care for a patient with muscle-skeletal disorder

a type of disease where the body's immune system mistakenly attacks healthy tissue

auto immune

is a structural disorder that exaggerates the thoracic curve to give a "hunchback" appearance.

dawsin khyposis

Which is the location in the long bone where hematopoiesis occurs?

e·piph·y·sis

osteoporosis

is a disorder where there is an increased breakdown of bone tissue without an increase in the deposit of new bone by osteoblasts, thus causing the bones to break easily.

________________ is an abnormal exaggeration of the lumbar spine.

lordosis

cancer of yellow bone marrow, too many immature and weak white blood cells are made

lukemia

____________________ is the inflammation of bone caused by pyogenic bacteria, most commonly staphylococcus, which enters through the _________________.

osteomyelitis, bloodstream

A disorder of bone formation in which there is a lack of normal calcium salt deposits and a decrease in bone protein is called

osteoporosis

What is a malignant tumor in bone tissue called?

osteosarcoma

Osteitis Deformans, also known as ____________ ______________, is a disorder that results in the bones becoming deformed, unstable and easily fractured.

paget's disease

disease where bone is recycled too quickly, never maturing, bones become fragile and misphapen

peget's disease

long-term disease that leads to inflammation of the joint and surrounding tissues

rheumatoid arthritis

disease characterized by a lack of vitamin d and calcium phosphate in the diet

rickets

pronation

rotation of the hand and forearm so that the palm faces backwards or downwards. 2 : rotation of the medial bones in the midtarsal region of the foot inward and downward so that in walking the foot tends to come down on its inner margin.

The most common structure disorder of the spine is _________________, which gives the spine a side-to-side or lateral curvature.

scoliosis

extension

the stretching of a fractured or dislocated limb so as to restore it to its natural position. 2 : an unbending movement around a joint in a limb (as the knee or elbow) that increases the angle between the bones of the limb at the joint — compare flexion sense 1.

plantar flexion

: movement of the foot in which the foot or toes flex downward toward the sole — compare dorsiflexion.

you may be able to tell when a gout attack is coming by

A tingling feeling in your toe. Many people with gout say they have a tingling feeling in a joint right before a flare starts. The pain can be so sudden and severe that it often wakes up people in the middle of the night. The affected joint is usually red, swollen, hot, and painful to touch.

When you're having a gout flare, it may help to

Apply ice.If you can bear the pressure, an ice pack may offer some pain relief. Gout flares often hurt so much, though, that you can't move your joint. That's why it's better to rest it than to stretch it. Many people say it hurts just to feel a sheet on their joint at night, so you may want to take off bedcovers. And you definitely don't want to wrap the joint.

Which food might protect against gout?

Cheese.Eating a diet high in low-fat dairy foods -- like cheese and milk -- might lower uric acid levels in your blood and lower your chance of gout. One study found that people with gout who drank an enriched skim milk shake every day had fewer flares and less painful symptoms.

This type of bone fracture is a simple fracture with no open wound.

Closed Fracture

Acute gout presents as painful inflammation of the big toe which is referred to as podagra. What is an acute treatment for gout?

Colchicine :In acute gout, monosodium urate crystals are deposited in joint generating an inflammatory response. Colchicine can therefore treat this condition by reducing inflammation by impairing neutrophil response. Other drugs used for acute treatment are glucocorticoids and NSAIDs e.g. naproxen. Allopurinol, febuxostat and probenecid are chronic gout drugs (preventative).

Name the type of bone fracture: There is more than one fracture line and the bone is splintered or crushed.

Comminuted Fracture

The term ______ refers to the shaft of a long bone

Diaphysis

Some people feel symptoms of gout most of the time.

Fact.Living with pain and gout symptoms can be almost constant for some people with chronic gout. Attacks happen in more joints with only short breaks in between attacks. Some people feel symptoms of gout most of the time.

There are medicines to prevent future gout attacks.

Fact.There are medicines that can prevent the buildup of uric acid in the blood, which can lead to fewer gout attacks in people who have chronic gout. There are also lifestyle changes people can make that can prevent future attacks.

