Musculoskeletal system

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Musculoskeletal system
2014-11-30 01:46:36
bones joints

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  1. Fracture types?patho? healing process? Tx? CM?
    • A fracture is a break in continuity of a bone, an epiphyseal plate, or a cartilagious joint surface.
    • Trauma may also occur to adjacent tissue.
    • types: open (compound) and closed (simple) -- the biggest complication in compound fracture is that the bone was exposed to air, n the pt is prone to osteomylitis.
    • Patho: Periosteum or blood vessels disrupted -- Hematoma formed --> inflammation rxn. -- site invaded by osteoclasts and osteoblast. -- Organized fibrin network formed. -- Bone forming cells activated.
    • Healing: Acascular bone is replaced by living bone through resorption and bone deposition. --> Callus formation leads to new bone formation.
    • Tx: its to stabilize the bone in conjunction for healing.
    • CM: unnatural alignment, swelling, muscle spasm (particullaly in the legs), tenderness, pain, etc.
  2. complication in bone healing? etiology? tx? complications of fractues?
    • healing: can include delayed union, which means not healed in 4-6 months.
    • Etiologies: nonapproximated fragments, infection, smoking, malnutrition, poor circulation.
    • tx: nobe grafting, internal/external fixation, electrical bone stimulation, or mixture.
    • Complications: fat embolism syndrome, petechial skin rash, compartment syndrome.
    • FES: it is like a PE, but w fat. It has the same signs of the PE as well.
    • Compartment: trauma to soft tissue around the fracture. -- Causes: decreased compartment size, increased compartment content, or external applied pressure. -- symptoms: the 6 ps. Painful, pulseless, pale, paresthesia (tingling or thicking), paresis (weakness, partial paralysis), cold.
  3. Dislocation vs subluxation? strain vs sprain? scoliosis?
    • Dislocation: complete separation of joint articulating surface.
    • Subluxation: Partial separation.
    • strain: tear in tendon.
    • Sprain: tear in ligament.
    • Scoliosis: lateral curvature and nonstructural scoliosis.
    • Lateral: resulting in a S or Cshaped spine.
    • Nonstructural: results when the pt bends to the affected side.
  4. osteoporosis Patho? tx? etiologies/risk factors?  CM?
    • patho: It is the most common metabolic disease that occurs when the bone reabsorption is greater than bone formation.
    • The density of mass of the bone reduced.
    • tx: calcium and vit D, exercise, estrogen replacement, etc.
    • etiologies: age, race (caucasia, asian), gender, body mass, strogen loss, sedentary occupation, thyroid meds, smoking.
    • CM:  25-30 % of bone loss before being able to see it -- history of loss height, back pain, dowager's hump, difficulty bending over.
  5. Myasthenia Gravis chts? etiology? patho? CM?
    • it is a chronic autoimmune disease; affects the nueromuscular function of voluntary muscles.
    • etiology: thymic tumors in the thymus, autoimmune.
    • Patho: Defect in nerve impulse transmission at neuromuscular junction.
    • Destruction of acetylcholine receptor sites in the post-dynapctic junction.
    • CM: ptosis, extreme fatigue after excercise, dx made w tensilon.
  6. Fibromyalgia etiology? chts? dx?
    • etiologies: unknown.
    • chts: pain all over.
    • dx: of exclusion.
    • tx: pts do well in antidepressants.
  7. Osteomyelitis chts? tx? patho?
    • Severe pyogenic infection of bone and local tissue -- direct infection can occur due to open frature, penetrating wounds, surgical contamination, or insertion of prostheses. -- Common agent is staphylocossus aureus. -- tx: 4-6 weeks of antibiotics usually thorugh a PIG line. -- It is very difficult to treat.
    • Patho: bateria growth causes abcess, pus spreads out, necrotic bone becomes trapped, sinuses develop to allow bone to drain.
    • CM: usually pt comes w fracture then 4-5 days later develops systemic manifestations of infection.
  8. Ligaments injuries chts? CM? tx?
    • Ligaments connect bone to bone.
    • occurs when loading exceeds the physiological range of motion.
    • CM: pain w weight bearing and acute swelling.
    • tx: depends on the degree, ACL, MCL, etc.
  9. Joint capsule injury chts?
    • affects the stabilizationg of synovial joint.
    • increase of vascularity and development of fibrous tissue leads to thick capsule and affects the ROM.
    • "frozen shoulder" lots of scared tissue that affect ROM.
  10. Fasciae and bursae? injuries?
    • Fasciae: are connective tissues of the body arrenged in sheaths that envelop the muscle.
    • Bursae: they are pockets of connective tissue lined w synovium in locations b/t muscles.
    • injuries cause pain and restriction of movement of M/S system.
  11. Injury of the tendons?
    • repetative motion, tennis elbow.
    • Grade from I to III, where tootal tair is III.
  12. Osteoarthritis (OA) chts? signs n symptoms? tx? etiology? patho? CM?
    • degenerative bone disorder associated w aging and wear and tear from repetitive stress. 
    • It is noninflammatory and the sign are very localized. The pain goes away after start moving.
    • Signs and symptoms: joint pain and crepitus (noise when moving).
    • tx: therapy, reducing pain.
    • etiology: unkown, stress on the joint, family history, weight increase stress on knees, hormonal status.
    • patho: reduction of cartilage, rub bone and bone, inflammation of the synovial bone after, reduction of mobility.
    • CM: crepitus w movement, pain w function, morning stiffness, heberden's (curved fingers) and bouchard's nodules.
  13. Rheumatoid Arthiratis chst? etiologies? tx? patho? CM?
    • Systemic inflammatory disease. Pain all the time.
    • Etiologies: autoimmune, may run in families, juvenile disease onset 2-5 or 9-12, adults peak 30-50s.
    • tx: NSAIDs, conticosteroids, and biological agents.
    • Patho: immune complexes activate change in chemical make-up of tissue, hydrolytic enzymes released into the joint fluid, which causes inflammation.
    • CM: need to have 4 or more to be Dx. morning stiffness, soft tissue swelling of 3 or more joint areas, subcutaneous R nodules, Rheumatoid factor present, EST elevated, Radiologic erosions.
  14. Systemic lupues Erythematosus? Scleroderma? ankylosins spondylitis?
    • SLE: chronic multisystem, inflammatory, autoimmune disease chts by periods of exacerbations and remisions w multiple organs affected.
    • Scleroderma: the same chts by skin thickening and deposition of collagenous tissue resulting in severe fibrousis.
    • the bid differences b/t these 2 is Raynaud phenomenon, which SLE doesn't have it.
    • ankylosins: Arthritis of the sacoiliac joints; it is a progressive pathology. CM: LBP, severe morning stiffness, and limited ROM.
  15. Gout? Gouty arthritis?
    • Pain when waking up.
    • production of uric acid exceeds removal, hyperuricemia, depositon of monosodium urate salts in articular, periarticular and subq tissue.
    • GA: great toe most often involved. lack of the ability to oxidize uric acid, problem w purine metabolism.