Transcript for Audio to Go: Topic 4 - …
Transcript for Audio to Go: Topic 4Common Skeletal System DisordersIntroductionThis topic supports these objectives:Describe selected Skeletal System diseases and disorders.Describe issues and changes related to the Skeletal System at different points in the lifespan.Abnormal Curvature of the SpineThere are numerous diseases and disorders of the Skeletal System that impact the entire health of the body. Abnormal curvature of the spine is where the spine curves either the wrong direction or laterally. There are three main types of abnormal curvature: scoliosis, lordosis, and kyphosis. These abnormalities are often diagnosed using an x-ray early in toddlers, children, or teenagers, and if not corrected at a young age, can cause significant problems and deformities with age. ScoliosisScoliosis is an abnormal, lateral curvature of the spine. As you look at an individual with scoliosis in anatomical position, the spin can appear as though it has an S-curve laterally. To treat scoliosis, orthopedic braces are often used to hold the spine in place as it grows. Surgical treatment may also be required in severe cases.LordosisLordosis is an exaggerated inward curvature of the lumbar spine, often called a sway-back. It is commonly found in men and women who are severely overweight, or in pregnant women. In children, you will see a predominantly protruding abdomen or buttocks. To treat lordosis braces and surgery can be used.KyphosisKyphosis results in an exaggeration of the thoracic curvature, often called humpback. This, abnormal curvature can be caused by a congenital defeat, a disease such as tuberculosis, syphillus, or a malignancy, a compression fracture, poor posture, osteoarthritis, rheumatoid arthritis, rickets, or osteoporosis. Treatment includes braces and surgery, and often depends on the health of the person and the cause.Types of FracturesFalling out of a tree, tripping down the steps, or simply stepping the wrong way are all ways to acquire a broken bone. In your youth a cast was a merit badge of sorts: a plaster medal your friends could sign. Now as adults, and with different technology, plaster casts are almost a thing of the past, and the break itself is a dubious achievement you’d rather not experience. Fractures, (FX), are common pathologies, and many people wear a cast or splint at least once in their life. There are several different types of fractures, differentiated by the way in which the bone breaks, or bends in one case. Although you can’t always avoid fractures, you can take Calcium supplements and Vitamin D to maintain bone density, as well as to treat fragile bone conditions such as osteoporosis, osteomalacia, and rickets. Closed Fracture – A fracture with no break in the skin, also called a Simple Fracture.Colle’s Fracture – A common type of wrist fracture, actually the distal end of the minuted Fracture – A fracture where the bone is shattered, splintered, or pound Fracture – A fracture where the skin is broken by the bone itself, also known as an Open Fracture.Greenstick Fracture – An incomplete fracture where only part of the bone is broken, typically seen in small children whose bones are not fully ossified.Impacted Fracture – A fracture where the bone fragments are pushed together.Oblique Fracture – A fracture at an angle to the bone.Spiral Fracture – A fracture where the break spirals around the bone shaft.Stress Fracture – A fracture caused by repetitive, low-impact forces, such as running.Transverse Fracture – A fracture straight across the bone at a right angle to the bone’s axis.Diseases and Disorders of the JointsThere are numerous diseases and disorders of the Skeletal System that effect the joints specifically. ArthritisArthritis is defined as an inflammation of the joint. Its characteristics include pain, swelling, and stiffness. Nonsteroidal, anti-inflammatory drugs such as Ibuprofen, Advil, Naproxen, Alieve, and salicylates, (Aspirin), can be prescribed for mild pain relief and anti-inflammatory benefits for this condition.BunionSome synovial joints contain a bursa, a sack-like structure lined with synovial membrane and filled with synovial fluid that provides cushioning. A bunion results when the bursa at the base of the big toe becomes inflamed. DislocationA dislocation occurs when the bones in a joint come apart from each other and are no longer in contact in the normal position. Osteoarthritis (OA)Osteoarthritis is arthritis caused by bone and joint degeneration, specifically the destruction of cartilage in the joint. The result is bone rubbing against bone. Rheumatoid Arthritis (RA) & Juvenile Rheumatoid Arthritis (JRA)Rheumatoid Arthritis (RA) is a chronic arthritis characterized by swollen and stiff joints and, in some cases, crippling deformities caused by changes in the cartilage. It is classified as an auto-immune disease. Corticosteroids are hormones that the adrenal cortex produces, and are effective at treating RA because of their anti-inflammatory properties. Prednisone, methylprednisolone, and dexamethasone are three corticosteroids currently prescribed.SprainA sprain is a twisted ankle or other joint. There is no break, and there is no dislocation. There is, however, damaged caused to the ligaments because they were overstretched.SubluxationSubluxation is an unfinished dislocation where the bones remain in contact but the joint is misaligned.Diagnostic ProceduresDiagnosing pathologies of bones goes beyond traditional x-rays, (radiography). Diagnosing today can include scans, and even small cameras. Procedures using contrast media, orthography and myelography, both involve injecting a substance into a specific area of the body. With orthography, a contrast medium is injected into the joint space and followed by a radiographic study. In myelography, an opaque contrast medium is injected so that the spinal column can be better studied.A third diagnostic procedure is a bone scan. Like the previous two, a medium is introduced to the body to create