There is a strong connection between gout and kidney disease.

Fact.There is evidence that gout can lead to kidney disease. The belief that gout leads to kidney disease is common among many doctors who specialize in the disease. When you have gout, you have too much uric acid in your blood. As your blood is filtered through your kidneys, uric acid can build up and form urate crystals. As the urate crystals pass through your kidneys, they can cause damage and scars. This kidney damage is thought to lead to kidney disease and failure over time, especially if your gout is left untreated.

Osteoporosis is less common is post menopausal women.

False

An acute attack of gout usually occurs around noon.

False. An acute attack commonly occurs at night. It can be triggered by stressful events, alcohol or drugs, or another acute illness.

Drinking too much caffeine can cause a gout attack.

False. Caffeine doesn't bring on a gout attack. Drinking too much alcohol can bring on a gout attack—but only if you have a higher than normal level of uric acid. The extra alcohol interferes with your body's work to remove the uric acid.

For many people, gout first appears in the thumb

False. Gout usually first affects the joints at the base of the big toe. Gout can also affect the instep, ankles, heels, knees, wrists, fingers, and elbows.

Women are more likely to develop gout than are men.

False. Men are more likely to develop gout than women. Men ages 40 to 50 are most commonly affected. Women rarely develop gout before menopause.

Although gout is quite painful, it usually doesn't cause any lasting damage.

False. The disease can progress through several stages. The final stage can cause permanent damage to the affected joints and sometimes to the kidneys. With proper treatment, though most people with gout don't reach this last stage.

Gout can be diagnosed with a simple blood test.

False.A blood test can measure your uric acid level, but that's not enough to diagnose gout. Even people without gout can have high uric acid. And people with a flare can have temporarily normal or low levels. To find out if you have gout, your health care provider will draw fluid from an inflamed joint with a needle and look for uric acid crystals. The shape, color, and appearance of the crystals can help diagnose gout.

This fracture is when the broken ends of the bone are jammed into each other.

Impacted Fracture

Taking aspirin can help ease a gout attack.

False.When you have a gout attack, a non-steroidal anti-inflammatory medicine (NSAID) like ibuprofen (Advil, Motrin) might help with the pain. Your health care provider also may give you a prescription for a stronger NSAID; steroids (like prednisone); or a drug called colchicine to have on hand in case of a gout attack. Taking aspirin, however, can be a bad idea. Aspirin can cause your uric acid levels to increase, which can bring on a gout flare or make a flare worse. Other medicines, such as diuretics (water pills) and cyclosporine, also can trigger a flare. That's why it's important that your rheumatologist knows about all your medications and that all your doctors know you have gout -- especially if they're going to start you on new medications.

Osteosarcoma occurs most often in the distal ___________ or proximal __________.

Femur,tibia

One side of the bone is broken and the other is bent with this type of fracture.

Greenstick Fracture

Select the cause/s of vitamin D deficiency.

Minimal sun exposure Poor diet Liver failure and renal failure Malabsorption

Gout only happens in people that drink too much alcohol or eat too much unhealthy food.

Myth.Although drinking alcohol or eating a diet high in purines can contribute to gout, most people do not get gout for these reasons alone. Instead, when someone has gout, their body does not use uric acid in the right way. Kidney disease is a common cause of gout that is not related to drinking too much alcohol or eating unhealthy foods.

Gout only happens in men.

Myth.Anyone can get gout, including women. It is more common in men, but once women reach menopause, the rate of gout in men and women evens out. Most women who develop gout show signs and symptoms after menopause.

Gout only causes damage during attacks.

Myth.Gout causes damage in the body even in between attacks. A gout attack is pain from urate crystals building up under the skin, but gout can cause high levels of uric acid in the body all the time. This can lead to more gout attacks, joint damage, and joint deformity when left untreated

Name the type of bone fracture described: A broken bone protrudes through the skin or an external wound leads to a broken bone.

Open Fracture

Which condition occurs when cartilage is worn down between bones?

Osteoarthritis

Assuming each disease is due to a single defect in cells involved in bone turnover, what are the most likely defects in osteoporosis and osteopetrosis, respectively?

