What refers to diseases of the musculoskeletal system. The most-most muscles of the body

Musculoskeletal system- one of the strongest human organ systems. The musculoskeletal system is the framework for the human body and makes it possible to walk upright.

The skull consists of 8 bones connected in pairs. They must be perfectly symmetrical. The bones of the skull can move and shift. The skull protects the human brain from physical damage and strictly follows its shape. Displacement of the skull bones at birth can cause cerebral paralysis, strabismus and hearing loss. This may be caused by a misalignment of the mother's pelvic bones. After birth, they gradually become harder, but still, they can be adjusted.

The spine consists of 7 cervical, 12 thoracic and 5 lumbar. If you look at a person in profile, you can see that there are 2 deflections. 1 in the neck area and 1 in the lumbar area. Spinal deflections allow you to relieve stress from the spinal discs. Between the vertebral discs there is a nucleus pulposus, which acts as a shock absorber.

Inside the cervical vertebrae there are openings through which the jugular veins and cervical arteries pass. This connection provides cerebral circulation. The habit of sleeping on a high pillow and any movements that permanently displace cervical vertebrae or injure them, can impair blood circulation and cause chronic diseases and stroke.

At the bottom of the spine, the hip joints are attached to the sacrum. The natural deflection of the spine in the lower back allows you to remove the load from it, shifting the center of gravity from it. If you remove the deflection, the sacrum will wedge into the pelvic bones. Excessive load will rest on the spinal discs, which will ultimately lead to injury.

The pelvic bones should be at the same level. The habit of carrying weights on one side of the body, using only one leg as a support leg can be the cause of pelvic confusion.

The displacement of the pelvic bones can be determined by the displacement of the level of the shoulders. With the left shoulder raised, the right leg will be “shorter,” that is, higher. And vice versa. This causes general asymmetry of the body, and as a result, heart pain, mastopathy, and kidney problems can occur.

Anything that goes numb or hurts in the muscular system, if it is not associated with direct damage, is most often a consequence of the general asymmetry of the body and compressed current, pinching the nerves going from and to the spine.

Scoliosis is not a condition of the spine, it is a condition of the pelvic bones, which act as the foundation.

When a person constantly shifts body weight to one side, the foot bends greatly. To prevent a person from falling, a bone grows on the big toe, then there will be cartilage and a seal. If a bone grew on both legs, it means that the person first stood on one leg, then it began to hurt, and he began to stand on the other.

You can straighten the pelvis with gymnastics and manual therapy.

Inflammatory processes in the joints, if there have been no injuries, are a consequence of diseases. Under each joint there are lymph nodes. If the body is affected by any infection (streptococcus, chlamydia, etc.), thrombosis of the lymph nodes occurs. Fluid will accumulate and pool in the joint. If the body lives for a long time or lymphatic filtration occurs, that is, every day, along with the infection, the cartilage that the infection has affected will become thinner.

In this case, you need to undergo an antibacterial, antiviral and antifungal program.

The fluid in the joint should be clear. The quality of the joint fluid can be determined by the condition of the nails. Nails are frozen joint fluid that flows out evenly and hardens every day. Nails should be transparent and hard. If the nails are grooved, then something is wrong with the liquid.

If there is a fungus on the nails, the same fungus is in the joint fluid, and it is worth treating the entire body for a fungal infection.

If the nails peel off, there is a deep violation mineral metabolism, plus the remains of fungi are washed away.

White dots on nails are not digested protein. Protein metabolism disorder means that proteins are not absorbed or digested

If there are white or slightly pinkish stripes on the nails, this may indicate salt poisoning heavy metals and liver pollution.

If there is cervical osteochondrosis, the joint fluid will flow out unevenly, and accordingly, bumps will form on the nails.

The spine must be treated, starting with the pelvic bones. Chinese or Japanese gymnastics will be a good choice.

Strabismus and crooked teeth can result from uneven skull bones.

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Musculoskeletal system Butakova video

1. Ecology.

Does not affect.

2.Food.

Lack of calcium, silicon, phosphorus, sulfur or amino acids may have an effect. The diet should be complete.

3. Water.

In its absence, the vertebral discs dry out and elasticity decreases.

4. Psychology.

Does not affect

5. Injuries.

They are of great importance. Damage to one element of the system forces others to adjust. Harmony is broken.

6. Heredity.

Deformed bones can be inherited, especially teeth, as the shape of the skull and facial proportions are passed on.

Scoliosis is not inherited.

Transmitted appearance, internal structure, not a disease.

7.Medicine.

Does not affect.

They cause inflammatory processes. One of the most severe is psoriatic arthritis.

9. Movement.

It has a very strong impact. Must be observed correct technique performing exercises and avoiding unsuccessful poses. It is advisable to sleep only on your back and with a cushion under your neck.

Algorithm for restoration of the musculoskeletal system

1. Movement. Understand how correctly physical activity is given.
2. Water. Increase the amount of water in the body.
3. Injuries. Remove the consequences of each injury.

As a result of injury, bone deformation occurs. Infringement of blood vessels and nerve conductors occurs. After a concussion, you may experience lifelong nausea.

Injury to the back of the skull can lead to loss. There are visual puffs there, which can be put under pressure by an unreduced bone.

After an injury, strabismus may appear. The eyes located in the orbits of the eye sockets will adjust. The brain will do the same.

In case of injury to the cervical vertebrae, the arteries responsible for the blood supply to the brain will be compressed. The same thing can happen if you don't sleep properly.

If pinched vertebral artery below the ears, a noise or ringing in the ears will be heard. The pressure of blood will be heard.

In order for the neck to straighten, it is necessary to correct the base of the bone muscular system- pelvic joints. And then train the muscle corset.

Diseases musculoskeletal system extremely varied. They can be roughly divided into diseases of the skeletal system, joints and skeletal muscles.

Diseases of the skeletal system

Diseases of this group can be dystrophic, inflammatory, dysplastic and tumoral in nature. Dystrophic diseases bones (osteodystrophy) are divided into toxic (for example, Urovsky disease), nutritional (for example, rickets - see. Vitamin deficiencies), endocrine, nephrogenic (see. Kidney diseases). Among dystrophic bone diseases, the most important is parathyroid osteodystrophy. Inflammatory bone diseases are most often characterized by the development of purulent inflammation of the bone marrow (osteomyelitis), often bone tissue is affected by tuberculosis and syphilis (see. Infectious diseases). Dysplastic bone diseases are most common in children, but can also develop in adults. Among them, the most common fibrous bone dysplasia, osteopetrosis, Paget's disease. Against the background of dysplastic bone diseases, tumors bone tissue (cm. Tumors).

