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Musculoskeletal RN
Diseases of bones and joints
86
Pathology
Undergraduate 2
02/22/2011

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Term
Ligaments
Definition
hold articulating bones together
Term
tendons
Definition
muscles are attached to
Term
Bursae
Definition
are fluid-filled sacs near joints that provide a cushion and help to reduce friction between structures.
Term
epiphysis
Definition
At each end of long bones
Term
diaphysis
Definition
Long bones have a central shaft
Term
metaphysis
Definition
The portion between the diaphysis and the epiphysis
Term
growth plate
Definition
In immature individuals it's located between the metaphysis and epiphysis
Term
periosteum
Definition
Bones are surrounded by an outer coating of thin tissue which serves as an attachment point for tendons and muscles and contains nerves and blood vessels
Term
cortex
Definition
The outer part of the bones themselves
Term
endosteum
Definition
lines the inner side of the cortex and contains blood vessels
Term
medullary cavity
Definition
The innermost part of the bone
Term
trabecular, cancellous, or spongy bone
Definition
buttressing type of bone
Term
Bones serve a variety of important functions
Definition
. These include hematopoiesis (production of blood cells), acting as a reservoir for minerals (calcium and phosphorus), providing structural protection, and providing support and leverage to enable locomotion
Term
endochondral ossification
Definition
Growth of the long bones takes place by formation of a cartilage template or model, which is then mineralized
Term
intramembranous ossification.
Definition
Most flat bones develop by mineralization of connective tissue
Term
Factors that are critical for the formation of bone
Definition
calcium, vitamin D, parathyroid hormone, and calcitonin (a hormone made by the thyroid).
Term
Osteoblasts
Definition
make the matrix of growing bone
Term
osteocytes
Definition
Mature osteoblasts residing in bone matrix
Term
bone-lining cells
Definition
Osteoblasts that exist in an inactive form
Term
Osteoclasts
Definition
break down and remove bone and are therefore essential for remodeling
Term
When an osteoblast is placed under mechanical stress...
Definition
it responds by producing bone
Term
Osteoclasts remove minerals by?
Definition
secreting acid
Term
Osteoclasts remove matrix by?
Definition
secreting degradative enzymes
Term
The growth of any bone requires that?
Definition
matrix and mineral be added and subtracted in an organized way.
Term
Bone loss can occur if? (in reference to osteoclasts)
Definition
osteoclasts get the upper hand!
Term
Bone matrix consists of
Definition
organic(osteoid) and inorganic(hydroxyapatite) components.
Term
hydroxyapatite consists of?
Definition
minerals, largely calcium and phosphorus complexed together.
Term
As bone develops...
Definition
the matrix transitions from largely proteinaceous osteoid to a form that consists largely of hydroxyapatite
Term
Disease of bone can develop from?
Definition
abnormalities in either the osteoid or mineral components of bone.
Term
woven bone
Definition
is characterized by collagen fibers that run haphazardly in random directions. It's easier and faster for the body to build than compact bone, so it is the first type of bone laid down after a fracture.
Term
lamellar bone
Definition
collagen fibers are arranged in orderly layers. Almost all bone in adults is of the this type.
Term
Wolff’s Law
Definition
states that bone is laid down according to the force that is exerted on it, also states it is important to keep weight on the bone to encourage faster re-growth of bone
Term
bunion
Definition
an outgrowth of bone at the base of the large toe.
Term
Osteomalacia
Definition
a condition where bone is soft due to a lack of proper mineralization.
Term
Osteomalacia is usually caused by inadequate...
Definition
Vitamin D, which is necessary for uptake of calcium from the diet and thus for maintenance of proper levels of calcium in the blood
Term
The primary manifestation of osteomalacia in adults are?
Definition
an increased risk of fractures, and the patient may complain of bone pain.
Term
Osteonecrosis AKA...
Definition
aseptic or avascular necrosis
Term
Osteonecrosis
Definition
death of bone due to a localized interruption of the blood supply.
Term
Steroids are often the cause...
Definition
Osteonecrosis
Term
Osteogenesis imperfecta AKA
Definition
“brittle-bone disease”
Term
Osteogenesis imperfecta
Definition
results from mutations in the gene for a type of collagen. As a result, bones, skin, teeth, etc. are weaker than normal. Sometimes parents of children with this condition may be falsely accused of child abuse, since the children are very prone to fractures.
Term
Paget’s disease
Definition
a fairly common disorder, affecting some 5% of the population over the age of 65. It is thought to result from excessive, uncoordinated activity of osteoblasts and osteoclasts, such that too little bone is deposited in some places and too much in others
Term
Fractures occur with Paget’s disease....
Definition
because the abnormal architecture of the bones makes them weaker than normal.
Term
Osteomyelitis
Definition
infections of bone. Such infections can lead to abscesses and/or death of bone tissue.
Term
tumors of bone
Definition
metastatic tumors that originated in other organs are far more common than primary bone tumors.
Term
osteoporosis
Definition
overall bone mass is reduced, the most common skeletal disease, certainly in this country, and is a major cause of hospitalization in the elderly.
