Musculoskeletal
Fracture
A break in the continuity of a bone
Which phase is it? Bone sections are removed by osteoclasts
Activation of the remodeling cycle
The type of joint connected by a fibrous joint capsule is a: A. Fibrous joint B. Synovial joint C. Diarthrosis joint D. Cartilaginous joint
B. Synovial joint Joints are classified by the type of connecting tissue holding them together. Fibrous joints are connected by dense fibrous tissue, ligaments, or membranes. Cartilaginous joints are connected by fibrocartilage or hyaline cartilage. Synovial joints are connected by a fibrous joint capsule. Joints are classified as synarthroses, amphiarthroses, or diarthroses, depending on the degree of movement they allow.
What kind of fracture is it? Due to longitudinal force
Bowing
Contains red bone marrow in trabeculae
Cancellous bone
Which bone is it? Spongy
Cancellous bone
Which disease? Neuromuscular disorder involving damage to the cortex, basal ganglia or cerebellum
Cerebral Palsy
Long term fatigue associated with viral infection
Chronic Fatigue Syndrome
Breaks into more than 2 fragments
Comminuted
Increased venous pressure in the muscle compartment leading to tissue hypoxia
Compartment syndrome
Bone broken entirely
Complete
Results from loss of passive range of motion
Contractures
Compact
Corticol bone
Highly organized?
Corticol bone
Which term is characteristic for a fracture in which one cortex is perforated and the spongy bone is splintered? A. Torus B. Spiral C. Bowing D. Greenstick
D. Greenstick A greenstick fracture is one that perforates one cortex and splinters the spongy bone. In a torus fracture, the cortex buckles but does not break. Bowing fractures usually occur with longitudinal force; typically, this occurs in paired bones. One is fractured and the other bows. A spiral fracture is one that encircles the bone. .
Promoted by inflammatory cytokines (IL1, IL6) and prostaglandins (PGE2)
Resorption
What does it need? Uses stored gylcogen and blood glucose are converted anaerobically to sustain brief activity without increasing oxygen demands
Resting muscle
Release of myoglobin due to trauma
Rhabdomyolysis
Associated with joint and systemic inflammation
Rheumatoid arthritis
Associated with pannus formation
Rheumatoid arthritis
Fracture encircles the bone
Spinal
Repeated strain on abnormal bone
Stress
Cortex buckles but does not break
Torus
Fracture straight across the bone
Transverse
Intramembranous bone formation occurs with primary and secondary healing
True
Secondary healing results from approximation of bone edges during a period of immobility
True
Appendicular Skeleton
- 128 bones - Upper and lower extremities - Shoulder girdle - Pelvic girdle
How many bones are in the human skeleton?
- 206 Bones - Consist of the axial and appendicular skeleton
Compartment syndrome
- Increased venous pressure within muscle compartment - Decreased blood flow - Hypoxia - Necrosis
Involves synovial joints
- Osteoarthritis - Rheumatoid arthritis
Which disease is it? Involves articular cartilage loss and damage
- Osteoarthritis: age related joint disease - Rheumatoid arthritis
Increased risk with aging
- Osteoporosis - Osteoarthritis
Axial Skeleton
- Skull - Vertebral column - Thorax - 80 bones
Pain is an early subjective symptom
-Osteoarthritis - Rheumatoid arthritis
Joint Classification
1. Synarthrosis: immovable 2. Amphiathrosis: slightly movable 3. Diarthrosis: freely movable
Which of the following is TRUE regarding the human skeleton? A. There are 280 bones in the skeleton. B. The axial skeleton consists of 126 bones. C. The skeleton contributes to 50% of total body weight. D. The axial skeleton consists of the skull, vertebral column, and thorax.
D. The axial skeleton consists of the skull, vertebral column, and thorax. The skeletal system has a total of 206 bones. There are 80 in the axial skeleton and 126 in the appendicular skeleton. The axial skeleton contains the skull, vertebral column, and thorax. The appendicular skeleton consists of the upper/lower extremities, the shoulder girdle, and the pelvic girdle. The skeleton contributes to 14% of the weight of the adult body.
Sarcopenia
Decrease in muscle mass and strength as part of the the aging process
Degeneration of skeletal muscle due to genetic mutation
Duchenne Muscular Dystrophy
Direct healing involves callus formation
False
True or False? Bone healing results in scar tissue formation
False
Manifests as pain in trigger points
Fibromyalgia
New bone section laid down by osteoblasts
Formation of the new bone
Promoted by growth factors (e.g estrogen, transforming growth factor beta (TGF-β)
Formation of the new bone
Perforates 1 cortex and splinters spongy bone
Greenstick
Requires oxygen and a constant, large supply of ATP
Hard working muscle
Fracture line parallel to the long axis of the bone
Linear
Fracture slanted angle to the shaft of the bone
Oblique
Joint stiffness less with activity
Osteoarthritis
Often involves formation of osteophytes
Osteoarthritis
Derived from mesenchymal stem cells
Osteoblast
Primary bone-producing cells
Osteoblast
Synthesize osteoid
Osteoblast
Major reabsorptive cells of the bone
Osteoclast
Synthesize matrix molecules
Osteocyte
Which cell is it? Located within the lacuna
Osteocyte
Altered bone mineralization
Osteoporosis
Fractue often the first manifestations
Osteoporosis
Involves corticol and cancellous bone
Osteoporosis
May be caused by endocrine dysfunction (PTH, THH, GH, cortisol)
Osteoporosis
Old bone is resorbed faster than new bone is produced
Osteoporosis
T score of -2.7 SD
Osteoporosis
The 6 Ps of compartment syndrome
Pain Pressure Pallor Parethesia Paresis Pulselessness