altered musculoskeletal func

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Contractile tissue:

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exam 4 part 2

111 Terms

1

Contractile tissue:

structures involved in contraction of muscle;

  • Muscle belly

  • Tendon

  • Bony insertion (enthesis)

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2

Inert or noncontractile tissue

no ability to contract or relax

  • Joint capsules

  • Ligaments

  • Bursae,

  • Fasciae,

  • Dura mater & Nerve roots

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3

Soft-Tissue Injuries:

contractile/inert tissue

altered range of motion around joint

pain, edema, adhesion, fibrosis

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4

Ligament Injuries

from loading xs of physiologic range of motion

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5

Ligament Injuries:

manifests

pain with weight bearing,

acute swelling,

“popping” sensation

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6

Joint Capsule Injuries

lead to

^vascularity & fibrous tissue → thick capsule

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7

Joint Capsule Injuries:

factors that prevent full range of motion

edema in joint → scar in lax capsule

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8

Joint Capsule Injuries:

altered synovial fluid flow

prevent fluid diffusion of cartilage →

compress & distend

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9

Joint Capsule Injuries:

Adhesive Capsulitis (Frozen Shoulder)

inflam w/swell & distend of joint capsule

prolonged no use → thickening of capsule

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10

Adhesive Capsulitis (Frozen Shoulder)

manifests

lose movement

^pain at night

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11

Adhesive Capsulitis (Frozen Shoulder)

prevention

avoid long periods of not using

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12

Internal Joint Derangement

Tears of menisci/ligaments → instability of joint.

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13

Fasciae

connective tissues of the body arranged in sheaths that envelop muscles.

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14

Fasciae: trauma causes

edema & scar

joint restriction.

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15

Bursae

pockets of connective tissue lined w/synovium

  • in between muscles or between muscle or tendon and bone.

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16

Bursae are found in areas of

^friction

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17

Bursae if inflammed

bursitis (v painful)

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18

Irritation or entrapment of a nerve causes

pain that radiates along structures innervated by that nerve. Example: herniated disk

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19

Injuries to Nerves, Nerve Roots, or Dura Mater

manifests

pain,

altered sensation (numbness and tingling),

motor weakness,

diminished reflexes

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20

Injury to Tendons

range from mild, complete tear, rupture

  • when stress on tendon > fibers can take

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21

Tendonitis:

inflam tendon w/in sheath

  • from infection, direct injury, repetitive motion (Tennis elbow)

    • Contractile Soft Tissue

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22

Muscle and Tendon Strains

minor tear to complete rupture

  • from abnormal muscle contrac

  • mild, moderate, severe

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23

Blunt Trauma (of contractile soft tissue)

bleeding → muscle belly;

  • inability to contract muscle;

  • coagulate and calcify;

  • myositis ossificans

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24

Soft-Tissue Healing After Trauma

disrupt circ & lymph → hemorrhage, fluid loss, cell dies

  • clotting

  • inflam → histamine → edema

  • can take 40+ wks

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25

Soft-Tissue Healing After Trauma

Norepi

constricts vessels

  • serotonin & platelets prolong vasoconstrict

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26

Wound Repair

  • inflam prep for repair

  • granulation forms

  • tensile strength from collagen

  • revasc

    • close/contract

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27

wound repair

reepithelialization

on wound surface to make basement membrane

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28

Bones

Protect internal organs,

mineral homeostasis,

produce blood cells,

muscle attachment

facilitate body movement

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29

Bones are _______ with a capacity for repair

vascular

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30

types of bone

cortical

cancellous

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31

Cortical (compact) bone

forms the cortex (outer shell) of bone;

  • when tension stress exceeds tolerance → fracture on convex side of bend

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32

Cancellous (spongy) bone

found in interior of bone & has spongy appearance

  • structural support but doesn’t tolerate compression

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33

fracture

Break in continuity of a bone, an epiphyseal plate, or a cartilaginous joint surface

  • Trauma may occur to adjacent tissue

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34

types of fractures are classified by

orientation of break:

  • transverse,

  • longitudinal,

  • oblique,

  • spiral

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35

Comminuted fracture:

more than one fracture line & more than two bone fragments

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36

Impacted fracture:

telescopes/drives one fragment into another

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37

Greenstick fracture:

incomplete break (ex. In kids)

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38

Stress fracture:

Failure of one cortical surface of the bone

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39

Nondisplaced fracture:

fragments remain in alignment and position;

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40

Displaced fracture:

ends of fracture fragments are separated

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41

Depressed fracture:

fragment below level of bone surface

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42

Complete fracture:

break through entire bone;

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43

Incomplete fracture:

break only buckles or cracks

  • open/compound when skin is penetrated;

  • closed/simple when skin is not broken

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44

avulsion fracture

clean break of the patella

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45

cortical bone fracture

bleeding

hematoma

osteoblasts invade

callus

remodel

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46

Cancellous fracture healing occurs mainly by

internal callus.

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47

Cancellous fracture healing

rich blood supply

prevents necrosis

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48

Cancellous fracture healing

osteogenic cells form

primary woven bone (spongy)

→ replaced by lamellar bone

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49

Cancellous fracture healing is ___ than cortical

faster

  • more blood supply

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50

complications of fractures

delayed healing

osteonecrosis

osteomyelitis

fat emboli

deep vein thrombosis

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51

Delayed union of fracture

3 to 6 months after fracture,

bone pain & tenderness increasing beyond expected healing period.