Osteoporosis is due to the increased function of osteoclasts, osteopetrosis is due to the decreased function of osteoclasts

What bone tumour is associated with lifting of periosteum off bone producing the Codman triangle and a sunburst appearance on X-ray?

Osteosarcoma

On biopsy, a mosaic pattern of lamellar bone is revealed. What disease is associated with these results?

Paget disease of bone..Paget disease is possibly caused by a paramyxovirus infection of the osteoclasts of the affected bone. It can be monostotic or polyostotic. It is characterized by an imbalance between osteoclasts and osteoblasts. There are 3 phases- an osteoclastic phase, a mixed osteoclastic- osteoblastic phase followed by an osteoblastic phase. This will result in abnormally thick bone that fractures easily. Biopsy shows the 'mosaic pattern of lamellar bone' which resembles puzzles pieces put together. Clinical findings include bone pain, lion like facies, hearing loss and increasing hat size. The complications are osteosarcoma as osteoblasts can get mutated in the disorder and high output cardiac failure as AV shunts are formed in bone.

What is Paget disease of the bone?

Paget disease of the bone is a chronic bone disorder. It causes bones to become enlarged and deformed. Bone may become dense, but fragile, because of excessive breakdown and deformation of bone. The disease is the most common bone disorder after osteoporosis in adults older than age 50.

The skeletal system function of hematopoiesis refers to the

Process of blood cell formation

What is the pathogenesis of osteopetrosis (marble bone disease)?

Poor osteoclast function due to a carbonic anhydrase II mutation.An acidic environment is needed for osteoclasts to remove calcium from bone. A defect in maintaining this acidic environment, leads to poor bone resorption by osteoclasts resulting in overgrowth and sclerosis of cortical bone. This abnormally thick bone fractures easily. Clinical features include bone fractures, anaemia, thrombocytopenia (due to bony replacement of marrow) and visual/ hearing loss due to cranial nerve compression. The patient can also develop renal tubular acidosis (defect in carbonic anhydrase leads to decreased reabsorption of bicarbonate) and hydrocephalus (narrowing of foramen magnum).

Synovial fluid was sampled for a joint condition and rhomboid shaped crystals with weak positive birefringence under polarised light were found. What joint disease is this an indicator of?

Pseudogout.Pseudogout has a similar presentation to gout clinically but it is due to deposition of calcium pyrophosphate dihydrate (CPPD) in tissues especially the joint, unlike the deposition of monosodium urate crystals seen in gout. Synovial fluid will show rhomboid crystals with weak positive birefringence under polarized light compared to gout for which there are needle shaped crystals with negative birefringence under polarised light ( yellow when parallel) in synovial fluid.

Which joint disease is associated with morning stiffness that improves with activity?

Rheumatoid Arthritis (RA...RA is a systemic and autoimmune disorder associated with chronic joint inflammation. HLA-DR4 link. An important clinical feature to distinguish it from osteoarthritis is the morning stiffness that improves with use. With osteoarthritis, a degenerative joint disease, the joint stiffness worsens during the day.

A metabolic bone disorder that is characterized by demineralization or loss of minerals from bone related to vitamin D deficiency.

Rickets

Which foods may trigger a gout attack?

Sardines and anchovies.Foods that are high in a substance called purines can raise the uric acid in your blood, and that can trigger a gout attack. Some seafood -- like sardines, anchovies, mussels, and salmon -- is rich in purines, as are organ meats, like liver and kidneys. It's hard to avoid purines completely because they are in many foods. Instead, your health care provider may suggest you follow a low-purine diet. People with gout should try to avoid foods that trigger an attack.

In this type of fracture, the bone has been twisted apart.

Spiral Fracture

How is osteoporosis treated?

The correct answer is A. Medicines. Treatment of osteoporosis aims to stop bone loss and rebuild bone. Making lifestyle changes can help. Several medicines are also available. Some will slow how fast you lose bone. Others will actually rebuild bone. These include estrogen, raloxifene, alendronate, risedronate, denosumab, and calcitonin. Doctors sometimes prescribe estrogen to replace the hormones lost during menopause. This slows the rate of bone loss and increases bone mass in the spine and hip. But estrogen and progesterone treatment may raise the risk for other health conditions.