Term
Senile osteoporosis AKA
Definition
post-menopausal osteoporosis
Term
Senile osteoporosis
Definition
primary disease that results from aging and, in women, the loss of the favorable effects of estrogens on bone.
Term
osteopenia
Definition
signifies a mild loss.
Term
sacral insufficiency fractures.
Definition
Another common site for spontaneous fractures is the sacrum
Term
The difference between
1.osteogenesis imperfecta
2.osteomalacia
3.osteoporosis.
Definition
1.faulty osteoid
2. deficient in minerals
3. both components are diminished
Term
Classification of joint diseases.
Definition
Fibrous, cartilaginous and synovial
Term
Cartilage
Definition
provides a near-frictionless surface to prevent bone from rubbing on bone
Term
subchondral bone plate
Definition
Beneath the cartilage of a joint
Term
synovium
Definition
a thin, Saran wrap-like structure that lines the joint space and makes nutrients for the cartilage.
Term
arthritis
Definition
Disorders of joints
Term
Osteoarthritis
Definition
A disease of the synovial lining of the joint. Characterized by a loss of cartilage and formation of bone spurs.
Term
Affected by osteoarthritis
Definition
including those in the cervical and lumbar spines; the last two rows of joints in the fingers and all joints of the thumb; the hips; the knees; and the front of the feet.
Term
periarticular
Definition
Structures that surround joints
Term
Non-autoimmune periarticular conditions
Definition
degenerative disease of the discs, tendonitis, Bursitis
Term
Bursitis
Definition
inflammation of the bursae and occurs most often in the hip.
Term
Rheumatoid arthritis
Definition
A disease of the synovium where the synovium overgrows and starts eating into adjacent structures, such as cartilage, tendons, and bones
Term
A key point is that RA...
Definition
is an autoimmune disease, in which there is activation and perpetuation of the immune response, resulting in chronic inflammation
Term
Rheumatoid factor
Definition
an antibody, usually of the IgM type, that reacts with immunoglobulin G (IgG) molecules
Term
CCP antibody
Definition
an autoantibody that reacts with cyclic citrullinated peptide and is regarded as a highly specific marker for RA.
Term
tumor necrosis factor
Definition
A cytokine that is involved in the pathogenesis of RA. It has many of the same activities as interleukin-1.
Term
pannus
Definition
overgrown synovium produced by RA. Which secretes enzymes that can degrade cartilage, bone, tendons, and ligaments
Term
Sjogren’s syndrome
Definition
results when the autoimmune response damages glands in the mouth and around the eyes, leading to dryness
Term
Baker’s cyst
Definition
excessive fluid accumulates in back of the knee joint. Sometimes this fluid escapes the joint and drains into the calf, which is very painful and can mimic deep vein thrombosis.
Term
Treatment for patients with RA.
Definition
. Non-steroidal anti-inflammatory drugs are used, as are low doses of steroids. So-called disease-modifying anti-rheumatic drugs, such as methotrexate, can help to slow the inevitable progression of the disease. there are now five drugs on the market that inhibit tumor necrosis factor
Term
Patients with RA are at increased risk of....
Definition
developing lymphoma, heart attacks, and stroke and have shortened life-spans.
Term
Spondyloarthropathy
Definition
a group of inflammatory arthritic diseases that have in common the involvement of the spine
Term
Types of Spondyloarthropathy
Definition
psoriatic arthritis, ankylosing spondylitis
Term
ankylosing spondylitis
Definition
a condition that is associated genetically with a form of the MHC Class I molecule called HLA B27. In this condition, the spine becomes fused due to calcification of the ligaments overlying the anterior edge of the spine
Term
Gout
Definition
a disease that results from abnormally high levels of uric acid, which is a normal product of metabolism
Term
Large collections of crystals
Definition
tophi
Term
Reactive arthritis
Definition
is so-called because it occurs in reaction to an infection but is not directly due to the invading microorganism
Term
Lyme disease
Definition
infectious organism that can cause arthritis directly when it invades joints
Term
erythema migrans
Definition
circular, spreading rash
Term
SYSTEMIC LUPUS ERYTHEMATOSUS (SLE)
Definition
associated with production of antibodies directed against the patient’s own DNA (seen in some 60% of cases) and other components in the cell nucleus; collectively, these are called anti-nuclear antibodies (ANA)
Term
Common manifestations of SLE
Definition
are arthritis, the aforementioned rash, and inflammation of the kidneys (nephritis).
Term
Polymyositis and dermatomyositis
Definition
are diseases in which there is an autoimmune attack on skeletal muscle
Term
scleroderma
Definition
excessive deposition of collagen (fibrosis) in the organs and blood vessels, which can cause hardening and inflexibility of the tissues. There is no effective therapy to slow this fibrosis. It is a systemic condition, and the lungs are often involved.
Term
Raynaud’s phenomenon
Definition
reversible spasms of small blood vessels in the hands and/or feet, which produces white (blanching) or blue (cyanosis) colors in the toes and fingers.
Term
Polymyalgia rheumatica
Definition
generally seen in older people and is marked by muscle pain (myalgias), particularly in the shoulders and thighs.
Term
Fibromyalgia
Definition
is a poorly understood condition that is associated with muscle pain and fatigue.
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