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INFECTION leads to INFLAMMATION of tisses by |
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TRANSMISSION via the bloodstream through the skin and/or open wounds |
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Although infections can kill, only in the most severe cases is there any evidence on the bone. |
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Diseases in the past may now be extinct or unknown nowadays e.g. Hungry Hall Mounds. |
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An infection of the bone due to bacteria, degeneration or trauma. |
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Infection of the periosteum. |
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Infection of the bone and bone marrow - bone swells rather than breaks. |
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90% Staphylococcus aureus and to a lesser extent, Streptococcus. |
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If we are talking about osteomyelitis following trauma, then.. |
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limb and cranial injuries will probably less lethal than abdominal injuries. |
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If we are talking about osteomyelitis following trauma, then limb and cranial injuries will probably less lethal than abdominal injuries, therefore evidence of osteomyelitis is more likely to be found in... |
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the cranium and limbs than in the skeleton or the trunk. |
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What does the course of Pyogenic Osteomyelitis involve? |
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In Pyogenic Osteomylitis, what spreads through the marrow cavity and raises the periosteum? |
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Areas of dead bone developed in Pyogenic Osteomyelitis. |
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A new bone which is grown as a response to the periosteum. |
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area of bone growth on the ends of the diaphysis |
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What usually doesn't appear on the metaphysis? |
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Why isn't there usually a necrosis on the metaphysis? |
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Because the pus can easily drain through the cortex. |
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When were infections more common? |
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After lifestyles changed from hunting to agriculture. |
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Why were infections more common after lifestyle changes? (2) |
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(1) With sedentism there is an accumulation of wastes and infectious organisms. (2) Once people sedentary then even mild wounds often result in infection, especially on the tibiae Also the change in diet substitutes a varied but less reliable diet for less varied but more reliable diet. |
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What are the best known infectious diseases? (3) |
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(1) Tuberculosis (2) Syphilis (3) Leprosy |
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A disease of the bones and joints is caused by the Mycobacterium tuberculosis (human or bovine type). |
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How does Tuberculosis usually penetrate? |
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Through the respiratory tract. |
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What is the primary focus of the penetration of Tuberculosis through the respiratory tract? (2) |
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In Tuberculosis, if the lesion fails to heal, what may spread vis the bloodstream? |
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Skeletal TB is only how much of all the incidences of the disease? |
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Who is Tuberculosis more common in? |
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Where are preferred sites for skeletal lesions in Tuberculosis? |
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In areas with hemopoietic (red) marrow and TB found in tarsal, carpals, epiphyses, diaphyses, and in cranial vault. |
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Upper ends of long bones and the spine. |
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Areas with hemopoietic (red) marrow. |
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Tuberculosis of the spine |
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What part of the spine is often involved in Pott's Disease? |
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The lumbar, but also the lower thoracic region. |
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What is the most usual portion of the vertebra involved in Pott's disease? |
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In Pott's Disease, the destruction of vertebral body leads to what? (2) |
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(1) The weakening and a forward collapse of the bodies (2) causing a sharp angular kyphosis (known as gibbus) - that is a hunch back appearance of the spine. |
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The adjoining auricular surfaces |
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Which joint is an extension of spinal T.B.? |
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In Tuberculosis of the hip, which joint has the most common involvement? |
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In Tuberculosis of the hip, what is formed into soft tissue which can eat right into the bone? |
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What is the problem with T.B.? |
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Which disease has literary references found to ancient history in the Old world, and was brought to the New World via colonization? |
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Leprosy (Hansen's disease) |
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What is Leprosy caused by? |
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How is leprosy contagious? |
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Through skin contact or inhaling bacterium. |
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No, you can live for a long time. |
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By attacking the peripheral nerves. |
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In Leprosy, what happens with the loss of nerve supply? (2) |
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(1) There is a loss of sensation and (2) eventual bone atrophy. |
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What characteristics did Moller Christenson find present in the bones of lepers? (3) |
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(1) Disappearance of anterior nasal spine. (2) Rounding and widening of nasal aperture. (3) Partial resorption of premaxillary alveolar area with or without the loss of the upper incisors. |
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is one of a group of treponemal infection. |
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Syphilis is one of a group of treponemal infections (Anaerobic parasite belonging to Genus Treponema) which includes: (4) |
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(1) pinta (does not affect the skeleton) (2) yaws (3) endemic syphilis (bejel) (4) venereal syphilis |
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What area of the world does Yaws typically afflict? |
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Definition
In humid tropical regions. |
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In Yaws, how do the infecting organisms affect the body? |
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They enter through the skin or mucous membranes. |
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When is Yaws primarily acquired? |
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The bending of what bone is observed in Yaws? |
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What does late Yaws show? (2) |
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(1) Destructive inflammation of single phalanges (dactylitis) (2) affects long bones, especially the tibia, radius and ulna. |
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What do the bones in late Yaws show? (2) |
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Definition