How does Paget disease affect the body's normal process of breaking down and rebuilding bone?

The correct answer is A. The process greatly speeds up. Throughout your life, your body is continually absorbing (breaking down) bone and building new bone. If you have Paget disease, this process is greatly speeded up.

4. The symptoms of Paget disease are often confused with:

The correct answer is B. Osteoarthritis. Although it is not arthritis, Paget disease can lead to arthritis. This happens as damaged bones put pressure on nearby joints or cause excessive wear and tear on joints. In many cases, however, people don't know they have Paget disease because they have no symptoms. When symptoms do appear, they include bone pain, fractures, headache (if bones in the skull or spine are affected), hearing loss (because of damage to the small bones in the ear), curvature of the spine, pressure on nerves, and hip pain. Symptoms get worse slowly.

Which test is used to screen for osteoporosis?

The correct answer is B. Special type of X-ray. Ordinary X-rays don't show bone loss until a large amount of bone density is gone. The best way to find bone density is by getting a DEXA scan (dual-energy X-ray absorptiometry). This is a painless, low-dose X-ray. Common places for the scan are the spine, hip, wrist, middle finger, heel, and shinbone. The DEXA scan can show whether you are at risk for a broken bone. If you have already broken a bone and your doctor thinks you might have osteoporosis, the test can confirm the diagnosis.

At what age do you have the most bone density?

The correct answer is B. Your 30s. Your body forms new bone at a faster pace than it loses it (resorption) until around age 30. After age 30, bone loss slowly gets faster than bone formation.

What causes a "dowager's hump," or stooped posture?

The correct answer is C. Broken vertebrae. A broken vertebra in the spine is called a compression fracture. The compression shortens the person's height. This causes a curved back.

Researchers believe that Paget disease may be caused by:

The correct answer is D. A and C. Researchers say a "slow virus" infection may be the main cause of the illness. A slow virus infection is one that works on the body for many years. A gene may also play a role in the disease. Paget disease tends to run in families.

A health care provider can best diagnose Paget disease with which test?

The correct answer is D. A combination of all of the above. A bone scan can tell your health care provider how much bone is affected by the disease. An X-ray can confirm a diagnosis of the disease. This is because affected bones have a particular look on an X-ray. A higher level of alkaline phosphatase can mean that you have Paget disease. People with a family history of the disease can have their alkaline phosphatase level checked every 2 to 3 years. If the test is positive, treatment can begin right away.

Paget disease most often strikes which age group?

The correct answer is D. Adults over 40. It is rare in people younger than 40. Both men and women can develop Paget disease.

Which of these makes it more likely that you'll get osteoporosis?

The correct answer is D. All of the above. Drinking too much alcohol interferes with how your body uses calcium and vitamin D. Both of these nutrients are important for healthy bones. Men with alcoholism also tend to make less testosterone. This is a hormone that helps with bone formation. Women with alcoholism can have irregular menstrual cycles. This lowers the amount of the hormone estrogen, which is important for bone health. Family history is another risk factor. If your parents have a history of broken bones, you may also be at risk for them. Smokers may have less bone density. But researchers aren't sure if that's because of smoking or because of other lifestyle factors like poor diet or too little exercise. Smoking causes a woman's body to make less estrogen. Men who smoke are 2 to 3 times more likely to get osteoporosis.

Treatment of Paget disease may involve which of these?

The correct answer is D. All of the above. For many cases of Paget disease, no treatment is needed. When pain is present, a nonsteroidal anti-inflammatory drug can offer relief. Steroids also may be prescribed. More severe cases can be treated with bisphosphonates or calcitonin. Exercise also is important. Talk with your health care provider to find out which type of exercise is best.

Which of these activities could cause a broken bone in someone with osteoporosis?