Parathyroid osteodystrophy(Recklinghausen's disease, generalized osteodystrophy) is a disease caused by hyperfunction of the parathyroid glands and accompanied by generalized skeletal damage. The disease occurs mainly in women 40-50 years old, rarely in childhood.

Etiology. Parathyroid osteodystrophy is associated with primary hyperparathyroidism, which is caused by adenoma of the parathyroid glands or hyperplasia of their cells (cancer is very rare). Primary hyperparathyroidism should be distinguished from secondary hyperparathyroidism, which develops with chronic renal failure, multiple cancer metastases to the bones, etc. The importance of hyperfunction of the parathyroid glands in the development of bone pathology was first substantiated by A.V. Rusa-

kov (1924), who proposed for the treatment of bone pathology surgical removal tumors of the parathyroid glands.

Pathogenesis. Increased synthesis of parathyroid hormone causes increased mobilization of phosphorus and calcium from the bones, which leads to hypercalcemia and progressive demineralization of the entire skeleton. Osteoclasts are activated in bone tissue, and foci of lacunar bone resorption appear. Along with this, diffuse fibroosteoclasia increases - bone tissue is replaced by fibrous connective tissue. These processes are most intensely expressed in the endosteal parts of the bones. In areas of intense restructuring, bone structures do not have time to mature and calcify; osteoid tissue, cysts, cavities filled with blood and hemosiderin are formed. Bone deformation and osteoporosis progress, and pathological fractures often occur. Formations appear in the bones that are indistinguishable from giant cell tumors (osteoblastoclastoma, according to A.V. Rusakov). In contrast to true tumors, these are reactive structures, which are giant cell granulomas in foci of organization of blood accumulations; they usually disappear after removal of the parathyroid tumor.

Hypercalcemia, which develops with parathyroid osteodystrophy, leads to the development of calcareous metastases, see. Disorders of mineral metabolism (mineral dystrophies). Nephrocalcinosis often develops, combined with nephrolithiasis and complicated by chronic pyelonephritis.

Pathological anatomy. IN parathyroid glands Most often, adenoma is found, less often - cell hyperplasia, and even less often - cancer. The tumor may have an atypical localization - in the thickness thyroid gland, mediastinum, behind the trachea and esophagus.

Skeletal changes in parathyroid osteodystrophy depend on the stage and duration of the disease. IN initial stage illness and low parathyroid hormone activity external changes bones may be missing. In an advanced stage, deformation of bones is detected, especially those that are exposed to physical activity- limbs, spine, ribs. They become soft, porous, and can be easily cut with a knife. Bone deformation can be caused by multiple tumor-like formations, which have a variegated appearance when cut: yellowish areas of tissue alternate with dark red and brown ones, as well as cysts.

At in the bone tissue, foci of lacunar resorption are identified (Fig. 243), neoplasms of fibrous tissue, and sometimes osteoid beams. In the foci of tumor-like formations, giant cell granulomas, accumulations of erythrocytes and hemosiderin, and cysts are found.

Death In patients, it often occurs from cachexia or uremia due to shrinkage of the kidneys.

Rice. 243. Parathyroid osteodystrophy. Lacunar bone resorption (shown by arrows) and new formation of fibrous tissue (according to M. Eder and P. Gedik)

Osteomyelitis

Under osteomyelitis(from Greek osteon- bone, myelos- brain) understand inflammation of the bone marrow, spreading to the compact and spongy bone and periosteum. Osteomyelitis is divided into the nature of the current - on spicy And chronic, according to the mechanism of bone marrow infection - on primary hematogenous And secondary (a complication of injury, including a gunshot wound, during the transition of the inflammatory process from surrounding tissues). Primary hematogenous osteomyelitis is of greatest importance.

Primary hematogenous osteomyelitis can be acute and chronic. Acute hematogenous osteomyelitis, usually develops in at a young age, 2-3 times more often in men. usually the outcome of an acute

Etiology. In the occurrence of osteomyelitis, the main role is played by pyogenic microorganisms: hemolytic staphylococcus (60-70%), streptococci (15-20%), coliform bacilli (10-15%), pneumococci, gonococci. Less commonly, fungi can be causative agents of osteomyelitis. The source of hematogenous spread of infection can be an inflammatory focus in any organ, but often the primary focus cannot be detected. It is believed that such patients have transient bacteremia due to minor intestinal trauma, dental diseases, and upper respiratory tract infections.

Pathogenesis. The peculiarities of the blood supply to bone tissue contribute to the localization of infection in long tubular bones. Usually purulent process begins with the bone marrow spaces of the metaphyses, where blood

the flow is slow. Subsequently, it tends to spread, causing extensive necrosis and spreading to the cortical bone, periosteum and surrounding tissues. Purulent inflammation spreads along the bone marrow canal, affecting more and more areas of the bone marrow. In children, especially newborns, due to the weak attachment of the periosteum and the peculiarities of the blood supply to the cartilage of the epiphyses, the purulent process often spreads to the joints, causing purulent arthritis.

Pathological anatomy. At acute hematogenous osteomyelitis the inflammation is phlegmonous (sometimes serous) in nature and involves the bone marrow, Haversian canals and periosteum; Foci of necrosis appear in the bone marrow and lamina compacta. Severe bone resorption near the epiphyseal cartilage can cause separation of the metaphysis from the epiphysis (epiphysiolysis), mobility and deformation of the periarticular zone appear. Around the foci of necrosis, tissue infiltration with neutrophils is determined, and blood clots are found in the vessels of the lamina compacta. Abscesses are often found under the periosteum, and phlegmonous inflammation is found in the adjacent soft tissues.

Chronic hematogenous osteomyelitis associated with chronic suppurative process, formation bone sequesters. Granulation tissue and a capsule are formed around the sequesters. Sometimes the sequestrum floats in a cavity filled with pus, from which fistulous tracts extend to the surface or cavities of the body, to the cavity of the joints. Along with this, bone formation is observed in the periosteum and medullary canal. Bones become thick and deformed. Endosteal bone growths (osteophytes) can lead to obliteration of the medullary canal, and the compact lamina thickens. At the same time, focal or diffuse irritation of the bone occurs due to its resorption. Foci of suppuration in soft tissues during chronic course hematogenous osteomyelitis usually scars.

Special shape chronic osteomyelitis is Brody's abscess. It is represented by a cavity filled with pus, with smooth walls, which are lined from the inside with granulations and surrounded by a fibrous capsule. In granulation tissue, many plasma cells and eosinophils are detected. No fistulas are formed, bone deformation is insignificant.

