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Name 4 characteristics of the Anatomical Position?
- 1. Person stands erect.
- 2. Feet parallel, flat on the floor.
- 3. Arms are at the sides of the body.
- 4. Palms forward.
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If the body is lying face down, what is this position described as?
Prone.
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If the body is lying face up, what is this position described as?
Supine.
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Directional Terms: Part A
Describe the Anatomical Terms with their meaning.
- Medial - nearer to the midline.
- LAteral - further (away) from the midline,towards the sides.
- Bilateral - both sides.
- Unilateral - one side.
- IpSilateral - on the same side.
- Contralateral - on the opposite side.
- Proximal - nearer to the 'attachment'.
- Distal - further from the 'attachment'.
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Directional Terms: Part B
Describe the Anatomical Terms with their meaning.
- Cranial - head/towards the head.
- Caudal - tail/towards the tail.
- Anterior/Ventral - nearer the front.
- Posterior/Dorsal - Nearer the back.
- Superior - Towards the top.
- Inferior - Towards the bottom.
- Superficial - Closer to the skin/surface.
- Deep - further under the skin.
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Describe the 3 planes of the body?
- 1. Coronal/Frontal Plane - vertical plane that divides the anterior (front) and posterior (back) parts of the body.
- 2. Sagittal - vertical plane that divides the left and right parts of the body.
- 3. Transverse - horizontal plane that divides the superior (top) and inferior (bottom) parts of the body.
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How many bones are the in the human body?
206.
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What are the 7 functions of the human skeleton?
- 1. Haemopoiesis - formation and development of blood cells.
- 2. Mineral haemopoiesis (mostly calcium and phosphate).
- 3. Support framework for the body.
- 4. Forms boundaries (skull).
- 5. Attachment for muscles and tendons.
- 6. Permits movement (joints).
- 7. Triglyceride storage (yellow bone marrow).
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Bone Cells: Define what Osteogenic Cells are and their function?
[Osteo] = bone
- Osteogenic Cells are unspecialised stem cells.
- They are the only bone cell to undergo division, which produces Osteoblasts.
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Bone Cells: Define what Osteoblasts are and their function?
- Osteoblasts are bone building cells.
- They surround themselves with extracellular matrix and become trapped in their secretions and become osteocytes.
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Bone Cells: Define what Osteocytes are and their function?
- Osteocytes are mature bones cells.
- They maintain daily metabolism of bone, such as nutrient/waste exchange.
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Bone Cells: Define what Osteoclasts are.
Osteoclasts are huge cells derived from fusion of as many monocytes(white blood cells).
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What does resorption mean?
It is when Osteoclasts break down the tissue in bones.
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Describe Compact Bone?
Compact bone is tightly-packed, contains few spaces and is strong.
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What is an Osteon?
An Oeston is a structural unit of compact bone.
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An Osteon contains what 4 parts?
- 1. Central canal - contains blood vessels and nerves.
- 2. Lamellae - calcified extracellular matrix containing minerals and collagen.
- 3. Lacunae - between lamellae, are small spaces called lacunae that contain osteocytes.
- 4. Canaliculi - interconnected canals that provides a route for nutrients/waste.
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What are the characteristics of Spongy/Cancellous Bone?
- 1. Does not contain osteons - instead it consists of thin columns called trabeculae.
- 2. Small spaces between trabeculae help make bone lighter and can be filled with bone marrow.
- 3. Spongy bone is always covered with a layer of compact bone.
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Like other connective tissues, what does the bone have?
Bone contains an extracellular matrix that surrounds separated cells.
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What is the most abundant mineral in the bone matrix?
Calcium Phosphate.
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What is a long bone?
- 1. A bone that has a greater length than width.
- 2. Contains a shaft=diaphysis and 2 heads=epiphyses.
- 3. Mostly compact bone in diaphysis and spongy bone in epiphysis.
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How are the Epiphyses separated from the Diaphysis?
They are separated by the epiphyseal plate.
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Describe the function of the epiphyseal plate?
- The epiphyseal plate is a layer of hyaline (thin glass-like) cartilage.
- This allows the diaphysis to grow in length.
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What type of bones does the Epiphysis contain?
- Thin outer compact bone covered by hyaline cartilage.
- Inner spongy bone with red marrow.
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Describe the diaphysis part of the long bone?
- Diaphysis are the tubular shaft part of the long bone.
- The outer compact bone is covered by periosteum.
- Central, medullary(bone marrow cavity) contains red/yellow bone marrow.
