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Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 1
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 2
Chapter 7 Diseases and Conditions of the Musculoskeletal System
Copyright © 2005 by Elsevier Inc. All rights reserved.
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 3
Learning Objectives
List the functions of the normal skeletal system.
Distinguish among the pathologic features of lordosis, kyphosis, and scoliosis.
Describe the signs and symptoms of the most common form of arthritis.
Explain the importance of early diagnosis and treatment of Lyme disease.
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 4
Learning Objectives (cont’d.)
Describe the treatment of bone tumors, both benign and malignant.
Discuss the specifics of a physical examination when fibromyalgia is suspected.
Explain why joint disability results from gout. Describe the picture of osteomyelitis and
explain how it is treated.
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 5
Learning Objectives (cont’d.)
Describe the disability that results from advanced osteoporosis.
Explain why osteomalacia is termed a metabolic bone disease.
Distinguish between hallus valgus and hallus rigidus.
Distinguish between a strain and a sprain. Explain the importance of proper treatment
of dislocations.
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 6
Learning Objectives (cont’d.)
Describe the cause of shin splints. List some factors that contribute to the
development of plantar fasciitis. Explain how torn meniscus is treated. Describe the signs and symptoms of
rotator cuff tears.
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 7
Chapter 7Lesson 7.1
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 8
The Muscular System
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The Muscular System (cont.)
The 3 Types of Muscles striated (skeletal) nonstriated (smooth) cardiac
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 10
The Muscular System (cont’d.)
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 11
The Skeletal System
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 12
The Skeletal System (cont.)
Types of Bones long bones – humerus (upper arm) short bones – carpal (wrist) flat bones – scapula (shoulder) sesamoid bones – patella (kneecap)
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 13
Joints
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Skeletal tissue
Ligaments: tough, dense, fibrous bands of connective tissue that hold bones together
Tendons: strong, tough cords of dense connective tissue that usually attach muscle to bone
Cartilage: semi-smooth, dense, supporting connective tissue
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 15
Fibromyalgia
Fibromyalgia: a chronic pain condition associated with stiffness and tenderness that affects muscles, tendons, and joints throughout the body. The cause is unknown.
• Eighteen tender points used in diagnosis• Treatment options
• Stress reduction• Physical activity• Medications
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 16
Major Spinal Disorders
Lordosis: an exaggerated inward curvature of the spine
Kyphosis: an abnormal outward curvature of the spine
Scoliosis: a lateral (sideways) curvature of the spine
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 17
Lordosis - Treatment Options
Weight loss Exercises to strengthen abdomen Pelvic tilt exercises
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 18
Kyphosis - Treatment Options
Exercises to strengthen muscles and ligaments
Back brace to stabilize condition Spinal fusion and temporary
immobilization Vertebroplasty
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 19
Scoliosis - Treatment Options
Exercise to strengthen weak muscles Back brace Fusion of the vertebrae
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 20
Osteoarthritis
Osteoarthritis: the breakdown and eventual loss of cartilage of one or more joints
Causes: aging process heredity injury chronic diseases such as diabetes and obesity
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 21
Osteoarthritis (cont’d.)
Signs and symptoms Spur formations on fingers Degeneration of spinal vertebrae and
pelvic joints
Diagnosis Radiographic testing to exclude other
causes
Treatment Reduce inflammation, minimize pain
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 22
Lyme Disease
Lyme disease: an infectious bacteriological disease spread by deer tick bites
Caused by the bacterium Borrelia burgdorferi Characterized by red, itchy rash with a red circle
center (“bull’s-eye” rash) Often characterized by flu-like symptoms such as
headache, fever, joint pain, and fatigue
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 23
Lyme Disease (cont’d.)
Treatment removal of tick oral antibiotics intravenous antibiotics bed rest and physical therapy
Prevention avoid tick bites by wearing long clothing inspect clothes and body for ticks
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 24
Osteomyelitis
Osteomyelitis: a serious infection of bone that requires aggressive antibiotic treatment Caused by bacterial organisms, viruses,
and fungi Characterized by inflammation, swelling,
redness, pain, localized heat, and tenderness
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 25
Osteomyelitis (cont’d.)
Treatment long-term antibiotic treatment increased intake of proteins and vitamins
A, B, and C bed rest control of chronic conditions Immobilization of affected part
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 26
Gout
Gout: a chronic disorder of uric acid metabolism that manifests an acute, episodic form of arthritis
Causes Overproduction or decreased excretion of
uric acid high levels of uric acid in the blood high levels of uric acid in synovial fluid in
joints
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 27
Gout (cont’d.)