Complications. Bleeding from fistulas, spontaneous bone fractures, formation of false joints, pathological dislocations, development of sepsis; in chronic osteomyelitis, secondary amyloidosis is possible.

Fibrous dysplasia

Fibrous dysplasia(fibrous osteodysplasia, fibrous bone dysplasia, Lichtenstein-Braitsev disease) is a disease characterized by the replacement of bone tissue with fibrous tissue, which leads to bone deformation.

Etiology and pathogenesis. The reasons for the development of fibrous dysplasia are not clear enough, and the role of heredity cannot be ruled out. Think that

The disease is based on a tumor-like process associated with improper development of osteogenic mesenchyme. The disease often begins in childhood, but can develop in young adulthood and old age. The disease predominates in females.

Classification. Depending on the distribution of the process, two forms of fibrous dysplasia are distinguished: monoosseous, in which only one bone is affected, and polyostotic, in which several bones are affected, mainly on one side of the body. The polyostotic form of fibrous dysplasia can be combined with melanosis of the skin and various endocrinopathies (Albright's syndrome). The monostotic form of fibrous dysplasia can develop at any age, the polyostotic form - in childhood, therefore, patients with this form of fibrous dysplasia have diffuse skeletal deformation and a predisposition to multiple fractures.

Pathological anatomy. In the monoosseous form of fibrous dysplasia, the ribs, long tubular bones, scapulae, and skull bones are most often affected (Fig. 244); with the polyostotic form - over 50% of the bones of the skeleton, usually on one side. The lesion may involve a small area or a significant part of the bone. In tubular bones it is localized mainly in the diaphysis, including the metaphysis. The affected bone at the beginning of the disease retains its shape and size. Subsequently, areas of “bloating”, bone deformation, elongation or

shortening. Under the influence of static load, the femurs sometimes take on the shape of a shepherd's crook. When the bone is cut, clearly defined foci of a whitish color with reddish inclusions are identified. They are usually round or elongated, sometimes merging with each other; in places of “swelling” the cortical layer becomes thinner. The medullary canal is expanded or filled with newly formed tissue, in which pockets of bone density and cysts are identified.

At microscopic examination foci of fibrous dysplasia are represented by fibrous fibrous tissue, among which poorly calcified bone beams of a primitive structure and osteoid beams are identified (see Fig. 244). Fibrous tissue in some areas consists of chaotically located bundles of mature collagen fibers and spindle cells, in other areas - from developing (thin) collagen fibers and stellate cells. Sometimes myxomatous foci, cysts, accumulations of osteoclasts or xanthoma cells, and islands of cartilaginous tissue are found. Some features of the histological picture of fibrous dysplasia of the facial bones are noted: the dense component in the foci of dysplasia can be represented by cement-type tissue (cementicle-like formations).

Complications. Pathological bone fractures are the most common. In young children, often during their first attempts to walk, the femur is especially likely to break. Fractures upper limbs rare. Typically, fractures heal well, but bone deformation increases. In a number of observations, sarcoma develops against the background of fibrous dysplasia, often osteogenic.

Osteopetrosis

Osteopetrosis(marble disease, congenital osteosclerosis, Albers-Schönberg disease) is a rare hereditary disease in which there is generalized excessive bone formation, leading to thickening of the bones, narrowing and even complete disappearance of the medullary spaces. Therefore, osteopetrosis is characterized by a triad: increased density bones, their fragility and anemia.

Etiology and pathogenesis. The etiology and pathogenesis of osteopetrosis have not been sufficiently studied. Undoubtedly, the participation of hereditary factors is associated with impaired development of bone and hematopoietic tissue. In this case, excessive formation of functionally inferior bone tissue occurs. It is believed that the processes of bone production prevail over its resorption, which is associated with the functional failure of osteoclasts. The increasing displacement of bone marrow by bone is associated with the development of anemia, thrombocytopenia, the appearance of foci of extramarrow hematopoiesis in the liver, spleen, lymph nodes, which leads to their increase.

Classification. There are two forms of osteopetrosis: early (autosomal recessive) and late (autosomal dominant). Early

form osteopetrosis manifests itself in early age, has a malignant course, often ending in death; late form proceeds more benignly.

Pathological anatomy. With osteopetrosis, the entire skeleton can be affected, but especially the tubular bones, bones of the base of the skull, pelvis, spine, and ribs. In the early form of osteopetrosis, the face has characteristic appearance: it is wide, with widely spaced eyes, the root of the nose is depressed, the nostrils are turned out, the lips are thick. With this form, hydrocephalus, increased hair growth, hemorrhagic diathesis, and multiple bone lesions are noted, while in the late form of osteopetrosis, bone damage is usually limited.

The outlines of the bones may remain normal, with only a flask-shaped expansion characteristic lower sections femurs. Bones become heavy and difficult to saw. On cuts in long bones the medullary canal is filled with bone tissue and is often not detected. In flat bones, the medullary spaces are also barely visible. In place of the spongy substance, dense, homogeneous bone tissue is found, reminiscent of polished marble ( marble disease). Bone growth in the area of ​​the holes and canals can lead to compression and atrophy of the nerves. The most common atrophy is associated with this optic nerve and blindness due to osteopetrosis.

Microscopic picture extremely unique: pathological bone formation occurs throughout the entire bone, the mass of bone substance is sharply increased, the bone substance itself is randomly piled up in the internal parts of the bones (Fig. 245). Bone marrow

Rice. 245. Osteopetrosis. Disorderly accumulation of bone structures (according to A.V. Rusakov)

the spaces are filled with randomly arranged layered bone conglomerates or lamellar bone with arcuate lines of adhesion; Along with this, beams of embryonic coarse fibrous bone are found. Single areas of ongoing bone formation are visible in the form of clusters of osteoblasts. Osteoclasts are rare, signs of bone resorption are insignificant. The architecture of the bone, due to the disordered formation of bone structures, loses its functional characteristics, which is obviously associated with bone fragility in osteopetrosis. In zones of enchondral ossification, cartilage resorption is practically absent. On the basis of the cartilage, peculiar rounded islands of bone beams are formed, which gradually turn into wide beams.

Complications. Bone fractures often occur, especially the femur. In places of fractures, purulent osteomyelitis often develops, which is sometimes a source of sepsis.

Causes of death. Patients with osteopetrosis often die in early childhood from anemia, pneumonia, and sepsis.

