Copyright 2005 © by Elsevier Inc. All rights reserved. Slide 0.


Chapter 7 Diseases and Conditions of the Musculoskeletal System

Copyright © 2005 by Elsevier Inc. All rights reserved.


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.


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.



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.



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.


Chapter 7Lesson 7.1


The Muscular System


The Muscular System (cont.)

The 3 Types of Muscles striated (skeletal) nonstriated (smooth) cardiac


The Muscular System (cont’d.)


The Skeletal System


The Skeletal System (cont.)

Types of Bones long bones – humerus (upper arm) short bones – carpal (wrist) flat bones – scapula (shoulder) sesamoid bones – patella (kneecap)


Joints


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


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


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


Lordosis - Treatment Options

Weight loss Exercises to strengthen abdomen Pelvic tilt exercises


Kyphosis - Treatment Options

Exercises to strengthen muscles and ligaments

Back brace to stabilize condition Spinal fusion and temporary

immobilization Vertebroplasty


Scoliosis - Treatment Options

Exercise to strengthen weak muscles Back brace Fusion of the vertebrae


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


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


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


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


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


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


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


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


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


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


Chapter 7Lesson 7.2


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


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


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


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


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


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


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


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



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


Treatment of Strains and Sprains

Elevation and rest of affected limb Immobilization with elastic bandage Application of ice Analgesics and anti-inflammatory

agents



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



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)



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



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



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



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

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