gummy tumors and osteomyelitis |
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Nasal voice in Spanish due to the destruction of the nasal septum and hard palate |
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Which disease is non venereal? |
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Definition
Endemic Syphilis (Bejel or Treponarid) |
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Where is endemic syphilis found? |
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Definition
Nowadays it is only found in underdeveloped countries with warm arid climates, but it was found historically in Ireland, Norway, Greece and Russia. |
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When and how is endemic syphilis acquired? |
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Definition
It is acquired in childhood under non-hygienic conditions - body contact, sharing food and drink. As living conditions improve, the incidence of bejel decreases. |
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How common are bone lesions in Endemic Syphilis? |
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What bones are most frequently affected in endemic syphilis? |
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The tibia and fibula then the radius and ulna, and finally the clavicle, phalanges, and calcaneus. |
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In endemic syphilis, what are the favored sites of bony changes? |
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In endemic syphilis, are joint lesions common or rare? |
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In endemic syphilis, bone lesions are like those of which other diseases? (2) |
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Yaws and venereal syphilis |
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What are the two forms of venereal syphilis? |
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What type of venereal syphilis invades the fetus of an affected mother after the third or fourth month in utero, and is spread to virtually every bone in the body. |
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What are the two categories of bony involvement with congenital syphilis? |
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(1) early congenital syphilis: birth to 3/4 years and (2) late congenital syphilis: 5-15 years this is a flare up of an earlier case. |
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In early congenital syphilis, almost all cases have bone involvement, but how many cases will heal, leaving no trace of the disease? |
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Are bone lesions more or less rare in late congenital syphilis? |
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Bone lesions are more rare, but more serious. |
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In venereal congenital syphilis, what are the major teeth involved? |
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Definition
Maxillary incisors and all the first molars. |
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Incisors with a notch through the middle of the incisal surface in venereal congenital syphilis. |
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Are smaller than the normal molar and the occlusal surface is very rough and irregular. |
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How is venereal syphilis acquired? |
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Passed through sexual contact or through the birth process via a chancre or sore, or via the blood stream. |
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Tertiary syphilis in long bones |
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An abnormal increase in bone density due to infection. |
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Soft tumors which contain bacteria and erode the cranial surface in venereal acquired syphilis. |
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How do stellate lesions appear? |
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With nasal bone involvement in tertiary syphilis, thin bones are destroyed resulting in damage or loss of which bones? (3) |
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(1) nasal septum, hard palate, and medial walls of the maxillary sinuses. |
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an inflammation of the joints |
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Specific to age and changes as articular cartilage of synovial joints breaks down and bone abrades on bone - eburnation. |
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A buildup of new bone at joint surfaces. |
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Sets up after an injury or systemic disease such as tuberculosis. |
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What are the causes of osteoarthritis? (4) |
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1. aging joints lose some vascular supply therefore cannot heal themselves 2. unusual wear and tear - by athletes 3. genetics - studies on mice show a genetic predisposition 4. diet - carrageenan (ice cream) produces arthritis in rats. |
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Arthritis found in intervertebral joints (secondary cartilaginous joints) |
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Where and with whom is Osteophytosis prevalent? |
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Definition
In all N. Am. over the age of 60 and a higher male incidence |
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What occurs in Osteophytosis? |
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Definition
Gradual degeneration of intervertebral discs. |
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Herniations into the body of the vertebrae. |
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is a collagen disease with an autoimmune component. |
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Rheumatoid Arthritis involves thickening of the what that leads to swelling of the joints? |
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Who is Rheumatoid Arthritis more commonly found in? |
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Definition
It is three times more common in women than men. |
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Which joints do Rheumatoid Arthritis especially affect? |
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Definition
The metacarpal joints and the interphalangeal joints. |
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is a chronic inflammatory disease affecting the spine. |
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Who does Ankylosing spondylitis primarily affect? |
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Is Ankylosing spondylitis genetic? |
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A disease which is present at birth, can include a cleft lip and palate, and achondroplastic dwarfism. |
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slow growing and non harmful |
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rapidly growing e.g. osteosarcoma (Ted Kennedy's son) |
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Button osteoma, a benign tumor |
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Malignant tumor, Osteosarcoma |
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Pituitary dwarfism (caused through deficiency of growth hormone due to malfunction of pituitary.) |
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Metabolic Disorders include: |
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Definition
dietary deficiencies rickets and scurvy |
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Definition
diseases of the blood forming tissues which can be either genetic or acquired. |
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What is a type of anemia? |
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How can anemia become acquired? |
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Due to diets low in meat and iron and also malnutrition |
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In anemia, what expands in bones where the blood formation is supposed to take place. |
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What do lesions associated with anemia usually affect? |
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The lesions associated with anemia which usually affect the skull vault lead to what? |
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Definition
A porous periosteum called porotic hyperostosis. |
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