| A | B |
|---|
| characterized by a decrease in bone mass and density | osteoporosis |
| bone resorption exceeds bone formation | osteoporosis |
| 7 factors predisposes to osteoporosis | aging; decreased mobility/sedentary life; hormonal factors; deficits of calcium, vitamin D, or protein; cigarette smoking; small, light bone structure; excessive caffeine |
| treatments for osteoporosis | dietary and fluoride supplements; biphosphonates; calcitonin; injected human parathyroid hormone; regular weight-bearing exercise program;selective estrogen receptor modulator drugs(raloxifene);strontium ranelate; surgery for spinal changes |
| result from defiict of vitamin D and phosphates required for bone mineralization | osteomalacia/rickets |
| lack of calcification of the cartilage forming at teh epiphyseal plate leads to weak bones and the typical "bow legs";yet height is below normal | rickets |
| occurs in adults in whom poor absorption of vitamin D or calcium causes soft bones and compression fractures | osteomalacia |
| occurs with dietary deficits; malabsorption; prolonged intake fo phenobarbital(for seizures), or lack of sun exposure | osteomalacia/rickets |
| maniffestations include pathologic fractures, compression fractures of vertebrae;headache and compression of CN;casues cardiovascular disease and heart failure | paget's disease |
| occurs from excessive bone destruction with replacement of bone by fibrous tissue and abnormal bone | paget's disease |
| progresssive bone disorder that's etiology is idiopathic; but childhood infection w/ slow virus adn evidence of genetics has been implicated | paget's disease |
| another name for paget's disease | osteitis deformans |
| primary malignant neoplasm that usually develps i nthe metaphysis of the femur, tibia, or fibula in children and young adults; males specifically | osteosarcoma/osteogenic sarcoma |
| malignant neoplasm common in adolescents that occurs in the diaphysis of long bones | Ewing's sarcoma |
| malignant neoplasm develops more gradually in the pelvi bone or shoulder girdle then metastisize to lungs; arise from cartilage cells and are more common in adults | chondrosarcoma |
| group of inherited disorders characterized by degeneration of skeletal muscle | muscular dystrophy |
| creatinine kinase | enzyme w/ an essential role in energy storage; elevated in ppl w/ muscle diseases; leaks out of damaged muscle cells into bodily fluids |
| a metabolic deficit, a deficit of dystrophin(muscle cell membrane protein) leads to degeneration and necrosis of the cell | muscular dystrophy |
| skeletal muscle fibers are replaced by fat and fibrous CT; muscle function is lost; cardiomyopathhy occurs | muscular dystrophy |
| motor weakness adn regression become apparent in a 3-yr child | Duchenne's muscular dystrophy |
| "Gower's maneuver" typical manifestation | muscular dystrophy |
| tendon reflexes reduced; vertebral deformities; respiratory insufficiency and infections; cardiac abnormalities and mental retardation | muscular dystrophy |
| most common type of muscular dystrophy | Duchenne's MD |
| MD w/ autosomal dominant inheritance | fascioscapulohumeral and myotonic MD |
| MD w/ autosomal recessive inheritance | limb girdle MD |
| MD w/ X-linked recessive inheritance | Duchenne's MD |
| MD distributed to face and hands | myotonic MD |
| MD distributed to hips, legs, shoulder, girdle(ascending) | Duchenne's MD |
| MD distributed to shoulder, neck, face | fascioscapulohumeral MD |
| MD distributed to shoulders, pelvis | limb girdle MD |
| group of disorders characterized by pain adn stiffness affecting muscles, tendons, and surrounding soft tissues(not joints) | primary fibromyalgia syndrome |
| tender or trigger points for fibromyalgia where pain and tenderness may be stimulated are identified in the tendons and ligaments of.... | neck, shoulders, trunk, limbs |
| disorder appears to be related to altered central neurotransmition, resulting in increased soft tissue sensitivity to substance P | primary fibromyalgia syndrome |
| aggravating factors of fibromyalgia include... | sleep deprivation, stress, fatigue |
| treatment of fibromyalgia include... | stress reduction, regular early morning exercise, rest as needed, local applications fo heat or massage, antidepressants,NSAIDs, lyrica |
| S/S fibromyalgia include... | generalized aching pain w/ fatigue, sleep disturbances, depression, irritable bowel syndrome & urinary symptoms due to interstitial cystitis; men have localized fibromyalgia ie jain pain or headache |
| degenerative, or "wear and tear" joint disease | osteoarthritis |
| pathophysiology of osteoarthritis | damage to articular cartilage or weight-bearing joints; surface of cartilage becomes rough and worn interefering w/ easy joint movement;tissue damage releases enzymes that accelerate disintegration of caritlage; subchondral bone may be exposed/damaged; cysts & osteophytes(new bone spurs) develop; pieces of osteophytes & cartilage break off into synovial fluid causing irritation; joint space is narrowed |
| etiology of osteoarthritis | obesity; aging; injury or abuse; genetic changes; |