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What is Periosteum?
Peri = surrounding Osteon = bone
Periosteum is a dense layer of vascular connective tissue that surround the external bone surface.
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Describe the function of the Periosteum?
- 1.Outer fibrous layer - protects bone.
- 2. Inner layer - mostly of osteoblasts and osteoclasts for growth and repair.
- 3. Serves as attachment for ligaments and tendons.
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What is Endosteum?
Endo =outside
Endosteum is a thin layer of vascular connective tissue that surrounds the internal medullary (bone marrow cavity) cavity.
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Name 5 types of bone?
- 1. Short bones - curved shaped.
- 2. Irregular bones - complex shapes.
- 3. Flat bone - 2 plates of compact bone.
- 4. Sesamoid bone - e.g. patella(knee).
- 5. Long bones - e.g femur(thigh).
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What general structure do all bones have?
- Periosteum
- Compact Bone
- Spongy Bone - containing red bone marrow.
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Name the 2 types of Bone Marrow?
- Red bone marrow - red blood cells, platelets, most white blood cells are created here.
- Yellow bone marrow - contains fat cells, some white blood cells are created here.
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Define Ossification?
The natural process of bone formation.
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When does Ossification occur?
- During foetal development.
- During growth.
- Throughout life.
- Repair.
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Name the 2 types of Ossification?
- 1. Intramembranous ossification - bone growth at embryo & foetus stage. All flat bones i.e. skull.
- 2. Endochondral ossification - bone growth from 2 months onwards. cartilage is broken down as ossification proceeds.
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Name the 2 types of Bone Growth?
- Long bones growth in length = interstitial growth.
- All other bones growth in thickness = appositional growth.
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Describe the process of Interstitial Growth.
- Epiphyseal Plate - a layer of hyaline cartilage in the epiphyses where bones cells are produced.
- ⬇︎
- Osteoblasts - move in to ossify the matrix to form bone.
- ⬇︎
- Early 20's epiphyseal plate completely ossifies to leve a thin epiphyseal line. Bone can no longer grow.
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If a bone fracture damages the epiphyseal plate during childhood, what might happen?
The fractured bone may be shorter than normal once adult bone formation is reached.
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Describe the process of Appositional Growth?
Osteoclasts resorb old bone that lines the medullary cavity, while osteoblasts, via intramembranous ossification, produce new bone tissue beneath the periosteum.
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How do hormones affect bone growth and remodelling (density)?
Hormones affect bone growth and remodelling by altering the ratio of osteoblast to osteoclast activity.
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What hormones affect a child and how?
- 1. Growth hormone - stimulate osteoblasts(bone-forming cells).
- 2. Thyroid hormone - promotes osteoblasts.
- 3. Cortisol(stress hormone) & steroid medications - Promotes osteoclasts (breaking down of bone cells).
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What hormones affect an adult and how?
- 1. Testosterone & Oestrogen - Promotes osteoblasts.
- 2. Calcitonin(lowers blood calcium) - Promotes osteoblasts.
- 3. Parathyroid hormone(increases blood calcium) - Promotes osteoclasts.
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What is the importance of Bone Homeostasis?
Bone is made up 99% calcium. Blood calcium levels have to be tightly controlled to ensure proper blood clotting, nerve and muscle function.
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What happens if blood calcium levels are too low?
Osteoclasts break down bone and release calcium into the blood. This is referred to as hypocalcemia.
Hypo =low
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What happens if blood calcium levels are too high?
An increased osteoblast activity takes calcium back into the bone. This is referred to as hypercalcemia.
Hyper =high
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How is calcium exchange regulated?
Calcium exchange is regulated by the parathyroid glands and the thyroid gland.
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Parathyroid Hormone:
1. Where is it produced?
2. Effect on blood calcium levels?
3. Describe its mechanism?
- 1. Parathyroid gland.
- 2. Increases blood calcium levels.
- 3. a. Increases osteoclast activityb. increased renal(kidney related) calcium absorption. c. increases calcitriol (active form of vitamin d).
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Calcitonin Hormone:
1. Where is it produced?
2. Effect on blood calcium levels?
3. Describe its mechanism?
- 1. Thyroid gland.
- 2. Decreases blood calcium levels.
- 3. a. Inhibits osteoclasts.
- b. Promotes osteoblasts.
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Why is Vitamin D so important to bones?
- 1. Vitamin D facilities calcium absorption.
- 2. Crucial for healthy bones.
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Vitamin D levels decrease with age. What other combination of factors could be associated?
