musculoskeletal injuries pathologic -Break occurs at the site of a \_\_\_\_\_. stress -\_\_\_\_\_ and \_\_\_\_\_ such as repetitive and strenuous activities that occur during athletics
preexisting abnormality
Fatigue
insufficiency
The bone is not straight
- Improper reduction or immobilization of a fractured bone may result in _____, _____, or _____.
- _____ is the healing of a bone in a nonanatomic position that could result in the bone not being straight.
nonunion
delayed union
malunion
Malunion
Subluxation
- _____ between the bones in the joint only partially lost
- _____ is the temporary displacement of a bone from its normal position in a joint. If the contact between the two surfaces is only partially lost, then the injury is referred to as a subluxation.
Contact
Dislocation
a _____ is fibrous connective tissue that attaches skeletal muscle to bone
tendon
Tear or injury to a tendon (fibrous connective tissue that attaches skeletal muscle to bone)
Strain
Tear or injury to a ligament (fibrous connective tissue that connects bones)
Sprain
_____
- Is inflammation of a tendon where it attaches to a bone
- _____: Lateral epicondylitis-tissue degeneration or irritation of the extensor carpi radialis brevis tendon.
Epicondylitis
Tennis elbow
Epicondylitis
clinical manifestation
-pain resulting from _____ and _____ injuries is usually described as _____ and _____, persisting over the distribution of the tendon or ligament.
tendon
ligament
sharp
localized
Rhabdomyolysis
- Release of _____ from damaged striated muscle cells injuries!!
- Life-threatening complication of severe muscle trauma with muscle cell loss
- -_____ versus _____
- -_____ syndromes
- Rapid breakdown of _____ that causes the release of _____ contents
- _____ into extracellular space and bloodstream
other causes rhabdomyolysis
-Sedatives and narcotics, particularly _____, _____ (a hypolipidemic agent), and the _____ acid often cause rhabdomyolysis and myoglobinuria.
myoglobin crush syndrome crush injuries compartment muscle intracellular protein pigment myoglobin street heroin clofibrate antifibrinolytic aminocaproic
Rhabdomyolysis
-_____ is an excess of myoglobin (an intracellular muscle protein) in the urine. Muscle cell damage releases the myoglobin.
The most severe form is often called _____. Less severe and more localized forms of muscle damage are called _____.
Myoglobinuria
crush syndrome
compartment syndromes
Rhabdomyolysis
classic triad:
_____ pain, _____, and _____ (from myoglobin)
muscle
weakness
dark urine
Osteoporosis Bone density -Normal bone --833 mg/cm2 -Osteopenic bone: \_\_\_\_\_ bone mass --833 to 648 mg/cm2 -Osteoporosis --
Decreased
648
Osteoporosis
potential causes
-decreased _____
types:
- _____- only classic regional osteoporosis is associated with disuse or immobilization of a limb because of fractures, motor paralysis, or bone or joint inflammation.
- _____
clinical manifestations
-_____
activity level
regional
Postmenopausal
bone deformity
Evaluation Dual x-ray absorptiometry (DXA)
-Generally, osteoporosis is radiographically detected as increased _____ of _____. By the time abnormalities are detected by x-ray examination, as much as _____ to _____ of bone tissue may have been lost.
radiolucency
bone
25% to 30%
Postmenopausal osteoporosis
-Occurs in middle-aged and older women. It can occur because of _____ deficiency, as well as estrogen-independent, _____-related mechanisms (e.g., secondary causes such as hyperparathyroidism and decreased mechanical stimulation).
- Recent studies indicate that increased _____ and increased intracellular _____ play significant roles in the development of age-related bone loss, as well as other age-related changes in the body.
- _____ deficiency also can increase with stress, excessive exercise, and _____ body weight. Increased formation and longevity of _____ results in increased bone resorption and is associated with a cascade of _____.
estrogen age oxidative stress reactive oxygen species Hormonal low osteoclasts proinflammatory cytokines
peak bone mass and strength reached in women
-_____ continues at a pace faster than resorption until peak bone mass—or maximum bone density and strength—is reached at approximately _____ years of age, after which bone resorption slowly exceeds bone formation.
-_____ in women is associated with _____. Bone loss is most rapid in the first years after menopause but persists throughout the postmenopausal years
Bone formation
30
Bone loss
menopause
Osteomalacia
- Deficiency of_____ lowers the absorption of calcium from the intestines.
- _____ is inadequate or delayed.
vitamin D
Mineralization
Paget Disease
- State of increased metabolic activity in bone
- -Is abnormal, and _____ and _____ are excessive. Paget disease most often affects the _____ skeleton, especially the vertebrae, skull, sacrum, sternum, and pelvis
bone resorption
formation
axial
Osteomyelitis
-_____, _____, _____, and _____ infections are all primary sources of bacteria in hematogenous bone infections.
Cutaneous
sinus
ear
dental
Sequestration and involucrum
-Lifting of the _____ disrupts _____ that enter bone through the periosteum, which deprives the underlying bone of its blood supply.
-This deprivation leads to _____ and death of the area of infected bone, producing _____, an area of devitalized bone.
periosteum
blood vessels
necrosis
sequestrum
Bone death as a result of osteomyelitis
-Vessel damage causes local _____ (blockage) of the small vessels, which leads to _____ (death) of bone.
thrombosis
ischemic necrosis
Treatment of bone infection
- Bone contains multiple microscopic channels that are _____ to the cells and _____ of the body’s natural defenses.
- _____ of bone is highly vulnerable to damage and destruction by bacterial toxins, leading to _____ of bone.
- Bone cells have a limited capacity to replace bone destroyed by _____.
impermeable biochemicals Microcirculation ischemic necrosis infections
Bone Tumors (cont’d) patterns of bone destruction -\_\_\_\_\_: Areas of partially destroyed bone adjacent to completely lytic areas
-An _____ is a malignant bone-forming tumor. It is aggressive and most often found in _____; it has a _____ pattern of bone destruction
moth-eaten
osteosarcoma
bone marrow
moth-eaten
bone tumors
myeologenic tunors
-Develop from various bone marrow cells
-_____ tumor
an overexpression of genes including _____
Giant cell tumors are typically located in the _____ in the femur, tibia, radius, and humerus.
They are _____-growing tumors that extend over the articular cartilage.
Giant cell
osteoprotegerin ligand (OPGL)
epiphysis
slow