The correct answer is D. All of the above. Something as harmless as coughing can cause a rib to break, but the most common cause of broken bones is a fall. The most common places for a bone to break are the back, wrist, and hip. It's important to prevent falls. Here are ideas: Use glasses or a hearing aid, if needed. Ask your healthcare provider if any of the medicines you are taking may make you dizzy or unsteady on your feet. Use a cane or walker if your walking is unsteady. Wear rubber-soled and low-heeled shoes. Make sure all the rugs and carpeting in your house are firmly attached to the floor. Keep your rooms well lit and the floor free of clutter. Use nightlights.

In addition to osteoarthritis, Paget disease may lead to what other disorders?

The correct answer is D. All of the above. When Paget disease affects the bones of the inner ear, you may have hearing loss in one or both ears. In people with severe Paget disease, the heart works harder to pump blood to the bones affected by the disease. This can cause problems if the person also has hardening of the arteries. A person with Paget is also more likely to develop kidney stones. Other disorders linked to Paget include nervous system problems, loose teeth, and rarely, vision loss.

How can osteoporosis be prevented?

The correct answer is D. B and C. Follow a diet that has plenty of calcium and vitamin D and get regular weight-bearing exercise. These are the best ways to prevent weakened bones later in later life. People ages 31 to 50 should get 1,000 mg of calcium each day. People over 50 should get 1,200 mg daily. Your body uses vitamin D to absorb calcium. Being out in the sun for 10 to 15 minutes a day, without sunscreen, 2 days a week helps most people's bodies make enough vitamin D. You can also get vitamin D from eggs, fatty fish, and cereal and milk fortified with vitamin D, as well as from supplements. Exercise makes bones and muscles stronger and helps prevent bone loss. It also helps you stay active and mobile. Weight-bearing exercises done 3 to 4 times a week are best. Good choices are walking, jogging, playing tennis, and dancing.

Which kind of exercise can help prevent osteoporosis?

The correct answer is D. B and C. Weight-bearing exercise is the only kind of exercise that builds bone density. Try walking, playing tennis, jogging, or dancing 3 times a week.

Which bones are most commonly affected by Paget disease?

The correct answer is E. All of the above. Any bone in the body can be affected by Paget disease. But the bones most commonly affected are those in the spine, skull, pelvis, thighs, and lower legs. Usually, Paget affects only 1 or 2 bones, and sometimes only part of a bone.

endosteum

The endosteum (plural endostea) is a thin vascular membrane of connective tissue that lines the inner surface of the bony tissue that forms the medullary cavity of long bones. This endosteal surface is usually resorbed during long periods of malnutrition, resulting in less cortical thickness.

abduction

The movement of a limb away from the midline of the body. The opposite of abduction is adduction

How is Paget disease of the bone treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is. Treatment may include: Physical therapy to help muscle strength Medicines called bisphosphonates to slow abnormal bone resorption Medicines to manage pain Surgery to cut, realign, or replace affected bone

Osteoporosis is a metabolic bone disorder.

True

Scoliosis is most common in teenage girls

True

Gout is a form of arthritis

True. Gout is one of more than 100 different forms of arthritis. It makes up about 5% of all arthritis cases.

The most common treatment for a gout attack is a nonsteroidal anti-inflammatory drug (NSAID).

True. NSAIDs reduce the inflammation caused by deposits of uric acid crystals. People usually begin to get better within a few hours of treatment. The attack goes away completely within a few days.

A painful joint that is swollen, red, and warm is one symptom of gout.

True. The pain and swelling usually come on suddenly, within a day. The attack usually affects only one joint, usually the toe, ankle, or knee. Later attacks may last longer. Or they may involve several joints.

Is oestrogen protective against bone loss?

Yes.Oestrogen protects against loss of bone mass. When menopause begins, there is an accelerated reduction in bone mass as the level of oestrogen is diminished. Osteoporosis is the reduction in trabecular bone mass resulting in porous bone. People achieve their peak bone mass by age 30, after which there is a gradual decline. Factors affecting the peak bone mass are exercise, genetics and intake of calcium and vitamin D.

How is Paget disease of the bone diagnosed?