Paget's disease

Paget's disease(deforming ostosis, deforming osteodystrophy) - a disease characterized by increased pathological restructuring of bone tissue, a continuous change in the processes of resorption and new formation of bone substance; in this case, the bone tissue acquires a peculiar mosaic structure. The disease was described in 1877 by the English physician Paget, who considered it inflammatory and called it deforming osteitis.

Later, the inflammatory nature of the disease was rejected, and the disease was classified as a dystrophic disease. A.V. Rusakov (1959) was the first to prove the dysplastic nature of Paget's disease.

The disease is observed more often in men over 40 years of age, progresses slowly, and usually becomes noticeable only in old age. It is believed that asymptomatic forms of the disease occur with a frequency of 0.1-3% in different populations. The process is localized in long tubular bones, skull bones (especially facial), pelvic bones, vertebrae. The lesion may involve only one bone (monostotic form) or several often paired or regional bones (polyostotic form), but it is never generalized, which distinguishes Paget's disease from parathyroid osteodystrophy.

Etiology. The reasons for the development of the disease are not known. Violation of phosphorus-calcium metabolism, viral infection as possible reason Paget's disease is excluded, but the familial nature of the disease is noted. The dysplastic nature of bone lesions in Paget's disease is evidenced by the non-functional nature of bone restructuring and the frequent development of sarcoma against this background.

Patho- and morphogenesis. The processes of bone tissue restructuring in Paget's disease occur continuously, their connection with functional load absent. Depending on the relationship between the process of osteolysis and osteogenesis, 3 phases of the disease are distinguished: initial (osteolytic), active (a combination of osteolysis and osteogenesis) and inactive (osteosclerotic). IN initial phase Bone resorption processes predominate with the participation of osteoclasts, and therefore deep lacunae are formed in the bone tissue. IN active phase deforming ostosis, along with osteolysis, new bone formation is also expressed; osteoblasts appear, lacunae are filled with newly formed bone substance. Wide, clear bonding lines appear where the old and new bone meet. Because of constant repetition and changes in the processes of osteolysis and osteogenesis, bone beams turn out to be built from small fragments forming a characteristic mosaic. For inactive phase characterized by the predominance of the process of osteosclerosis.

Pathological anatomy. Bone changes in Paget's disease are quite characteristic. Long tubular bones especially the femur and tibia, are curved, sometimes spiral-shaped, which is explained by the growth (elongation) of the bone during its restructuring. At the same time, the length of a healthy paired bone does not change. The surface of the affected bone is rough, cuts reveal a narrow medullary canal, sometimes it is completely obliterated and filled with randomly alternating beams. When the periosteum is removed, small numerous openings of the vascular canals are usually visible on the surface of the cortical layer (normally they are almost invisible). This is due to the fact that bone restructuring is accompanied by intense resorption of the bone walls of the vascular canals and a sharp dilation of blood vessels. When cut, the cortical layer of the bone loses its compact structure and becomes spongy. However, this is only an external resemblance to spongy tissue, since the restructuring in Paget's disease is afunctional in nature.

In case of defeat skull bones the process usually involves only bones brain skull. In the bones of the roof of the skull there is no division into the inner, outer plate and middle spongy layer; the entire bone mass has an unevenly spongy structure with areas of rarefaction and compaction. If the bones of the facial skull are also changed, then the face becomes sharply disfigured. The thickness of the bones when cut can reach 5 cm, and the thickening of the bone can be either uniform or uneven. Despite the increased volume, the bones are very light, which is due to the decrease in lime in them and the presence of a large number of pores.

IN spine the process involves one or more vertebrae in any of its parts, but the whole thing is never affected spinal column. The vertebrae increase in volume or, on the contrary, flatten, which depends on the stage of the disease. Foci of osteoporosis are found on the cuts and

osteosclerosis. Pelvic bones may also be involved in pathological process, which captures one or all bones.

Microscopic examination convinces us that the structural features of bone tissue in Paget's disease reflect its pathological restructuring. The mosaic structure of bone structures characteristic of Paget's disease is associated with the continuous change in the processes of resorption and construction of bone substance (Fig. 246). Small fragments of bone structures with uneven contours, with wide, clearly defined basophilic adhesion lines. The areas of bone fragments of the mosaic are usually well calcified, their structure is disordered, finely fibrous or lamellar. Sometimes osteoid structures are found. In the deep lacunae of bone structures, a large number of osteoclasts and axillary resorption cavities are found. Along with this, signs of new bone formation are noted: expanded bone spaces are filled with soft fibrous tissue. Bone remodeling processes also involve vascular bed, usually the caliber of the feeding arteries is sharply increased, they acquire a sharp tortuosity.

Complications. Hemodynamic disorders, pathological fractures, development of osteogenic sarcoma. Hemodynamic disorders, associated with vasodilation in the affected bone tissue, in the skin over the lesions, can cause heart failure in patients with bone lesions of more than a third of the skeleton. Pathological fractures usually develop in active phase diseases. Osteogenic sarcoma develops in 1-10% of patients with deforming ostosis. Sarcoma is most often localized in the thigh, tibia, pelvic bones, zygomatic bone, scapula, primary multiple sarcomas have been described.

Rice. 246. Paget's disease. Mosaic bone structure (according to T.P. Vinogradova)

Joint diseases

Joint diseases may be associated with dystrophic (“degenerative”) processes in the structural elements of the joints (arthrosis) or their inflammation (arthritis). The synovium of the joint and cartilage can be a source of tumor (see. Tumors). Arthritis may be associated with infections(infectious arthritis), be a manifestation rheumatic diseases(cm. Systemic connective tissue diseases), metabolic disorders(For example, gouty arthritis, cm. Disorders of nucleoprotein metabolism) or other diseases (for example, psoriatic arthritis).

The most important among arthrosis is osteoarthritis, among arthritis - rheumatoid arthritis.

Osteoarthritis

Osteoarthritis- one of the most common joint diseases of a dystrophic (“degenerative”) nature. Elderly women are more often affected. Osteoarthritis is divided into primary (idiopathic) and secondary (for others, such as endocrine diseases). As you can see, osteoarthritis is a collective concept that unites a large number of diseases. However significant differences There is no difference between primary and secondary osteoarthritis. Joints most commonly affected lower limbs- hip, knee, ankle, somewhat less frequently - large joints upper limbs. Usually the process simultaneously or sequentially involves several joints.

Etiology and pathogenesis. For the development of osteoarthritis, predisposing factors are important - hereditary and acquired. Among hereditary factors special meaning give a genetically determined metabolic disorder in articular cartilage, especially a disorder of the catabolism of its matrix. From acquired Mechanical injury plays a leading role.

