Chapter 15- Musculoskeletal System Hybrid Course

8/14/2019 Chapter 15- Musculoskeletal System Hybrid Course

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MusculoskeletalDiseases & Disorders

Chapter 15



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



Deformities of the Spine

Lordosis

Kyphosis

Scoliosis



Lordosis

Inward curvature of aportion of spine

Swayback

Caused by pregnancy,obesity or largeabdominal tumors



Kyphosis

Outward curvative of

spine

Humpback

Associated withosteoporosis and a

degenerative deformity



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?



Herniated Disk

Ruptured or bulging disk

Caused by fall, straining or heavy lifting



Osteoporosis

Metabolic bone disease – loss of calcium from bone

Progressive loss of bone density



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.



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



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



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





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



Osteoarthritis Degenerative joint disease

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



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



Rheumatoid Arthritis

Chronic, systemic, inflammatory diseaseaffecting the synovial membranes of the

joints.



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



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



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



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



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.



Myasthenia Gravis Autoimmune disease - antibodies destroys

acetylcholine (Ach) receptors sites in

muscles Acetylcholine is a neurotransmitter to muscles



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



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



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



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.



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



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



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.

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Chapter 15- Musculoskeletal System Hybrid Course