CM & LD: Intro to MSK

What are the key components of synovial joints?

The key components include articular cartilage, synovial fluid, and the joint capsule.

What is the basic structure and function of articular cartilage?

Articular cartilage is a smooth, white tissue that covers the ends of bones in synovial joints, providing a cushion and reducing friction during movement.

What role does synovial fluid play in joint health?

Synovial fluid lubricates the joint, nourishes articular cartilage, and acts as a shock absorber.

How can joints be differentiated based on their structure and range of motion?

Joints can be classified as fibrous, cartilaginous, or synovial, with synovial joints allowing the greatest range of motion.

What is the relationship between bone density, calcium metabolism, and osteoporosis risk?

Low bone density and poor calcium metabolism increase the risk of osteoporosis, a condition characterized by weak and brittle bones.

What are some diagnostic tests used in rheumatology?

Common diagnostic tests include Rheumatoid factor and ANA (Antinuclear Antibody) tests.

What is orthopedics?

A medical specialty focused on the diagnosis, treatment, prevention, and rehabilitation of disorders of the musculoskeletal system.

What are the key areas of orthopedics?

Trauma and fracture care, joint replacement and reconstruction, spine disorders, sports medicine, and pediatric orthopedics.

What is rheumatology?

A medical specialty focused on the diagnosis and treatment of rheumatic diseases affecting joints, muscles, bones, and sometimes internal organs.

What are the major areas of focus in rheumatology?

Autoimmune and inflammatory disorders, degenerative joint and spine diseases, soft tissue rheumatism, and metabolic bone disorders.

What are the structural components of bone?

Cortical (compact) bone, trabecular (cancellous) bone, medullary cavity, and periosteum.

What is the function of the periosteum?

It is a double-layered connective tissue coat covering bone, with an outer tough fibrous membrane and an inner layer containing bone cell precursors.

What are the types of bones?

Long bones, short bones, flat bones, sesamoid bones, and irregular bones.

What is the epiphysis in long bones?

The ends of the long bones that contain red marrow and function in joint formation.

What are osteoblasts?

Bone-forming cells responsible for synthesizing bone matrix proteins and regulating osteoclast activity.

What are osteoclasts?

Bone-resorbing cells that release calcium and phosphate from the bone matrix.

How does parathyroid hormone (PTH) affect serum calcium levels?

It increases serum calcium by stimulating bone resorption, increasing renal calcium reabsorption, and enhancing intestinal calcium absorption.

What is the role of vitamin D in calcium regulation?

It increases serum calcium by enhancing intestinal absorption, promoting bone mineralization, and increasing renal calcium reabsorption.

What are the types of joints based on composition?

Synovial joints, fibrous joints, and cartilaginous joints.

What is a synovial joint?

A freely movable joint characterized by a fluid-filled joint cavity.

What is the function of articular cartilage in synovial joints?

It covers the ends of bones and provides a smooth, slippery surface for joint movement.

What are the different types of joint motion?

Ball and socket, hinge, pivot, gliding (or plane), saddle, and condyloid.

What is tendonitis?

Inflammation or irritation of a tendon, often caused by repetitive stress or overuse, with common sites including the shoulder, elbow, and knee.

What is tendinosis/tendinopathy?

A chronic degenerative condition of a tendon without active inflammation.

What are common joint pathologies?

Tendonitis, tendinosis/tendinopathy, bursitis, sprains, strains, fractures, and arthritis.

What is the function of ligaments in joints?

They connect bones to other bones and provide stability to the joint.

What is the role of bursa in joints?

A small, fluid-filled sac that acts as a cushion to reduce friction in some joints.

What is the function of the joint capsule?

A fibrous sac that encloses the joint and provides stability.

What is the significance of the metaphysis in long bones?

It is the narrow growth zone (growth plate) between the epiphysis and diaphysis.

What is the diaphysis in long bones?

The shaft of long bones that consists of yellow marrow and is responsible for weight bearing.

What is structural damage in the musculoskeletal system?

Results from repetitive microtrauma leading to a failed healing response, typically developing over time.

What are common manifestations of structural damage?

Localized pain, stiffness (especially in the morning), decreased strength and flexibility, and possible swelling.

Which tendons are commonly affected by structural damage?

Achilles tendon, patellar tendon, rotator cuff tendons, and elbow tendons.

What is a sprain?

Stretching or tearing of ligaments caused by a sudden twist or force applied to a joint.

How is the severity of a sprain graded?

On a scale of 1 to 3, with 3 being a complete tear.

What are common sites for sprains?

Ankle, wrist, and knee.

What is a strain?

Stretching or tearing of muscles or tendons, which can be acute or chronic.

What are common manifestations of a strain?

Pain, tenderness, swelling, muscle spasms, weakness, and limited range of motion.

Where are strains commonly located?

Lower back, hamstring, and quadriceps.

What is bursitis?

Inflammation of a bursa, often caused by repetitive motions or pressure.

What are common symptoms of bursitis?

Pain with movement, stiffness, aching, swelling, and warmth in the affected area.