Classification. Based on clinical and morphological manifestations, 3 stages of osteoarthritis are distinguished. In stage I, pain in the joints is noted during exercise, and x-rays reveal a narrowing of the joint space and osteophytes. In stage II, joint pain becomes constant, the narrowing of the joint space and the development of osteophytes are more pronounced on X-ray examination. IN Stage III Along with constant joint pain, functional joint insufficiency is noted due to the development of subchondral sclerosis.

Pathological anatomy. Macroscopic changes in osteoarthritis depend on the stage of its development. In the early (I) stage, roughness and tissue disintegration appear along the edges of the articular cartilage. Later (stage II) on the articular surface of the cartilage they find patterns And lumps, bone growths are formed - osteophytes. In the advanced (III) stage of the disease, articular cartilage disappears on the bones of the joints

Dents form and the joints themselves become deformed. The intra-articular ligaments are thickened and loosened; folds joint capsule thickened, with elongated papillae. The amount of synovial fluid is sharply reduced.

Microscopic characteristics stages of osteoarthritis have been well studied (Kopyeva T.N., 1988). In stage I, articular cartilage retains its structure; in its superficial and intermediate zones, the content of glycosaminoglycans decreases. In stage II, shallow lesions appear in the superficial zone of the cartilage, along the edge of which chondrocytes accumulate, and the content of glycosaminoglycans in all zones of the cartilage decreases. If there are no abnormalities in the superficial zone of cartilage, then in the superficial and intermediate zones the number of “empty lacunae”, chondrocytes with pyknotic nuclei, increases. The subchondral part of the bone is also involved in the process. In stage III of osteoarthritis, the superficial zone and part of the intermediate zone of the cartilage die, deep lesions are found, reaching the middle of the intermediate zone; in the deep zone, the content of glycosaminoglycans is sharply reduced, the number of chondrocytes with pyknotic nuclei is increased. The damage to the subchondral part of the bone intensifies. In all stages of osteoarthritis, in the synovial membrane of the joints they find synovitis varying degrees of severity, lymphomacrophage infiltrate and moderate proliferation of fibroblasts are found in the synovium; as a result of synovitis, sclerosis of the stroma and vascular walls develops.

Rheumatoid arthritis

Rheumatoid arthritis- one of the most striking manifestations of rheumatic diseases (see. Systemic connective tissue diseases).

Skeletal muscle diseases

Among skeletal muscle diseases, the most common are diseases of striated muscle dystrophic (myopathies) and inflammatory (myositis) character. Muscles can be the source of a number of tumors (see. Tumors). Of particular interest among myopathy are progressive muscular dystrophy (progressive myopathy) and myopathy in myasthenia gravis.

Progressive muscular dystrophy(progressive myopathy) includes various primary hereditary chronic diseases of the striated muscles (they are called primary because the lesion spinal cord and peripheral nerves are absent). The diseases are characterized by increasing, usually symmetrical, muscle atrophy, accompanied by progressive muscle weakness, up to complete immobility.

Etiology and pathogenesis little studied. The significance of abnormalities in structural proteins, sarcoplasmic reticulum, innervation, and enzymatic activity is discussed muscle cells. Characterized by an increase in the activity of muscle enzymes in the blood serum, corresponding electrophysiological disorders in damaged muscles, and creatinuria.

Classification. Depending on the type of inheritance, age, gender of patients, localization of the process and course of the disease, there are 3 main forms of progressive muscular dystrophy: Duchenne, Erb and Leiden. The morphological characteristics of these forms of muscular dystrophy are similar.

Duchenne muscular dystrophy(early form) with a recessive type of inheritance associated with the X chromosome, usually appears at the age of 3-5 years, more often in boys. First, the muscles of the pelvic girdle, thighs and legs are affected, then the shoulder girdle and torso. Erb's muscular dystrophy(adolescent form) has an autosomal dominant type of inheritance and develops from puberty. The muscles of the chest and shoulder girdle, sometimes the face, are mainly affected (myopathic face - smooth forehead, insufficient eye closure, thick lips). Atrophy of the muscles of the back, pelvic girdle, and proximal limbs is possible. Muscular dystrophy Leiden with an autosomal recessive type of inheritance begins in childhood or during puberty and proceeds more quickly compared to the juvenile form (Erba), but more favorably than the early form (Duchenne). The process, starting with the muscles of the pelvic girdle and hips, gradually involves the muscles of the torso and limbs.

Pathological anatomy. Usually the muscles are atrophic, thinned, and depleted of myoglobin, so when cut they resemble fish meat. However, muscle volume can be increased due to the vacant growth of fatty tissue and connective tissue, which is especially typical for Duchenne muscular dystrophy (pseudohypertrophic muscular dystrophy).

At microscopic examination muscle fibers have different sizes: along with atrophic ones, there are sharply enlarged ones; the nuclei are usually located in the center of the fibers. Dystrophic changes in muscle fibers (accumulation of lipids, decrease in glycogen content, disappearance of cross-striations), their necrosis and phagocytosis are pronounced. Signs of regeneration are determined in individual muscle fibers. Accumulate between damaged muscle fibers fat cells. In severe cases of the disease, only single atrophic muscle fibers are found among extensive growths of adipose and connective tissue.

Ultrastructural changes in muscle fibers have been studied in more detail in Duchenne muscular dystrophy (Fig. 247). At the onset of the disease, expansion of the sarcoplasmic reticulum, foci

Rice. 247. Duchenne muscular dystrophy. Necrosis of muscle fiber with destruction of myofibrils. x 12,000

destruction of myofibrils, expansion of interfibrillar spaces in which the amount of glycogen increases, movement of nuclei to the center of the fiber. In the late stage of the disease, myofibrils undergo fragmentation and disorganization, mitochondria are swollen, the T-system is expanded; in muscle fibers the number of lipid inclusions and glycogen increases, and autophagolysosomes appear. At the end of the disease, the muscle fibers become denser, surrounded by a hyaline-like substance, and macrophages and fat cells appear around the necrotic muscle fibers.

Death In patients with severe progressive muscular dystrophy, it usually occurs from pulmonary infections.

Myasthenia gravis

Myasthenia gravis(from Greek myos- muscle, asthenia- weakness) is a chronic disease, the main symptom of which is weakness and pathological fatigue of the striated muscles. Normal contraction muscles after their active activity decreases in strength and volume and may stop completely. After rest, muscle function is restored. In an advanced stage of the disease, the rest time increases, creating the impression of muscle paralysis. With myasthenia gravis, any muscles of the body can suffer, but more often the muscles of the eyes (ptosis develops in 80% of cases), chewing, speech, and swallowing. In the extremities, the proximal muscles of the shoulder and thigh are most often affected. The respiratory muscles may also be affected.