a degree of contrast. Here, the patient is given a radioactive dye before being scanned for various pathologies, such as stress fractures and bone cancers and for measuring the progress of osteomyelitis treatments. Imaging AloneThis second category of diagnostic procedures also uses scanning and radiography, but the difference is no dyes are involved. With radiography the patient is x-rayed. With Dual Energy Absorption, DXA Imaging, a low dose x-ray is used for bone density testing. VDTIf fragile bone conditions such as osteoporosis or Paget’s disease are diagnosed, patients can take bone reabsorption inhibitors such as alendronate or ibandronate, phosimax, and boneva respectively to reduce bone reabsorption by the osteoclasts.ArthroscopyArthroscopy involves the use of an arthroscope, a miniature camera sent into the joint by the physician so that he or she can see any damage, or even in some cases, repair the damage. Therapeutic ProceduresNow that you know about some pathologies related to the Skeletal System, it makes sense to address the therapies for these conditions. There are a variety of options available, including surgical procedures and fracture care. Surgical procedures range from complete amputation, to fusion, to reconstruction. Fracture care has one main goal: to reconnect the bone so that it can heal. Fractures are typically taken care of in one of three ways: fixation, reduction, or traction.AmputationAmputation is the complete removal of a bone or bones done in cases where there is essentially no other recourse. Uncontrollable infections, tumors, and gangrene are just three reasons bones might have to be removed. FixationFixation involves stabilizing the fractured bone. Noninvasive fixation is called External Fixation and typically involves a cast or splint. Move serious stabilization can require surgery to insert pins, rods, or screws in a process called Internal Fixation.ReductionWith Reduction the bone fragments are realigned. As with Fixation therapy, this may or may not be done surgically. Closed Reduction is the noninvasive form. Open Reduction requires an incision at the site of the fracture, usually to remove bone fragments or when Internal Fixation is required. ORIF, Open Reduction Internal Fixation, refers to this specific procedure.TractionThe third option for fracture care is Traction. Here, pulling force is applied to the fractured limb to realign it. Traction can also be used for dislocated limbs, or to realign the vertebral column.Bone GraftBone grafts, like skin grafts, involve taking a piece of a bone from one site and grafting it to another site to replace a removed or damaged bone.Spinal FusionSpinal fusion is the surgical immobilization of adjacent vertebrae.Total Hip Arthroplasty (THA) & Total Knee Arthroplasty (TKA)THA and TKA are surgical procedures that involve reconstruction of the hip (THA) or knee (TKA) joints by replacing them with prosthesis. These two procedures are also called Total Hip Replacement (THR) and Total Knee Replacement (TKR) respectively. Changes across the LifespanThe skeleton changes throughout life, although the changes in childhood are the most dramatic. InfantsWhen infants are born they have very different features than adults, including an undersized lower jaw, shortened neck, and small sloping shoulders. The limbs are shorter and the legs are often bowed. The head appears large compared to the rest of the body and accounts for about 1/4th the total body size. The anterior and posterior fontanels are the diamond shaped area at the top front and rear parts of the head respectively. These are soft spots. When a baby is born these areas are unossified to allow for expansion of the brain. The soft spots last for up to 18 months.ChildrenAs infants grow their limbs grow faster than their torso, giving a different proportion to the body. By 12 to 15 months, the chest circumference is larger than head circumference. By age 8 or 9 the growth of the head is nearly complete. The jaw bone grows longer and the mandible extends forward. Deciduous teeth are lost, and replaced at a rate of about 4 teeth per year until about 11 or 12.AdolescentsDuring adolescence, there is a major period of accelerated growth, just as in infancy. This accelerated growth spurt occurs about 2 years earlier in females than in males. Between age 15 and 18 most adolescents approach full adult size and appearance.AdulthoodAs adults mature skeletal growth is complete by age 25 or possibly sooner. This is when the epiphyseal line ossifies and fuses with the main shaft on bones. The vertebral column continues to grow until about age 25. The smaller leg bones, the sternum, pelvic bones, and vertebrae, all obtain the adult distribution of red marrow by about this age. By age 40 the bones have lost some mast and density. This process begins earlier in women. As age increases the cartilage in all joints begins to lose the ability to regenerate itself. As adults move to middle age, there is a gradual flattening of the intervertebral discs and a resulting loss of height as the spinal column is compressed.Later AdulthoodAs adults move into later life their posture becomes more flexed. The head tends to tilt forward, while hips and knees stay slightly flexed. Calcium is progressively lost from the bone, which is related to the loss of hormone function. Bone loss is greater in females than in males. Posture becomes curved or stooped as osteoporosis sets in the vertebrae, which is caused by the collapse and loss of calogen. Osteoporosis also increases the risk of broken bones, especially at the hips and in the spinal column. Activity can help significantly to prevent osteoporosis. Bones must be physically stressed to maintain mon Skeletal System Disorders ReviewThis topic supported these objectives:Describe selected Skeletal System diseases and disorders.Describe issues and changes related to the Skeletal System at different points in the lifespan. ................
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