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