1. Diseases and Conditions of the Musculoskeletal System
Chapter 7
Diseases and Conditions of the Musculoskeletal System
Copyright © 2013 by Saunders, an imprint of Elsevier Inc. All rights reserved. 1

2. The Musculoskeletal System
Discuss the functions of the muscular system.
What is muscle fiber made of?
How is movement of the body and its internal organs accomplished?
Copyright © 2013 by Saunders, an imprint of Elsevier Inc. All rights reserved. 2

3. The Musculoskeletal System (Cont’d.)
The Three Types of Muscles
Striated (skeletal)
Nonstriated (smooth)
Cardiac
What are differences among the three types of muscles? Refer to Figure 7-2 (p. 300).
How do voluntary and involuntary muscle classifications differ?
What is the difference between origin and insertion of a muscle?
Copyright © 2013 by Saunders, an imprint of Elsevier Inc. All rights reserved. 3

4. Fibromyalgia
Fibromyalgia: chronic pain condition associated with stiffness and tenderness that affects muscles, tendons, and joints throughout the body
Cause is unknown
Eighteen tender points used in diagnosis
Treatment options
Stress reduction
Physical activity
Medications
Besides stiffness and tenderness, what are some of the other characteristics of fibromyalgia?
What is substance P?
What other conditions must be excluded before a diagnosis of fibromyalgia can be made?
Copyright © 2013 by Saunders, an imprint of Elsevier Inc. All rights reserved. 4

5. 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
What are some of the possible causes of lordosis?
What is Scheuermann's disease?
What is a probable cause of hunchback in older persons and postmenopausal women?
What age and gender group is most likely to develop scoliosis?
Copyright © 2013 by Saunders, an imprint of Elsevier Inc. All rights reserved. . 5

6. 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
What is the most common form of arthritis?
In which parts of the body does osteoarthritis usually appear?
Why is osteoarthritis such a growing problem today?
Discuss advertising for today's prescription and OTC arthritis drugs.
Copyright © 2013 by Saunders, an imprint of Elsevier Inc. All rights reserved. 6

7. 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 flulike symptoms such as headache, fever, joint pain, and fatigue
What areas of the body can be affected by Lyme disease?
What precautions can be taken to help prevent Lyme disease?
What are methods of removing ticks?
What diseases can Lyme disease be mistaken for?
Copyright © 2013 by Saunders, an imprint of Elsevier Inc. All rights reserved. 7

8. 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 © 2013 by Saunders, an imprint of Elsevier Inc. All rights reserved. 8

9. 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 and tissues
What area of the body does gout typically affect?
What dietary modifications can help in treatment of gout?
How is kidney function related to gout?
Copyright © 2013 by Saunders, an imprint of Elsevier Inc. All rights reserved. 9

10. 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
Gradual weight reduction in those who are overweight
Dairy products have been shown to reduce frequency of gouty arthritis.
Pain can be acute and severe with mild systemic symptoms.
Treatment with pain medication is urgent with gouty arthritis.
Copyright © 2013 by Saunders, an imprint of Elsevier Inc. All rights reserved. 10

11. 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
What is the most common type of primary bone neoplasm?
What is the most common presenting complaint for bone tumors?
What is a pathologic fracture?
What areas of the body are most commonly affected by muscle tumors?
Copyright © 2013 by Saunders, an imprint of Elsevier Inc. All rights reserved. 11

12. Musculoskeletal Tumors (Cont’d.)
Symptoms
Malignant tumors have characteristic signs
Palpable mass; dull, localized pain
Pathologic fracture, commonly in acetabulum or proximal femur
Diagnosis
Radiographic studies, MRI, CT scan, biopsy
Elevated serum alkaline phosphatase
Elevated serum calcium
Treatment
Surgical excision
Chemotherapy/radiation therapy
Are most muscle tumors malignant or benign?
Copyright © 2013 by Saunders, an imprint of Elsevier Inc. All rights reserved. 12

13. 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
Discuss different types of fractures. Refer to Figure 7-25 (p. 330).
Name some of the technologies used in diagnosing fractures.
What are some immobilization techniques?
Copyright © 2013 by Saunders, an imprint of Elsevier Inc. All rights reserved. 13

14. 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 (open reduction)
Copyright © 2013 by Saunders, an imprint of Elsevier Inc. All rights reserved. 14

15. 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
Discuss the differences between strains and sprains.
Which is considered the more serious injury?
Which symptoms do strains and sprains have in common?
What is the difference between acute and chronic trauma?
How long does it normally take for strains and sprains to heal?
Copyright © 2013 by Saunders, an imprint of Elsevier Inc. All rights reserved. 15

16. Traumatic and Sports Injuries (Cont’d.)
Treatment of Strains and Sprains
Elevation and rest of affected limb
Immobilization with elastic bandage
Application of ice
Analgesics and antiinflammatory agents
Copyright © 2013 by Saunders, an imprint of Elsevier Inc. All rights reserved. 16

17. Traumatic and Sports Injuries (Cont’d.)
Dislocation: the forcible displacement of a bone from its joint, causing loss of joint function
Treatment: a physician should be seen immediately for proper repositioning of the joint
Discuss the three most common causes of dislocation.
What are possible consequences of untreated dislocation?
Which joints are especially susceptible to recurring dislocation?
What is Ehlers-Danlos syndrome?
Copyright © 2013 by Saunders, an imprint of Elsevier Inc. All rights reserved. 17

18. 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 © 2013 by Saunders, an imprint of Elsevier Inc. All rights reserved. 18

19. 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
What are the two most common causes of shin splints?
Discuss the relationship of pronation to shin splints.
When do shin splints usually begin to appear?
Copyright © 2013 by Saunders, an imprint of Elsevier Inc. All rights reserved. 19

20. 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
Antiinflammatory medication
Heel pads
Cortisone
What is plantar fascia and what is its function? Refer to Figure 7-30 (p. 339).
What conditions must be ruled out before plantar fasciitis can be diagnosed?
Which people are most susceptible to plantar fasciitis?
Copyright © 2013 by Saunders, an imprint of Elsevier Inc. All rights reserved. 20

21. 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
What are the two types of meniscus cartilage in the knee joint? Refer to Figure 7-32 (p. 341).
What is the preferred technology for diagnosing torn meniscus?
Discuss arthroscopic surgery.
Copyright © 2013 by Saunders, an imprint of Elsevier Inc. All rights reserved. 21