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Lecture notes

Nurs 208 Musculoskeletal Pathophysiology Notes

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This is a comprehensive and detailed note on musculoskeletal pathophysiology for Nurs 208. *Essential!! *For you!!

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Musculoskeletal Pathophysiology




Terms
1. Fractures- break that occurs when for is applied that exceeds the tensile of compressive
strength of the bone


2. Osteoporosis- too much osteoclast activity. old bone is being reabsorbed faster than new
bone is being made so bones lose density


3. Open fractures: skin broken over fracture; possible soft tissue trauma. lot of swelling and
major blood loss -> can lose the leg
spiral fractures: curves around the cortices and may become displaced by twist
greenstick fractures: break in only one cortex of bone
transverse fractures: horizontal break through bone
impacted fractures: one end wedged into opposite end of inside fractured fragment; no space in
the cartilage (extremely vascular -> hemorrhage)
ex: bone is shoved up in the pelvic griddle -> can cause hemorrhage


4. Direct healing: intramembranous bone formation occurs when adjacent bone cortices are in
contact with one another. Ex: surgical fixation for broken bone
no callus formation


5. Indirect healing (most common and secondary): intramembranous and endochondral (bone
formation that begins with underlying cartilage scaffold) bone formation, development of callus,
and eventual remodeling of solid bone. (membrane heals on its own) ex. stubbing a toe


6. Callus- necrosis at the end of bones when it’s healed


7. Periosteum: double layered connective tissue that covers the bone


8. Bone Mass Density


9. Sarcopenia: age-related loss in skeletal muscle. Muscle mass and strength ↓ slowly.
but strength is maintained through 5th decade then slowly declines after 70

, 10. Osteomyelitis- bone infection caused by bacteria, starts in the inside when bacteria eats the
bone and skin


11. Staphylococcus aureus- primary microorganisms of osteomyelitis, destroys neutrophils


12. Biofilm- colonies of microorganisms that adheres to surfaces -> ↑ antibiotic resistance
**biofilm and inflammation alter the normal balance between osteoblast and osteoclast activity


13. Inflammatory response: osteomyelitis causes inflammation, vascular engorgement occurs
and edema. Yellow discharge = dead neutrophils, vessels thrombose (clot)


14. Osteoblast: builds, lays down new bone


15. Osteoclast: crush, reabsorbs bone


16. Osteoarthritis: age-related disorder of synovial joints
-loss of articular cartilage -> bones become unprotected -> sclerosis occurs -> cysts form
creating pressure in the synovial cavity which breaks through the articular cartilage -> cellular
degradation (cytokines, TNF, interleukin 1) -> proteolytic and collagenolytic enzymes inhibit
growth factor activity


17. Synovial joints
-diarthrotic joint: freely moveable
-synarthrotic joint: immoveable
-amphiarthrotic joint: slightly moveable
-fibrous joint: little, if any movement


18. Sclerosis: occurs in osteoarthritis, bone density ↑ and becomes hard


19. Fibromyalgia: chronic musculoskeletal syndrome. Diffuse pain, fatigue, increased sensitivity
to touch, non REM sleep (can’t heal), absence of systemic or localized inflammation, anxiety
and depression. Joint pain is a major complaint


20. Rhabdomyolysis: rapid breakdown of muscle that cause the release of intracellular contents
(myoglobin) into the extracellular space and bloodstream. (997)
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