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52

Malunion of fracture

improper alignment of fracture fragments

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53

Nonunion of fracture

Not healed by >6 months

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54

Osteonecrosis:

Compromised circulation

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55

Osteomyelitis:

Severe pyogenic infection of bone & local tissue

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56

Osteomyelitis:

caused by organisms reaching bone thru

blood

soft tissue

directly

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57

Osteomyelitis:

thru adjacent soft tissue

Caused by burns,

sinus disease,

trauma,

malignant tumor necrosis,

periodontal infection,

infected pressure ulcer

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58

Osteomyelitis:

direct infection

causes open fracture,

penetrating wounds,

surgical contamination,

insertion of prostheses, metal plates, or screws

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59

Hematogenous osteomyelitis

from infection thru blood from elsewhere in body

  • most common

  • in kids <16 or elderly

  • Staph aureus

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60

Hematogenous osteomyelitis

manifests

kids: high fever, pain at bone involvement

adults: fever, malaise, anorexia, night sweats, and weight loss

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61

If osteomyelitis not managed

necrotic bone can separate from healthy bone into dead segments called sequestrum

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62

Fat emboli syndrome:

Fat is released from bm & lodges in lung blood vessels

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63

Dislocation:

displacement of bone from normal position

  • joint surfaces completely lose contact

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64

Subluxation refers to

displacement of a bone from normal position

  • joint surfaces lose partial contact

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65

Dislocations and Subluxations

lead to

tissue damage

pain

loss of mobility

change length

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66

Scoliosis

lateral curve of spine (S or C)

  • nonstructural resolves w/bend

  • structural has vertebral rotation

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67

Scoliosis

manifests

Asymmetry of shoulders, hips, chest wall;

possible respiratory problems

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68

metabolic bone diseases

osteoporosis

rickets & osteomalacia

paget disease

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69

Osteoporosis

  • most common metabolic disease

    • bone reabsorb (osteoclast) > (osteoblast) bone forming

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70

Osteoporosis

etiology

low estrogen

low Ca

disuse

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71

Osteoporosis effect on bones

Trabeculae decreased,

width & mass decreased;

fragile bone → fractures

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72

Osteoporosis

Cancellous bone lost ___ than cortical bone

faster

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73

osteoporosis

manifests

Shortened stature,

muscle wasting,

back muscle spasms,

difficulty bending over

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74

osteoporosis

diagnosis

based on bone mineral density measured by DXA

  • T < -2.5

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75

rickets and osteomalacia

vitamin D deficiency

soft/weak bones

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76

rickets

in kids

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77

osteomalacia

in adults

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78

rickets and osteomalacia

manifests

Kyphosis,

genu valgum (knock knee),

genu varum (bowleg);

pain in adults

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79

rickets and osteomalacia

etiology

low vita D & phosphorus supplements

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80

pagets disease

slow progressive metabolic disease

  • xs osteoclast func→then xs osteoblast func

  • genetic or viral infection

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81

pagets disease

manifests

Painful bone deformities

bone fractures

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82

sarcoma

malignant tumor

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83

carcinoma

metastatic tumor spread to bone

  • from breast, prostate, lung, kidney

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84

common sites of bone neoplasms

vertebral bodies,

pelvis,

proximal ends of the femur and humerus,

ribs

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85

benign tumors

osteochondroma

chondroma

osteoid osteoma

giant cell tumor

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86

Osteochondroma

Cartilage-containing;

asymptomatic;

long bones

  • benign

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87

Chondroma

Cartilage-containing;

often in bones of hands and feet

  • benign

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88

Osteoid Osteoma

Often found in tibia and femur;

persistent dull pain

  • benign

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89

Giant cell tumor (osteoclastoma)

Richly vascularized tumor;

fast-growing;

femur and tibia

  • benign

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90

Malignant Bone Tumors

osteosarcoma

chondrosarcoma

ewing sarcoma

multiple myeloma

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91

Osteosarcoma

Extremely malignant bone-forming & most common;

destructive

Form bone/osteoid by tumor cells

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92

Osteosarcoma

mostly in

kids & YA

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93

osteosarcoma

Located in the

femur, tibia, fibula, humerus and flat bones of the pelvis, skull, scapula, ribs, or spine

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94

Chondrosarcoma

  • Malignant cartilage-forming tumor that

  • slow

  • 30 to 60 years of age

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95

Chondrosarcoma

tends to develop in the

pelvic and shoulder girdles

proximal ends of long bones

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96

Ewing Sarcoma

  • 3rd most common prim sarcoma

  • rapid growth, malignant

    • 5-25 years old

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97

Ewing Sarcoma

happens in

long bones

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98

Ewing Sarcoma

composed of and spreads to

dense small cells w/round nuc

metastasize to lungs

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99

Multiple Myeloma

  • slow malignant w/prolif of single clone plasma cells

  • elderly

  • bone pain

    • Ig in urine & serum

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100

Multiple Myeloma

affects

kidneys

immune

circ system

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