Chapter 15- Musculoskeletal System Hybrid Course

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MusculoskeletalDiseases & Disorders

Chapter 15

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Musculoskeletal System

Function Provides the body with a supportive

framework

Protects the internal organs

Gives shape to the body

Acts as a storage & supply area for minerals

Serves as a site for blood cell production

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Deformities of the Spine

Lordosis

Kyphosis

Scoliosis

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Lordosis

Inward curvature of aportion of spine

Swayback

Caused by pregnancy,obesity or largeabdominal tumors

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Kyphosis

Outward curvative of 

spine

Humpback

Associated withosteoporosis and a

degenerative deformity

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Scoliosis

Sideways curvature

Associated with Congenital defects

Poor posture

Discrepancy in leg

lengths

Growth retardation

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Which type of spinedeformities do these picturesdepict?

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Herniated Disk

Ruptured or bulging disk

Caused by fall, straining or heavy lifting

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Osteoporosis

Metabolic bone disease – loss of calcium from bone

Progressive loss of bone density

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Osteoporosis  Signs and symptoms

Asymptomatic

Pain from fractures of vertebrae, hips, wrists or 

other bones

Loss of height

Diagnosis dual energy x-ray absorptometry (DEXA) scan.

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Osteoporosis Risk Factors

Age

Race

Family History

Frame size Tobacco use

Estrogen Levels

Nutrition

Chemotherapy Drugs

Thyroid/Parathryoid

Disorders

Sedentary Lifestyle Excess soda consumption

Chronic alcoholism

Corticosteroid Medications

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Osteomyelitis

Infection in the bone Staphylococcus aureus – 90%

Fungus

Prominent in those with

Diabetes Prosthesis

Strep throat

Sickle cell

Cancer  Open wounds

DX: Culture of infections

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Paget’s Disease/Osteitis

Deformans  Metabolic skeletal disorder where breakdown of 

bone is faster than new bone formation

Symptoms Bone/hip pain

Headaches & hearing loss Bowed limbs, curvature of spine

Joint pain

DX ↑Alkaline phosphatase

X-rays & bone scan

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Fractures  Greenstick – only one side is broke or bent Displaced – totally broken; compound fracture

Incomplete – partial break

Comminuted – fragmented bone Segmental – broken in two or three places

Butterfly – circular break

Spiral – elongated break from twisting Hairline – very small fracture

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Osteoarthritis Degenerative joint disease

breakdown & eventual loss of the cartilage due towear and tear on joints

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Osteoarthritis

Signs and symptoms Aching stiffness Joint soreness Dull pain Clicking or crackling in joints

Decreased range of motion Bouchard’s/Heberden Nodes on

extremities

DX X-rays/MRI/CAT scan

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Rheumatoid Arthritis

Chronic, systemic, inflammatory diseaseaffecting the synovial membranes of the

 joints.

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Rheumatoid Arthritis

Autoimmune disease Symptoms

Joint pain & stiffness

Swelling Malaise, fatigue, low-grade fever 

Diagnosis Positive RF and Anti-CCP test

Elevated ESR(indicates inflammation)

X-rays

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Gout

Chronic disorder of uricacid metabolism Urate crystals

accumulate in synovialfluid of the joints.

Symptoms: Severe excruciating pain Swelling & redness

Risk Factors DX

Joint Fluid Analysis Uric acid blood test

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Bursitis & Tendonitis

Inflammation in bursae Inflammation of tendons Bursitis caused by

Excessive frictional forces

i.e. tennis elbow Tendonitis caused by

Overuse, Rheumatoid Arthritis

Postural misalignment

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Strains and Sprains  Strain

overstretching a muscle Sprain

A partial tear of a muscle or tendon around a joint

that may also involve blood vessel and nervedamage Caused by trauma or injury

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Carpal Tunnel Syndrome

Median nerve in the wrist iscompressed Overuse or incorrect use of 

hands and fingers Inflammation or fibrosis of 

the tendon sheaths that pass

through the carpal tunnel.

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Myasthenia Gravis Autoimmune disease - antibodies destroys

acetylcholine (Ach) receptors sites in

muscles Acetylcholine is a neurotransmitter to muscles

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Myasthenia Gravis Symptoms

Weakness & fatigability Dropping eyelids and double vision Difficulty swallowing & Bobbing head DX: Neurological exam Blood test for AChR-binding antibodies Positive Tensilon Test

Nerve Conduction Studies & Single-Fiber Electromyography

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Muscular Dystrophy Degeneration of the skeletal muscles that control

movement X-linked Signs and Symptoms

Progressive weakening of skeletal muscles Difficulty climbing stairs, walking & running Eventually is crippling

DX Made from physical characteristics Muscle biopsy showing atrophy EMG Elevated Serum Creatine Kinase

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Polymyositis

Chronic, inflammation of connective tissue withdegeneration of skeletal muscles Idiopathic disease associated with virus or 

autoimmune etiologies.

Muscle weakness in hips & thighs Difficulty going up & down stains and/or rising from a sittingor kneeling position

Difficulty swallowing (dysphagis) Mild joint or muscle tenderness

Fatigue DX

Muscle biopsy showing inflammation & degeneration

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Systemic Lupus

Erythematosis Chronic, inflammatory connective-tissue

disorders Autoimmune disease with antibodies to DNA.

Symptoms Butterfly rash on face

Weight loss, fatigue, & fever 

Photosensitivity of skin

Joint & muscle pain Diagnosed by antinuclear antibodies tests.

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Fibromyalgia

Chronic debilitating syndrome causingwidespread pain in fibrous tissues,

muscles, tendons, and other connective

tissues

Characterized by restless sleep,

depression, fatigue, anxiety and bowel

dysfunction

Etiology is unknown- maybe stress,trauma to CNS, chemical imbalances

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Fibromyalgia Diagnosis

HX & PE Ruling out other disorders

Tenderness in specific

tender points at a minimumof 11 location

Pain must persist for at least

3 months

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Bone Tumors

Malignant tumors are either primary or 

secondary

Osteosarcoma - most common type in

children (bone pain, fever, swelling) Secondary tumors - metastasize to bone from

breast, lung, thyroid, kidney, prostate.