The disease occurs at any age (peak incidence is 20 years), 3 times more often in women compared to men.

Etiology and pathogenesis. Etiology unknown. There is a correlation between anomalies thymus gland and myasthenia. Thymectomy often gives positive effect. The development of the disease is associated with a decrease of up to 90% in the number of acetylcholine receptors per unit of muscle plate, which is caused by autoimmune reactions. Antibodies to acetylcholine receptors were extracted from the thymus gland, they were found in the blood serum (in 85-90% of patients), using the immunoperoxidase method, IgG and C 3 were constantly detected in postsynaptic membranes. It is possible that not only antibodies, but also effector immune cells are involved in the blockade of acetylcholine receptors.

Pathological anatomy. In the thymus gland of patients with myasthenia gravis, follicular hyperplasia or thymoma is often found. Skeletal muscles are usually slightly changed or are in a state of dystrophy, sometimes their atrophy and necrosis, focal accumulations of lymphocytes among muscle cells are noted. Using immune electron microscopy, it is possible to detect IgG and C 3 in postsynaptic membranes. In the liver thyroid gland, adrenal glands and other organs find lymphoid infiltrates.

Diseases of the musculoskeletal system and connective tissue

Gout is a disease associated with impaired purine metabolism, manifested by the deposition uric acid in tissues and leading to characteristic lesion joint and other organs. The disease is accompanied by periodic pain in the joints of the arms and legs. The reasons for the development of gout can be overeating, alcohol abuse, eating foods containing purine bases(meat, cottage cheese, fats, fish, red wine) and sedentary image life. Salts are deposited in the joints and synovial membranes, resulting in the destruction of cartilage.

Main clinical symptoms

The onset of the disease coincides with the onset of arthritis suddenly, often at night. The patient wakes up from a tearing pain; in most cases, the pain syndrome forms in the first metatarsophalangeal joint of the big toe, but sometimes it begins in several joints.

In addition, there is a rise in temperature to 40 °C. The joints increase in size, become painful, and the skin underneath them becomes hyperemic.

Diagnostics

On the blood side, there is an increase in uric acid, acceleration of ESR and neutrophilic leukocytosis. X-rays reveal defects in places where uric acid salts are deposited.

A diet is prescribed excluding purines, meat, legumes and smoked meats. IN acute period non-steroidal anti-inflammatory drugs and drugs that reduce purine synthesis (allopurinol, etc.) are used. In addition, massage, exercise therapy and sanatorium- spa treatment.

Arthrosis is a degenerative lesion of cartilage. They can be primary if the etiological factor is unknown, and secondary - after injury, fracture or inflammatory diseases leading to changes articular surfaces And mechanical damage cartilage. They can be complicated by inflammation of the synovial membrane, then active synovitis, arthrosis with secondary synovitis, or arthrosis arthritis develop.

Coxarthrosis (deforming arthrosis of the hip joint) is the most severe form of arthrosis, characterized by pain when supporting the leg, lameness and limitation of movements in the joint. At a later stage, subluxation of the femoral head occurs. With bilateral lesions, a “duck” gait occurs.

Arthrosis knee joint– gonoarthrosis – characterized by pain that occurs when descending from the stairs, and pain on palpation of the knee joint.

Deformation develops due to changes in the bone. In addition, slight swelling occurs periodically.

Arthrosis of the distal interphalangeal joints (Heberden's nodes) most often occurs in women during menopause. Symmetrical persistent thickenings of the interphalangeal joints develop, painful on palpation.

Diagnostics

The main criterion for making a diagnosis is persistent deformation of the joint without pronounced inflammatory changes in the blood. An x-ray shows narrowing of the joint space and marginal osteosclerosis.

First of all, it is necessary to reduce the load on the legs and improve the metabolism of cartilage. Indomethacin, voltaren, acetylsalicylic acid, biostimulants and vitamin therapy are prescribed. Hydrocortisone is injected into the joint. In addition, paraffin applications, massage, exercise therapy, ultrasound and spa treatment are indicated. In case of severe coxarthrosis, surgical intervention is performed.

Systemic connective tissue lesions

Connective tissue damage is a group of diseases characterized by autoimmune and immune complex inflammation of connective tissue or increased fibrosis formation.

The cause of the development of connective tissue lesions is unknown. However, sex differences and nonspecific effects may be etiological factors. external environment(infections, insolation, cooling, stress, unbalanced diet, family genetic predisposition to autoimmunity, etc.).

Main clinical symptoms

Signs characteristic of connective tissue diseases include arthritis and myositis, less commonly serositis and damage to internal organs (kidneys and blood vessels) and the central nervous system.

At laboratory research are also observed general indicators immunological status. These include: hyperimmunoglobulinemia, the presence of antinuclear and rheumatoid factors, detection immune complexes. Typical individual indicators can be:

– high level antibodies to native DNA (lupus erythematosus);

– antibodies to RNP ( mixed disease connective tissue);

– antibodies to cytoplasmic antigens (Sjögren’s disease).

The course of most diffuse connective tissue diseases is recurrent, progressive and requires the use of complex therapy, including anti-inflammatory drugs (non-steroidal and hormonal), immunosuppressants and immunomodulators. Plasmaphoresis, plasma filtration and hemosorption are widely used.

Systemic connective tissue diseases include the following:

– polyarthritis nodosa and related conditions;

– systemic lupus erythematosus;

– dermatopolymyositis;

– systemic sclerosis;

- other systemic lesions connective tissue, including Behçet's disease and polymyalgia rheumatica.

Osteocondritis of the spine

Spinal osteochondrosis is a disease accompanied by degeneration of the intervertebral disc with a significant decrease in its height, sclerosis of the disc surfaces of the vertebrae and the proliferation of marginal osteophytes.

The main reason is constant overload of the spine, as a result of which the discs lose their blood supply and dystrophic changes develop. Cracks and breaks appear in them, through which masses of the altered nucleus pulposus can fall out with the development of a hernia.

Main clinical manifestations

For cervical region The spine is characterized by pain in the occipital and interscapular areas, a feeling of heaviness in the shoulder girdle, pain in the neck, numbness of the fingers during sleep, as well as dizziness and flashing of spots.

For osteochondrosis thoracic fatigue of the back muscles, inability to remain in an upright position and pain along the spine are observed.