- 1. Low sun exposure.
- 2. Reduced dietary absorption.
- 3. Reduced ability to produce an active form of vitamin D through liver, kidneys and skin.
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What chemical co-factor is needed for the conversion of vitamin d?
Magnesium.
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Why is exercise so important to bones?
- 1. Bones can become stronger in response to mechanical stress e.g. pull of skeletal muscle.
- 2. Mechanical stress leads to increased mineral deposition and increased production of collagen fibres.
- 3. Mechanical stress is important for ensuring bone formation occurs more quickly than bone resorption.
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How bones does the Axial Skeleton contain?
The axial skeleton is the 'central skeleton' and consists of 80 bones.
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What 5 parts consist of the Axial Skeleton?
- 1. Skull
- 2. Inner ear ossicles.
- 3. Throat hyoid bone.
- 4. Chest (thoracic cage).
- 5. Vertebral column.
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Describe the function of the Skull and what are the bones joined with?
- The Skull forms the cranium and face and encapsulates the brain.
- The skull bones are joined with fibrous joints called sutures.
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Describe the function of Sinuses?
Sinuses are spaces within the skull.
- 1. Communicate with nasal cavity.
- 2. Give resonance to the voice.
- 3. Lighten bones of face and cranium.
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How many vertebrae are there?
- There are 33 vertebrae. The upper 24 are articulating and separated from each other by intervertebral discs.
- The lower nine are fused in adults, five in the sacrum and four in the coccyx.
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Name and number the vertebrae in the human body?
- Cervical (7) C1-C7
- Thoracic (12) T1-T12
- Lumbar (5) L1-L5
- Sacrum (5 in human embryo) Fuse together once born.
- Coccyx (4 in human embryo) Fuse together once born.
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What are the vertebrae's function?
- 1.Protection.
- 2. Support.
- 3. Axis.
- 4. Movement.
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How many intervertebral discs are there?
There are 24 intervertebral discs which make up 1/3 of the length of spinal column.
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Name the 2 parts of the intervertebral discs and their function?
- Intervertebral discs are composed of an annulus fibrosus and a nucleus pulposus.
- 1. Annulus Fibrosus - strong radial tire–like structure made up of lamellaeThe annulus fibrosus encloses the nucleus pulposus.
- 2. Nucleus Pulposus - gel-like pad that absorbs shock.
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What does the Thoracic cage and Ribs consist of?
- Sternum.
- Ribs (12 pairs).
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Why are Ribs 11 + 12 called 'floating ribs'?
They are called 'floating ribs' because they are only attached to the vertebrae.
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How many bones in the Appendicular Skeleton and what is it's function?
- There are 126 bones in the appendicular skeleton.
- Their main functions are;
- 1. Body movement
- 2. Protects organs of digestion, excretion and reproduction.
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What are the 6 major areas of the Appendicular Skeleton?
- 1. Shoulder Girdle.
- 2. Arm.
- 3. Hand.
- 4. Pelvic Girdle.
- 5. Leg.
- 6. Foot.
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Name the main bones in the Arms and Shoulder.
- 1. Clavicle (collar bone).
- 2. Scapula (shoulder blade).
- 3. Humerus (funny bone).
- 4. Ulna (elbow)
- 5. Radius (arm bone).
- 6. Carpals (wrist bones).
- 7. Metacarpals ([meta=after/along], hand bones).
- 8. Phalanges (finger/toe bones).
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Name the main bones in the Pelvic Girdle?
- 1. Hip Bones.
- 2. Sacrum.
- 3. Coccyx.
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Name the main bones in the Leg?
- 1. Femur - (thigh bone) longest and strongest bone in the body.
- 2. Tibia (shin bone).
- 3. Fibular (lower leg bone).
- 4. Tarsals (anke bones).
- 5. Metatarsals ([meta=after/along], foot bones).
- 6. Phalanges (toe/finger bones).
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Muscle Origin and Insertion: Definition and Actions
- The muscle's points of attachment to bones or other muscles are designated as origin or insertion.
- 1. The part of the muscle that does move is is called the origin.
- 2. The part of the muscle that does move is called insertion.
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What fibrous structures are attached to muscles?
Tendons.
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Why are the attachment of joints so important to our muscles?
Attachments bridge one or more joints so that muscle contraction produces movement of these joints.
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How many joints are there in the human body?
187.
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What are the characteristics of fibrous joints and give an example?
- 1. Connected by dense connective tissue.
- 2. Limited movement.
