Musculoskeletal Disorders: Kickball!!!

What produces new bone?

Osteoblasts - bone-producing cells that secrete the matrix of bone

What is the chemical transmitter at the neuromuscular junction?

Acetylcholine (ACh)

What is a compound fracture?

Same as an open fracture; the skin is broken along with the bone. Fragments may be angled or protrude through the skin.

What is a compression fracture?

Common in vertebrae; bone is crushed or collapsed into small pieces.

What causes a pathologic fracture?

Weakness in the bone due to tumor, osteoporosis, or excessive steroid use. Spontaneous, with very little stress on the bone.

Repeated stress on bone can cause what?

Stress fractures / fatigue fractures

A break along the axis of the bone is what kind of fracture?

Linear fracture

A twisting fracture is what kind of fracture?

Spiral fracture - a break that angles around the bone, usually from a twisting injury

What are eight complications of fractures?

1. muscle spasms 2. infection 3. ischemia 4. compartment syndrome 5. fat emboli 6. nerve damage; 7. failure to heal 8. fractures near a joint with residual effects such as osteoarthritis

A tear in a ligament is called a...

Sprain

A tear in a tendon is called a...

Strain

Know first, second, and third degree muscle tears

1st degree: tear in only a small percentage of the muscle.

2nd degree: tear in a large percentage of the muscle, but not all the way through.

3rd degree: complete tear through the width of the muscle.

What diagnosis marks the midpoint in progression to osteoporosis?

Osteopenia - bone density slowly becomes lower

Who is at risk for osteoporosis? (example)

Postmenopausal women with estrogen deficiency

A disease of unknown cause, possibly linked to a childhood viral infection?

Paget disease

What conditions are directly related to vitamin D deficiency?

Rickets and osteomalacia

What is required to absorb calcium?

Vitamin D

What is loss of bone density by loss of calcium?

Osteoporosis

What are the four functions of skeletal muscle?

1. Facilitate body movement 2. maintain body position 3. stabilize joints 4. produce heat

What is a Colles fracture?

Fracture of the distal radius (wrist)

In fracture healing, the hematoma is what?

A fibrin network forms a clot

Inflammation after a fracture can cause what?

Osteomyelitis, swelling, warmth, redness

What does a dislocation look like?

One bone is out of position while the other bone remains in its normal position

Duchenne muscular dystrophy is inherited how?

X-linked recessive (affects males)

What evaluates the integrity of bones and joints?

Bone disorders: X-rays, bone scans.

Muscle disorders: EMG, biopsy

Joint disorders: X-rays, arthroscopy, MRI, synovial fluid exam.

A metabolic defect (deficit of dystrophin) leading to degeneration and necrosis of the cell?

Duchenne muscular dystrophy (MD = group of inherited disorders with degeneration of skeletal muscle)

Pain of unknown cause with no evidence of inflammation or degeneration?

Primary fibromyalgia syndrome. Onset higher in women age 20-50; history of physical/psychological trauma or chronic pain; aggravated by sleep deprivation, stress, fatigue.

What limits joint movement in osteoarthritis?

Enlarged, hardened joints from osteophytes (bone spurs) and an irregular cartilage surface

Why do joints affected by osteoarthritis affect healthy joints?

Uneven mechanical stress is applied to other parts of the joint, shifting more weight onto healthy joints

What is a bone infection?

Osteomyelitis - an inflammatory condition affecting the bone and bone marrow

Abnormal curvature of the spine caused by the slipping forward of vertebrae?

Lordosis: Swayback; spine curves significantly inward at the lower back. Causes include obesity and discitis.

Abnormal curvature of the spine caused by spina bifida?

Kyphosis: Hunchback/humpback; abnormally rounded upper back. Causes include poor posture, spina bifida, and spinal tumors.

Abnormal curvature of the spine caused by an unknown cause?

scoliosis: S- or C-shaped sideways curve; cause unknown but tends to run in families

A malignant neoplasm in the metaphysis of the femur, tibia, or fibula in children?

Osteosarcoma

Tumors that develop in the pelvic bone or shoulder girdle and metastasize to the lung?

Ewing sarcoma (and osteosarcoma)

A systemic inflammatory disorder due to an autoimmune reaction?

Rheumatoid arthritis

What does the joint look like when RA is exacerbated?

Red, swollen, sensitive to touch, painful; stiff; movement impaired by swelling and pain. Eventually no longer inflamed but fixed and deformed (burned out).

What is a long-term effect of using steroids for arthritis?

Osteoporosis

What causes an attack of gout?

Uric acid (urate) crystals deposit in the joint, triggering acute inflammation (hyperuricemia)

Fluid-filled sacs of synovial membrane between tendons and ligaments that act as cushions?

Bursae

An autoimmune disease affecting joints causing inflammation of the synovial membrane?

Rheumatoid Arthritis

What are the differences between rheumatoid arthritis and juvenile rheumatoid arthritis?

RA: adult-onset, symmetric small-joint involvement, RF often positive, progressive deformity.

JRA: onset before age 16, often large joints, systemic features (fever, rash), rheumatoid factor often negative, many children go into remission. MORE ACUTE onset

Septic arthritis is caused by what?

Gonococcus or Staphylococcus

A chronic, progressive inflammatory condition affecting sacroiliac joints, intervertebral spaces, and costovertebral joints?

Ankylosing spondylitis

What are risk factors of impaired mobility?

Fat emboli, osteoporosis, joint stiffness, muscle weakness

What is an electromyogram (EMG)?

Measures the electrical charge associated with muscle contraction; helps differentiate muscle disorders from neurologic disease and determines strength of individual muscle groups

What does CK (creatine kinase) measure?

Serum CK is measured to identify muscle disorders; levels are elevated in many muscle diseases