Osteochondrosis of the lumbar region is characterized by a feeling of fatigue, pain in the gluteal region and along the back of the thigh. Acute unbearable pain can also occur when lifting heavy objects.

Diagnostics

Staging final diagnosis made on the basis of clinical data and results x-ray examination.

During the period of exacerbation, prescribed bed rest on a board under the mattress to unload the spine, massage, spinal traction, analeptics, B vitamins, and in case of severe pain - novocaine blockade.

After the pain disappears, physiotherapy, hydrotherapy and physiotherapy. In addition, it is necessary to wear an unloading orthopedic corset. If conservative treatment is ineffective, the cartilage hernia is removed and 2 adjacent vertebrae are fused. To prevent complications, light work without stress on the spine, a hard bed, exercise therapy, constant wearing of a corset, as well as hydrogen sulfide and radon baths are recommended.

Spondylitis

Spondylitis is a group of inflammatory diseases of the spine in which the vertebral bodies are destroyed, which leads to spinal deformation. Spondylitis can be specific and nonspecific. The former include tuberculous and other spondylitis caused by various infections, and the latter include hematogenous purulent, rheumatoid spondylitis, etc.

Main clinical symptoms

Clinically, spondylitis is characterized by an acute onset, chills and elevated temperature bodies. There is sharp pain in the area of ​​the affected spine with irradiation to the abdomen or legs depending on the level of damage to the spine, local pain at the site of the lesion, leukocytosis and acceleration of ESR. The disease can be chronic.

Surgery is being performed.

Spondylosis

Spondylosis is a chronic disease caused by dystrophic changes in the outer parts of the fibrous ring of the intervertebral disc and the anterior longitudinal ligament with limited mobility of the spine. The disease develops as a result of static-dynamic overloads or spinal injuries.

Main clinical symptoms

At the end of the day, pain occurs in the back, and sometimes there are lesions in the roots.

Diagnostics

The x-ray shows disorders and bone growths along the edges of the vertebral bodies, which have sharp points in the form of wedge-shaped protrusions or staples.

Reduced physical activity, non-steroidal anti-inflammatory drugs and physiotherapy are prescribed, as well as exercise therapy, massage, etc.

Sciatica – inflammatory lesion roots spinal nerves at the level of the lumbosacral spine.

Main clinical symptoms

Most important signs are pain in the lumbar region, radiating to the buttock, along the back of the thigh and lower leg, the outer edge of the thigh, lower leg and foot, as well as sensory disturbances of the radicular type, etc.

Sciatica is observed with spinal osteochondrosis, injuries and infections.

Held complex therapy taking into account the underlying disease.

Myositis is a polyetiological disease that is characterized by an inflammatory process in the muscles, accompanied by pain, muscle weakness and possible muscle atrophy. Myositis can be purulent, non-purulent, infectious-allergic, infectious and non-infectious.

They are also divided into acute, subacute and chronic. In addition, they can be localized and widespread.

Myositis is characterized by a pronounced reaction of connective tissue with the development of fibrosis in the inflamed muscle.

Sclerosis of the intermuscular tissue and bone elements in it may occur, when not only the muscles are affected, but also the tendons and muscle membranes.

Main clinical symptoms

A set of disorders in various diseases unite under common name myopathy. There are:

– myopathy with impaired coordination between agonists, antagonists and synergists;

– impaired coordination not only of whole muscles, but also of bundles within muscles;

– myofasciculitis, characterized by a combination with inflammatory changes in the muscles.

Diagnostics

The final diagnosis is made based on characteristic symptoms and results clinical trials, pus culture and electromyography.

Antibiotics and analgesics are used, and, if indicated, surgical interventions and physical therapy are used. In addition, pain reduction and treatment of the underlying disease are carried out.

Synovitis

Synovitis is a disease that affects synovium, which is limited to its limits and is accompanied by the accumulation of effusion.

The most common sites of injury are the knee, ankle, elbow and wrist joints.

Synovitis occurs with infectious and aseptic inflammation, as well as with injuries.

Main clinical symptoms

The joint increases in size and changes shape, and there is pain on palpation. There is also a dysfunction of the joints: redness of the joint area.

Diagnostics

The final diagnosis is made based on clinical symptoms and the results of the study of joint fluid punctate.

Surgical intervention is performed, according to indications - joint puncture, drainage of the joint cavity, UHF therapy.

Tenosynovitis

Tenosynovitis – inflammatory process, which often affects the junction of tendon and muscle.

Tenosynovitis of the extensor brevis muscle in the abductor pollicis longus muscle develops as a result of prolonged tension. Manifested by pain in the area of ​​the styloid process radius, which intensify when the thumb moves.

Tenosynovitis of the extensor carpi ulnaris is characterized by pain in the styloid process ulna, radiating to the elbow of the IV and V fingers.

A “snap finger” is caused by microtrauma to the superficial flexor muscles of the fingers. It manifests itself as pain and swelling on the palmar surface of the fingers. The feeling of obstruction and snapping is overcome with the help of the healthy hand.

Carpal finger syndrome: sudden intense pain and paresthesia in the area of ​​the 1st and 3rd fingers on the palm side, swelling of the hands and the appearance of erythema, cyanosis and marbling of the skin.

It depends on the stage of the disease. Anti-inflammatory and painkillers are prescribed orally or locally. If the nerve is compressed, surgical intervention is indicated.

Bursopathies

Bursopathies are inflammations of the synovial bursae located between the tendons and bone protrusions. They occur during trauma or microtrauma and accompany other injuries. The outcome of bursitis can be fibrosis. The ulnar and trochanteric areas are most often damaged. There are ulnar, trochanteric, sciatic and prepatellar bursitis, as well as bursitis crow's foot in the area of ​​the tibia.

First, cold is prescribed, then heat, deep heating and anti-inflammatory drugs. For purulent bursitis, surgical intervention is performed.

Heel spur

Heel spur- outgrowths on the surface of the heel bone or calcaneal tubercle, representing a formation bone structure with a predominance of sclerosis.

Main clinical symptoms

When walking, running or wearing uncomfortable shoes arises strong pain in the area of ​​the heel bone.

Diagnostics

The final diagnosis is made based on the identification of a spinous, pyramidal or wedge-shaped growth on an x-ray.

Held conservative treatment, physiotherapy, exercise therapy and massage are prescribed.

Osteoporosis

Osteoporosis is a disease characterized by a decrease in bone density as a result of a decrease in bone substance or insufficient mineralization.