E.g. Suture, like those between skull bones.
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What are the characteristics of cartilaginous joints and give an example?
- 1. Limited to no movement.
- 2. Connected by hyaline cartilage or fibrocartilage.
e.g intervertebral discs, epiphyseal growth plate.
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What are the characteristics of synovial joints and give an example?
- 1. Free movement.
- 2. Covered by a layer of hyaline cartilage called articular cartilage that reduces shock/friction.
- 3. Covered by articular capsule which unites articulating bones.
- 4. Contains synovial fluid.
e.g. ‘ball and socket’ (shoulder & hip) & hinge (elbow & knee).
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What are Bursae?
Bursae are sac-like structures that are strategically located to reduce friction.
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As well as the Bursae we also have Tendon Sheaths. What are these?
A tendon sheath is a layer of synovial membrane around a tendon.
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Describe what Angular Movements are?
Increase or decrease in the angle between bones.
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List the 8 angular movements?
- 1. Flexion - Decrease in angle (usually saggital plane)
- 2. Extension - Increase in angle (usually saggital plane)
- 3. Hyperextension - Extension beyond anatomical position
- 4. Rotation - movement around its longitudinal axis. In the limbs it can be medial
- (towards the midline) or lateral (away from the midline)
- 5. Lateral flexion - Movement of trunk away from the midline
- 6. Abduction – Movement away from Midline
- 7. Adduction – Movement towards Midline
- 8. Circumduction – Circular - flexion, abduction, extension, hyperextension,
- adduction in succession.
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What is hypermobility and how could it affect bones and joints?
- Joint hypermobility means that some or all of a person's joints have an unusually large range of movement.
- This can cause dislocations.
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List the 11 Special Movements?
Occur at specific joint:
- 1. Elevation - Superior movement (up)
- 2. Depression - Inferior movement (down)
- 3. Protraction - Anterior movement in transverse plane (forward).
- 4. Retraction - Posterior movement in transverse plane (backward)
- 5. Inversion – Medial movement of sole (turn in).
- 6. Eversion – Lateral movement of sole (turn out).
- 7. Dorsiflexion – Bending foot up.
- 8. Plantar flexion – Bending foot down.
- 9. Supination – Movement of forearm to turn the palm up.
- 10. Pronation – Movement of forearm to turn the palm posteriorly.
- 11. Opposition – Movement of thumb across palm to touch fingertips.
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What is a fracture and how is it caused?
A fracture is any break in a bone.
Causes included trauma, low bone density, Vitamin D deficiency.
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Name the 6 different classified Fractures.
- 1. Complete - completely separated.
- 2. Incomplete - remains intact/simple fracture.
- 3. Linear - along bone length.
- 4. Transverse - dissects across bone.
- 5. Compound - protrudes through skin.
- 6. Simple - does not protrude skin.
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Name the 4 stages of Fractures Repair?
- 1. Haematoma & Inflammation.
- 2. Fibrocartilaginous Callus Formation.
- 3. Bony Callus Formation.
- 4. Bone Remodelling.
-
Describe the 4 stages of Fractures Repair.
- Blood leaks into fracture site.
- ⬇︎
- Phagocytes breakdown damaged cells. Fibroblasts invade fracture site and lay down collagen forming a soft callus. (2-3 weeks).
- ⬇︎
- Osteoblasts replace fibrocartilage with new bone (3 months).
- ⬇︎
- The callus is mineralised & compact bone laid down. Osteoclasts reshape the new bone. (months-years).
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What are some treatments for a fracture?
Improve circulation and nutrients to the bone to aid repair.
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Describe what a sprain is and how to treat it?
- A sprain is when trauma forces the joint to go beyond its normal range.
- This causes stretching/tearing of ligaments.
-
What are ligaments?
Ligaments are bands of connective tissue that attach bone to bone. They are tougher than muscle but less flexible.
-
How would you normally treat a sprain?
RICE - Rest, Ice, Compression, Elevation
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What is a Subluxation?
Incomplete or partial dislocation of a joint or organ.
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What is a Dislocation?
Complete separation of two bones at a joint.
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Name a complication due to Dislocation?
Soft tissue damage possibly involving nerves and blood vessels.
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What are X-Rays used for?
Commonly used to visualise lungs, heart, teeth and skeletal system.
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What do X-Rays release upon a specified region in the body?
Electromagnetic Radiation.
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How does an X-Ray work?
- An X-ray will pass through less dense matter like air, fat, muscle, but absorbed or scattered by denser materials such as bones, lungs affected by severe
- pneumonia, appearing white.