Treatment bed rest to reduce pressure on affected
joints application of ice to inflamed joints NSAIDs and corticosteroids low-purine diet and frequent fluid intake antihyperuricemic medications
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 28
Musculoskeletal Tumors
Bone tumor: any abnormal growth (whether benign or malignant) in the bone chondrogenic (from cartilage) osteogenic (from bone) fibrogenic (from fibrous tissue)
Muscle tumor: muscle neoplasms, benign or malignant sarcomas, that may arise at any site in the body
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 29
Musculoskeletal Tumors (cont’d.)
Symptoms palpable mass; dull, localized pain pathologic fracture, commonly in acetabulum or
proximal femur Diagnosis
radiographic studies elevated serum alkaline phosphatase elevated serum calcium
Treatment surgical excision chemotherapy/radiation therapy
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 30
Chapter 7Lesson 7.2
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 31
Osteoporosis
Osteoporosis: a condition that features the loss of normal bone density due to imbalance between breakdown of old bone tissue and manufacture of new bone
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 32
Osteoporosis (cont’d.)
Symptoms asymptomatic until bone breaks spontaneous fractures and loss of height
are the most common signs
Treatment increased intake of calcium and vitamin D estrogen replacement therapy bisphosphonate medications moderate exercise
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 33
Osteomalacia
Osteomalacia: a disease characterized by a defective mineralization of the bones, causing them to become soft, flexible, and deformed When osteomalacia occurs in children, it
affects the growing skeleton and is called rickets
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 34
Osteomalacia (cont’d.)
Symptoms general fatigue muscle weakness progressive stiffness tender, painful bones
Treatment vitamin D supplements add vitamin D, calcium, and calcitonin to diet exposure to sunlight
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 35
Hallus Valgus & Hallus Rigidus
Hallus Valgus (Bunion): a localized area of enlargement of the inner portion of the metatarsophalangeal (MTP) joint at the base of the big toe
Hallus Rigidus (Rigid Big Toe): a stiff big toe that develops as a result of degeneration of the cartilage of the first metatarsophalangeal (MTP) joint
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 36
Hallus Valgus & Hallus Rigidus (cont’d.)
Symptoms painful bunions MTP joint becomes stiff, painful, and
swollen
Treatment wearing shoes with more room application of ice anti-inflammatory agents for hallux rigidus, removal of bone spurs
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 37
Traumatic and Sports Injuries
Fractures (broken bones): caused by stress on the bones resulting from a traumatic insult to the musculoskeletal system, severe muscle spasm, or bone disease
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 38
Traumatic and Sports Injuries (cont’d.)
General treatment of fractures depends on location, severity, type, and cause simple fracture of long bone: reduction
and immobilization compound fracture: cleaning, debriding,
reduction, immobilization internal fixation
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 39
Traumatic and Sports Injuries (cont’d.)
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 40
Traumatic and Sports Injuries (cont’d.)
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 41
Traumatic and Sports Injuries (cont’d.)
Strains: injured tendons, muscles or other tissues resulting from overuse, overstretching, or excessive forcible stretching of the tissue beyond its functional capacity
Sprains: acute partial tears of a ligament
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 42
Treatment of Strains and Sprains
Elevation and rest of affected limb Immobilization with elastic bandage Application of ice Analgesics and anti-inflammatory
agents
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 43
Traumatic and Sports Injuries (cont’d.)
Dislocation: the forcible displacement of a bone from its joint, causing loss of joint function
Treatment Proper repositioning of joint within 30
minutes of injury
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 44
Traumatic and Sports Injuries (cont’d.)
Severed tendon: caused by injury or laceration; involves the forearm, hand, calf, or foot. The severed ends snap away from each other. Symptoms: immediate, severe pain,
inflammation and immobility Treatment: tenorrhaphy (suturing of the
two ends of the tendon)
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 45
Traumatic and Sports Injuries (cont’d.)
Shin splints: a painful condition involving inflammation of the periosteum, the extensor muscles of the lower leg, and the surrounding tissues Symptoms: inflammation, edema, pain on
inner aspect of the tibia Treatment: rest plus applications of ice or
heat
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 46
Traumatic and Sports Injuries (cont’d.)
Plantar fasciitis: an inflammatory response at the bottom of the heel bone, generally caused by overuse Symptoms: pain on bottom of foot Treatment:
application of ice anti-inflammatory medication heel pads cortisone
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 47
Traumatic and Sports Injuries (cont’d.)
Torn meniscus: a crack or fissure to the meniscus cartilage in the knee joint Symptoms
acute pain when putting full weight on affected leg and knee
snapping or clicking on flexion or extension Treatment
immobilization and elevation surgery
Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 48
Traumatic and Sports Injuries (cont’d.)
The rotator cuff: the four tendons of the rotator cuff, formed by the muscles of the shoulder, partially surround the head of the humerus and stabilize it in the glenoid cavity of the socket
Rotator cuff tears: tears to any of the rotator cuff tendons that limit the function of the shoulder