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59-RNSG 2432-online Mod_17 Notes Su07

59-RNSG 2432-online Mod_17 Notes Su07 -...

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NOTES Musculoskeletal  cmj Module #17: Musculoskeletal: Autoimmune, Inflammatory, Metabolic, & Infectious  Disorders. Part I  Autoimmune/Inflammatory  (RA/SLE/ALk/Sclero/Lyme) Etiology/Pathophysiology  (general) Complete PDS-Ms Michaels  A. Normal physiology- autoimmune/inflammatory musculoskeletal disorders. 1. Commonly called “arthritis”; more than 100 types of “arthritic”  disorders affecting skeletal  system: focus- “chronic systemic disorder” 2. Diffuse inflammatory lesions and degenerative changes in connective tissue 3. *Review osteoarthritis (p. 1239-1241) Rheumatoid Arthritis A. Etiology/Pathophysiology of Rheumatoid Arthritis 1. Normal antbodies become autoantibodies (rheumatoid factors or RF); attack host tissues  which bind with target antigens in blood and with synovial membranes > immune  complexes. 2. Synovial membrane damaged from inflammatory and immune processes > erosion of  articular cartilage and inflammation of ligaments and tendons.  3. Granulation tissue (pannus ) forms over denuded areas of synovial membrane and scar  tissue > immobilizing joint. (p. 1249 Fig  39-5).  See joint changes and deformities in  Power Point as disease progresses (refer to PPT slides in “Required” resources).  What  is “pannus”   (p. 1249)  4. Diarthroidal      or synovial joints - primarily involved.  RNSG 2432 125 Moderately advanced  pannus  formation
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5. Compare to osteoarthritis (as above). B. Common Manifestations/Complications of Rheumatoid Arthritis  1. Joint manifestations a. Onset insidious; may be acute after stressor b. Systemic manifestations (See p.1251)  c. Joint swelling- stiffness, warmth, tenderness and pain; usually multiple joints;  symmetric involvement, small, non-weight bearing joints d. Proximal interphalangeal and metacarpophalangeal joints of fingers, wrists, knees,  ankles, and toes most frequent. Assessment RA Deformities that may occur with RA Synotenovitis Ulnar drift Swan neck deformity Boutonniere deformity e. Joint deformity results: swan neck and boutoniere; wrist deformity, etc. See p. 1250  fig 39-6
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