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What is one of the main side affects of having an X-Ray.
The radiation can cause cancer.
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Describe what Kyphosis is?
A normal healthy spine curve will include a thoracic spine kyphosis.
[Kyphos] - hump
-
What is the term called when one has an excess curvature of the upper back?
Exaggerated Kyphosis.
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Describe what Lordosis is?
A normal, healthy spinal curve will include a cervical spine and lumbar spine lordosis.
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When would Lordosis be adapted in women?
During pregnancy to support the cervical and lumbar spine.
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What are some of the side affects of exaggerated lordosis?
- 1. Muscular Fatigue.
- 2. Encourages the vertebral joints to move closer causing inflammation.
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What is Scoliosis?
A lateral 'S' shaped curve in the spine.
-
What symptoms does a Scoliolisis have?
People often live with a scoliosis and are asymptomatic.
-
What damage can Scoliosis do?
Scoliosis can build up pressure on the nerves and cause spinal nerve impingement.
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What is Osteoporosis?
Chronic, progressive thinning of the bone.
-
How is Osteoporosis characterised?
It's characterised by decreased bone mineral density (BMD).
-
Name the 2 types of Osteoporosis?
- 1. Primary osteoporosis: Age related or idiopathic (unknown cause).
- 2. Secondary osteoporosis: Secondary to
- another condition/medication/lifestyle.
-
What type of scan would you use to measure BMD?
a Dexa Scan.
-
What 2 types of readings are there in a Dexa Scan?
- 1. T-Score (compared to young normal adult of same sex -age 30)
- 2. Z-Score <50yrs (compared to normal adult of same age, sex, height)
-
What are the risk factors for Osteoporosis?
- 1. Increasing age. (over 30 years o age the ability o retain calcium lowers).
- 2. Female & Post-menopausal.
- 3. Poor diet.
- 4. Drugs.
- 5. High alcohol consumption and smoking.
- 6. Genetics.
- 7. GIT diseases - liver disease, malabsorption syndromes.
- 8. Sedentaty lifestyle - little or no physical activity.
- 9. Endocrine problems - e.g. hyperparathyroidism, hyperthyroidism, inability to produce oestrogen.
- 10. Toxins (metals).
- 11. Low body weight.
-
What are the signs of Osteoporosis?
Asymptomatic until the bone has reached critical thinness whereby fragility fractures occur spontaneously with minor trauma.
-
What are the symptoms and side affects of Osteoporosis?
- Pain is usually severe.
- Pain is aggravated by increased sitting, standing or bending.
- Rib or spinal deformities such as kyphotic posture.
- Loss of height due to vertebral crushing and fracture.
-
Treatment of Osteoporosis: Give one Allopathic and one Alternative?
Allopathic: Bisphosphonates (Aledronic Acid) – Inhibit osteoclast activity.
Alternative: Healthy non acidic diet.
-
Describe Osteomalacia & Rickets?
- [Osteo] =bone [malacia] = 'softening'
- Osteomalacia is characterised by decalcification of bone and 'softening'.
- Rickets occurs in patients under 18 years old.
- Osteomalacia occurs in adults or adolescents.
-
What are some causes of Osteomalacia & Rickets?
- Mainly caused by Vitamin D Deficiency.
- Could also have a secondary deficiency: malabsorption disorders.
-
What are the signs and symptoms of Osteomalacia & Rickets?
- 1. Deformed bones (bowing of legs).
- 2. Severe back pain.
- 3. Severe muscle weakness.
- 4. Fracture
- 5. In rickets: Delayed closure of fontanelles and skull softening.
-
What is Hypercalcaemia?
[Hyper] =elevated [calc] =calcium [aemia] = in the blood
Elevated blood calcium.
-
What are some causes of Hypercalcaemia?
- 1. Uncontrolled release of calcium from bones e.g. tumour.
- 2. Hyperparathyroidism.
(hyperparathyroidism, an enlargement of one or more of the parathyroid glands causes overproduction of the hormone, resulting in high levels of calcium in the blood)
-
What are some signs and symptoms of Hypercalcaemia?
- 1. Muscle weakness.
- 2. If high calcium is coming from the bones, bone density will be compromised and fractures may occur.
-
What is Osteomyelitis?
[Osteo] = bone [myelo] = marrow [itis] = inflammation
- A bacterial infection of the bone marrow resulting in necrosis(death of cells) of bone cells and hence becomes weak.
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