Your healthcare provider will review your medical history and do a physical exam. Other tests may include: Blood test. A blood test called serum alkaline phosphatase measures the levels of the enzyme alkaline phosphatase in the bone. Any condition of bone growth or an increased activity of bone cells, including Paget disease, will cause alkaline phosphatase levels to rise. Bone biopsy.These biopsies are sometimes done with a needle, using numbing medicine only or with sedation. Sometimes they are done in the operating room through small incisions. You may have a bone biopsy if an X-ray does not confirm or rule out the disease. Bone scan. This is a nuclear imaging test that uses a very small amount of radioactive material called tracer injected into the blood. This tracer can be detected by a scanner. This test shows blood flow to the bone and cell activity within the bone. X-ray. This test uses invisible energy beams to make images of tissues, bones, and organs.

Periosteum

a dense layer of vascular connective tissue enveloping the bones except at the surfaces of the joints.

congenital disease where the gene that produces collagen is defective

brittle Bone disease

is a congenital deformity in which there is an opening in the roof of the mouth.

cleft plate

Chronic gout means having two or more attacks a year, and there are medicines for it.

fact. Chronic gout does not necessarily mean having gout attacks all the time. Chronic gout is considered having two or more gout attacks per year. Having chronic gout can lead to permanent joint stiffness, damage, and deformity, and attacks can increase in frequency over time. There are medicines used for chronic gout that can prevent gout attacks.

dorsiflexion

flexion in a dorsal direction especially : flexion of the foot in an upward direction — compare plantar flexion.

Excessive mechanical stress on bone is capable of causing a ______________.

fracture or brake

e·piph·y·sis

he end part of a long bone, initially growing separately from the shaft.

condition where spinal disc ruptures which can pinch spinal nerves

herniated disc

http://novella.mhhe.com/sites/0071363610/student_view0/chapter90/self_assessment_quiz.html

https://www.urmc.rochester.edu/search.aspx?q=osteoporosis

Osteosarcomas are prevalent in males or females between the ages of 20-40? patients present with severe, unrelenting pain.

males

When epithelial tumors or carcinomas from various organs spread it is called _______________.

metastasis or metastases

Gout pain is not so bad.

myth.Gout pain can be extremely severe, and some people have gout pain all the time. The pain is caused by tiny, sharp crystals building up under the skin. Gout is one of the most painful types of arthritis.

Gout attacks only happen in the big toe.

myth.The big toe is the most common place for gout attacks to happen, and many people have their first gout attack in their big toe. But gout can happen in all joints in the body including the hands, elbows, knees, and ankles. When people have chronic gout, often several of their joints are affected.

What is a muscle strain?

tearing of muscle fibers

flexion

the action of bending or the condition of being bent, especially the bending of a limb or joint. "flexion of the fingers"

What are the symptoms of Paget disease of the bone?

these are the most common symptoms of Paget disease of the bone: Arthritis Bone deformity Pain Risk for bone fractures Very rarely, Paget disease may progress to bone cancer. The symptoms of Paget disease of the bone may look like other bone disorders or medical problems. Always talk with your healthcare provider for a diagnosis.

Drinking beer can trigger a gout attack.

true.beer and liquor are high in purines, which can raise uric acid and trigger gout attacks. They also tend to cause dehydration -- another common gout trigger. When you don't drink enough fluids, uric acid builds up in your body, and you can be more prone to a flare. Some fructose-sweetened drinks also can trigger a flare. Water is your best bet for staying hydrated.

What are the key lab features in osteomalacia?

↓ serum calcium, ↓ serum phosphate, ↑ PTH, ↑ alkaline phosphatase.,,,Active vitamin D is responsible for raising serum calcium and phosphate levels by acting on the kidney (↑ reabsorption of calcium and phosphate), intestine (↑ absorption of calcium and phosphate) and bone (↑ resorption of calcium and phosphate). Thus if vitamin D is reduced, serum calcium and phosphate will also be reduced. Parathyroid hormone (PTH) is increased to compensate for the low calcium level. Alkaline phosphatase is increased as there is osteoblast hyperactivity- osteoblasts produce osteoid but there is defective mineralization of the osteoid and the mineralization is needed to form bone, so there is an excess of osteoid.