What is the RICE protocol for joint treatment?

Rest, Ice, Compression, Elevation.

What defines a fracture?

A partial or complete break in the bone.

What is the difference between open and closed fractures?

Open fractures have broken skin, while closed fractures have intact skin.

What are the subtypes of complete fractures?

Transverse, oblique, spiral, and comminuted.

What is a greenstick fracture?

An incomplete fracture where one side of the bone is broken and the other side bends, common in children.

What are stress fractures?

Small fractures often caused by repetitive force or overuse.

What is osteoporosis?

A condition characterized by decreased bone density and increased fragility.

What is the gold standard for diagnosing osteoporosis?

Dual-energy X-ray absorptiometry (DEXA) scan.

What are the two most common types of arthritis?

Osteoarthritis (OA) and Rheumatoid Arthritis (RA).

What is osteoarthritis?

A degenerative joint disease characterized by the breakdown of joint cartilage and underlying bone.

What is rheumatoid arthritis?

A chronic autoimmune disease that causes inflammation of the joints and surrounding tissues.

What are common sites affected by osteoarthritis?

Knees, hips, hands, and spine.

What are common sites affected by rheumatoid arthritis?

Hands, wrists, feet, ankles, knees, elbows, and shoulders.

What are general signs and symptoms of fractures?

Pain, swelling, deformity, bruising, and limited movement.

What are the basic principles of fracture management?

Immobilization, pain management, reduction (if displaced), surgical intervention (if necessary), and rehabilitation.

What are non-traumatic causes of musculoskeletal injuries?

Non-traumatic causes include general medical history factors such as cancer, heart disease, neurologic conditions, medications (anticoagulants, steroids), and gait instability.

What does HPI stand for in the context of musculoskeletal injuries?

HPI stands for History of Present Illness, which includes factors like Onset, Location, Duration, Characteristics, Aggravating/Relieving factors, Radiation, Timing, and Severity.

What should be assessed during the physical exam of a musculoskeletal injury?

Essential components include inspection for wounds, swelling, discoloration, deformity, active and passive range of motion (ROM), tenderness, deformity, and neurovascular status.

What is the significance of a wound present with a fracture?

The presence of a wound with a fracture indicates an open fracture.

What are the common imaging modalities used in musculoskeletal diagnostics?

Common imaging modalities include X-ray, CT Scan, MRI, and Ultrasound.

What is the primary purpose of an X-ray in musculoskeletal assessment?

The primary purpose is to produce 2D images of bones and joints to detect fractures, assess alignment, and evaluate bone density.

What are the advantages and limitations of X-rays?

Advantages include being quick, inexpensive, and accessible. Limitations include limited soft tissue detail and radiation exposure.

What is the purpose of a CT scan in musculoskeletal evaluation?

CT scans provide cross-sectional, 3D visualization for complex fractures, pre-op planning, and spine pathologies.

What are the advantages and limitations of CT scans?

Advantages include high-resolution bone detail and speed. Limitations include higher radiation dose and limited soft tissue contrast.

What is the purpose of MRI in musculoskeletal diagnostics?

MRI uses magnetic fields and radio waves to visualize soft tissues, including ligament and tendon injuries, cartilage damage, and early inflammation.

What are the advantages and limitations of MRI?

Advantages include no radiation and excellent soft tissue contrast. Limitations include being expensive and not suitable for patients with metal implants.

What is the purpose of ultrasound in musculoskeletal assessment?

Ultrasound provides real-time imaging for tendon and ligament injuries, synovitis, muscle tears, and guidance for injections.

What are the advantages and limitations of ultrasound?

Advantages include no radiation, portability, and real-time imaging. Limitations include operator dependence and poor visualization of bone.

What does the 'Rule of Two' in radiographic protocols entail?

The Rule of Two includes obtaining two views (AP and lateral), examining two joints (above and below), and repeating on two occasions if needed.

What does the ABCs interpretation method stand for in X-ray analysis?

A - Alignment, B - Bones, C - Cartilage, S - Soft Tissue.

What does 'Alignment' refer to in the ABCs of X-ray interpretation?

Alignment refers to checking the anatomical relationships between bones and identifying fractures or dislocations.

What are the types of fracture patterns?

Fracture patterns include transverse, oblique, spiral, comminuted, segmental, impacted, compression, and depression.

What is the difference between displaced and nondisplaced fractures?

Nondisplaced fractures maintain alignment, while displaced fractures have fragments that are out of alignment.

What does an open fracture indicate?

An open fracture indicates there is an open wound or break in the skin near the site of the broken bone.

What is the significance of bone resorption in radiographic visibility?

Bone resorption may take 7-10 days to become radiographically visible, which can affect the diagnosis of fractures.

What factors guide the choice of imaging modality in musculoskeletal assessment?

Factors include history and physical exam findings, cost, availability, target structure, and diagnostic purpose.

What is the role of serology in musculoskeletal diagnostics?

Serology is used to assess inflammatory markers and autoimmune conditions related to musculoskeletal disorders.