someone at risk for a PE and DVT? | Blood pooling at sites of injury lads to increased coagulation |
| What is a joint dislocation? | When the articular surfaces of bones are not aligned |
| Pathological fracture | Fracture due to weakened or fragile bone cause: osteoporosis, degeneration, infection |
| Symptoms of a hip fracture | painful ROM 5 p's |
| What is bursitis? | Synovial lining produces excess fluids leading to localized swelling and pain stiffness around joints |
| What is tendonitis? | Inflammation of tendons - pain at join, stiffness, loss of motion, mild swelling |
| Bursitis and tendonitis causes | repetitive movements, excessive pressure on joints, injury |
| Carpal tunnel syndrome | When the median nerve at the wrist is compressed causing pain, tingling, numbness and weakness |
| carpal tunnel syndrome causes | pregnancy, trauma, diabetic neuropathy, hypothyroidism |
| What is necessary in our diets for bone health? | Vitamin D and calcium |
| How does PTH regulate calcium? | Released from the parathyroid gland it increases osteocyte activity which raises blood calcium levels and breaks down bone |
| How does vitamin D regulate calcium? | Calcitriol, released from kidneys and absorbed in our diets, it facilitates calcium absorption |
| How does calcitonin regulate calcium? | Released from the thyroid gland, it increases calcium absorption (osteoblasts) and reduces serum calcium levels |
| Testosterone and bone health | increases muscle growth which leads to stronger bones think: weight-bearing activities |
| Estrogen and bone health | suppresses osteoclasts, less bone degeneration |
| Arthritis | Arthropathy - joint disorder polyarthritis: one or more joints |
| Chondrocytes | cells that make up cartilage |
| Cartilage | flexible connective tissue on the surfaces of two opposing bones |
| What causes cartilage degeneration? | excessive force leads to cartilage degeneration |
| What is osteoporosis? | Low bone density porous bone |
| Cause of Osteoporosis | Primary: chronic low calcium Secondary: disorders affecting bone tissue (hyper para and thyroidism) |
| RF osteoporosis | female, low calcium, postmenopausal lack of T or estrogen low calcitriol hyperthyroidism, hyperparathyroidism |
| Osteoporosis symtpoms | silent disease, unknown until pathological fracture occurs |
| Osteoporosis diagnosis | Blood tests DEXA |
| What is osteoarthritis? | Joint degeneration (cartilage) |
| Joint vs. cartilage | joint: where two bones meet cartilage: cushioning at joint |
| Cause of osteoarthritis | pressure causes degeneration |
| Osteoarthritis symptoms | Osteophytes: hallmark sign boney projections crepitus: popping noise pain/aches/stiffness nodes |
| Osteoarthritis diagnosis | X-ray confirms physical exams |
| What is degenerative disc disorder? | Herniated disc thinned disc degenerated disc (osteophyte may be present) bulging disc |
| Degenerative disc disorder symptoms | lumbar: sciatica numbness, tingling, pain relieved with walking or reposition Cervical: shoulder and neck pain, tingling, weakness, numb in hands and fingers |
| Degenerative disc disorder diagnosis | x-ray, MRI, DTR, sensory dermatomes |
| What are the two ways bone can get infected? | 1. Contiguous: wound or opening; surgery or trauma 2. Hematogenous: infection spread through bloodstream |
| Osteomyelitis and number 1 bacteria that causes it | osteomyelitis: bone infection most commonly caused by staph aureus |
| What are the 3 categories of osteomyelitis? | 1. Contiguous 2. Hematogenous 3. Chronic |
| Contiguous osteomyelitis | surgery or trauma diabetes Risk factor and peripheral vascular disease |
| Hematogenous osteomyelitis | Spread through bloodstream most common in children because of higher vascularization in growing bones rapid onset sequestrae of necrotic bone |
| Chronic osteomyelitis | 6-8 weeks acute--> chronic--> necrotic bone--> increased gangrene risk |
| Osteomyelitis symptoms | Chills fever malaise localized tenderness reduced ROM edema |
| Gout | Recurrent inflammation of joints synnovial fluid caused by hyperuricemia uric acid forms crystals in synovial fluid |
| primary vs. secondary gout | primary: metabolic dysfunction, renal dysfunction, something with break down of purines secondary: variety of different disorders resulting in high uric acid levels |
| Where is gout? and what symptoms would you expect? | Synovial joints (1st metatarsal toe) Redness, Swelling, localized pain, warmth |
| tophi | uric acid in crystals deposited in subcutaneous tissue (layer right above muscle) |
| Podagra | acute inflammation of metarsophalangeal joint of great toe |
| Gout risk factors | high in red meat obesity chemo (cell death--> purine-->uric acid) family history alcohol |
| Gout complications | Kidney stones-->AKI-->renal failure/kidney disease cartilage and bone destruction, joint deformity |
| How do you diagnose gout? gold standard | Aspiration of joint showing urate crystals centesis of synovial fluid |
Created by:
mdedobbe