| S/S of osteoarthritis | pain w/ use; limited joint movement; joint appears enlarged & hard as osteophytes develop; muscles atrophy; walking & mastication is difficult;crepitus; little soft tissue swelling; no systemic signs |
| treatment of osteoarthritis | minimize undue stress of joint; adequate rest; ambulatory aids; orthotic inserts for shoes; physiotherapy;massage theraphy, surgery ie arthroplasty; intraarticular injection; glucocorticoids; NSAIDs, |
| autoimmune disorder causing chronic systemic inflammatory disease w/ higher incidence in women. remissions and exacerbations lead to progressive damage to the joints | rheumatoid arthritis |
| first step in the development of rheumatoid arthritis is... | an abnormal immune response causing inflammation of synovial membrane w/ vasodilation, increased permeability, and formation of exudate causing red, swollen, painful joint |
| Rheumatoid factor(RF) | antibody against IgG present in the blood and synovial fluid |
| process of Rheumatoid arthritis | synovitis; pannus formation( granulation tissue from synovium that spreads over caritalge and releaases enzymes and inflammatory mediators, destroying cartilage); cartilage erosion; fibrosis; ankylosis(joint fixation) |
| changes occuring w/ Rheumatoid arthritis | muscles atrophy;alignment of bones in joint shifts; inflammation adn pain cause muscle spasm; contractures & deformity w/ subluxation develop |
| etiology of rheumatoid arthritis | genetic factor; familial predisposition; viral infections;aging; women more than men; RF NOT present in all patients |
| S/S of rheumatoid arthritis | joint stiffness; red, swollen, sensitive joints; malocclusion fo teeth from TMJ involvemnt; eventually jontis no longer inflamed but is fixed and deformed(" burned out"); rheumatoid or subcutaneous nodues on ulna, pleura, heart valves,or eyes; iron deficiency anemia w/ low serum iron levels |
| criteria for hte diagnosis of rheumatoid arthritis | swelling of three joints for a minimum of 6 weeks |
| diagnostic test for rheumatoid arthritis | synovial fluid analysis |
| treatment of rheumatoid arthritis | balance between rest and moderate activity; PT & OT; antiinflammatory analgesic aspirin, glucocorticoids, COX-2, gold salts/compounds, immunosupressants; heat and cold modalities; spliniting; assitive devices; surgery to remove pannus, replace damaged tendons, reduce contractures, or replace joints |
| arthritis w/ systemic effects more marked than but lacks rheumatoid nodules | juvenile rheumatoid arthritis |
| arthritis that involves 4 or fewer joints but causes uveitis( inflammations of iris, ciliary body, choroid in the eye) | juveile rheumatoid arthritis |
| systmeic form, aka Still's disease, develops w/ fever, rash, lymphadenopathy, and hepatomegaly as well as joint involvement | juvenile rheumatoid arthritis |
| arthritis that usually develops in a single red, swollen, painful joint w. decreased ROM; swollen synovium; purulent exudate | infectious (septic) arthritis |
| what confirms the diagnosis of septic arthritis | aspiration of synovial fluid followed by culture and sensitivity tests; often reveals blood-borne bacteria gonococcus or staphylococcus as sources of inflammation |
| what disease caused by spirochete adn transmitted by ticks is characterized by a migratory arthritis and rash | Lyme disease |
| results from deposits of uric acid and urate crystals in the joint | gout(gouty arthritis) |
| what is uric acid | waste product of purine metabolism normally excreted by kidneys |
| often affects a single joint like the big toe causing redness, swelling, and severe pain | gout |
| tophi occurs a few years after an attack and may develp at joint bursae, extensor surfaces of forearm, or on pinnae of ear | gout |
| what is a tophi | large hard nodule consisting of urate crystals |
| treatment of gout | reducing serum uric acid levels becasue uric acid kidney stones; increasing fluid; increasing pH of urine |
| chronic progressive inflammatory condition tht affects sacroiliac joints, intervertebral spaces, and costovertebral joints of the axial skeleton | ankylosisng spondylitis |
| causes "poker back" | ankylosing spondylitis |
| S/S of ankylosing spondylitis | low back pain; morning stiffness; pain marked when lying down;discomfort relieved by walking; calcification develops adn spine becomes rigid and ROM is impaired; systemic signs liek fatigue, fever, weight loss occur; uveitis occurs |
| treatment of ankylosing spondylitis | relief of pain; maintain mobility; sleep in supine position; daily exercise; proper posture; anti-inflammatory drugs |
| pathophysiology of ankylosing spondylitis | vertebral joints become inflamed; fibrosis, calcification, fixation of joints; inflammation of lower back at sacroiliac joint progresses up spine; kyphosis & osteoporosis develops; lung expansion is limited |
| subluxation | bone is partially displaced, w/ partial loss of coween the surfacesntact bet |
| avulsion | ligaments or tendons are completely separated from their bony attachments |