The main reasons for the development of osteoporosis: decreased physical activity, dietary patterns, alcohol consumption, smoking, lack of vitamin intake, as well as decreased nutrition with a decreased intake of calcium and phosphorus. Osteoporosis can be local or general. The first develops most often with circulatory disorders and prolonged immobility associated with fractures, neuritis, frostbite or the appearance of phlegmon. General osteoporosis is registered with intoxication, nutritional and metabolic disorders, age-related involution and endocrine diseases, as well as with the use of glucocorticoids.

Main clinical symptoms

Osteoporosis can occur without any particular symptoms; patients complain of pain in the bones and muscles of the back. Fractures in osteoporosis occur without traumatic impact after a small load. They usually occur in thoracic vertebrae, femoral neck fractures are also recorded. In secondary osteoporosis, symptoms are caused by the underlying disease.

Diagnostics

The main research method is radiography, which detects a decrease in bone density.

Vitamin D and calcitonin are prescribed. Currently there are many complex drugs. The cure for secondary osteoporosis consists of treating the underlying disease.

It should be taken into account that the development of osteoporosis is prevented by physical activity and balanced diet with sufficient intake of calcium and phosphorus in equal proportions. Daily dosage calcium, depending on age, is 1000–1500 mg. The source of calcium is dairy products, and the source of phosphorus is seafood, beans and bran.

Osteomalacia

Osteomalacia (softening of bones) is a syndrome that occurs with insufficient mineralization of bone tissue as a result of depletion of the body in calcium and phosphorus salts.

This condition may be associated with a lack of vitamin D, increased filtration of salts in the kidneys and impaired absorption of salts in the intestines. At the same time, the volume of bone matter and its mineralization decrease, which is accompanied by softening of the bones and their curvature.

Main clinical symptoms

The most indicative signs are bone deformation, bone pain, fractures, hypotension and muscle wasting. X-rays show osteopenia. In children, changes are localized in metaphases tubular bones.

Children are prescribed vitamin D, calcium and phosphorus supplements, deformity correction and general strengthening therapy. Treatment for adults is aimed at normalizing phosphorus-calcium metabolism to improve bone mineralization.

Osteomyelitis

Osteomyelitis is an inflammatory process affecting all structural elements of the bone and bone marrow.

Main etiological factor is a pyogenic microflora. Entrance gate Infections in hematogenous osteomyelitis can be the nasopharyngeal mucosa and foci of chronic infection.

Non-hematogenous osteomyelitis occurs due to trauma. In addition, the course of the disease can be acute and chronic.

Main clinical symptoms

There are 3 forms of osteomyelitis.

At mild form local symptoms prevail over the general ones. Intoxication is moderate, body temperature does not exceed 38 °C. Local changes localized in the affected area, pain is moderate.

The septicopyemic (severe) form is characterized by a sudden onset, chills, and a rise in temperature above 40 °C. Symptoms of intoxication are observed: weakness, adynamia, nausea and vomiting. The severity of local manifestations is noted. Quite quickly, sharp pain occurs, forcing you to limit your movements and take a forced position. The skin above the lesion becomes red, and the venous pattern appears more clearly. With an unfavorable course of the disease, the symptoms of intoxication intensify.

In the fulminant form, severe intoxication develops on the first day with confusion, convulsions, and symptoms of irritation. meninges and cardiovascular failure. Patients may die on the 1st day from the onset of the disease.

Complications of osteomyelitis include sepsis, purulent arthritis, pneumonia, myocarditis, pathological fracture and transition to a chronic form.

Diagnostics

The final diagnosis is made based on characteristic clinical symptoms and X-ray results.

Conducted surgical treatment local process, targeted action on the pathogen by prescribing an antibiotic and improving the body’s resistance by increasing caloric intake. In addition, vitamins, microelements and immunomodulators are prescribed, as well as detoxification and symptomatic therapy.

Skeletal muscles provide all movements associated with walking, eating and labor processes. A person has about 600 pairs of them, and they make up almost 40% of his body weight. There are 222 bones and approximately 206 joints in the human body.

The musculoskeletal system performs the musculoskeletal function. It consists of a skeleton, the bones of which serve as levers, and striated muscles attached to the bones, which act as a power unit. The skeleton consists of bones and their joints. It performs the functions of support, movement and protection. The supporting function is manifested in the fact that the skeleton supports other organs, gives the body a constant shape and allows it to take certain positions. Skeletal bones, within certain limits, provide protection for internal vital organs from external harsh physical influences. Thus, the brain is located in the cranium, and the spinal cord is in the spinal canal, the bones of the chest protect the heart, lungs and other organs located in it, and the pelvic bones protect the organs. genitourinary system. According to their shape, all bones are divided into long (tubular bones of the limbs), short (vertebrae, calcaneus) and flat (scapula, ribs, pelvic bones). All bones are covered with periosteum, which is a connective tissue plate tightly fused with the bone. From it, nerve fibers and vessels penetrate the bone and provide metabolic processes. Special cells of the periosteum - osteoblasts - are involved in the formation of bone tissue, both during its growth and during healing after fractures.

5. Circulatory system. Structure and functions.

The circulatory system is a system of vessels and cavities through which blood circulates. Through the circulatory system, the cells and tissues of the body are supplied with nutrients and oxygen and are released from metabolic products. Therefore, the circulatory system is sometimes called the transport, or distribution, system.

Blood vessels are divided into arteries, arterioles, capillaries, venules and veins. Arteries carry blood from the heart to the tissues. Along the blood flow, the arteries branch into trees into more and more small vessels and turn into arterioles, which in turn break up into a system of the finest vessels - capillaries. The capillaries have a lumen almost equal to the diameter of the red blood cells (about 8 microns). Venules begin from the capillaries, which merge into veins that gradually enlarge. Blood flows to the heart through the largest veins.

There are two circles of blood circulation - large and small.

Pulmonary circulation begins pulmonary trunk, which arises from the right ventricle. It delivers blood to the pulmonary capillary system. Arterial blood flows from the lungs through four veins that flow into the left atrium. The pulmonary circulation ends here.

The skeletal system is susceptible to injury, wear and tear, infection, tumors and metabolic diseases that lead to bone damage

The human skeleton consists of 206 bones, which are connected together by ligaments and connective tissue. The skeleton not only provides motor function, but also protects vital important organs(brain, heart, lungs and abdominal organs). However, our skeletal system is susceptible to damage, wear and tear, infection, tumors and metabolic diseases that lead to bone damage that can become life-threatening. Below are some general diseases skeletal system.

General diseases of the skeletal system

Arthritis: a disease of the skeletal system characterized by wear and tear of bones and joints

Arthritis comes in two main forms. Osteoarthritis is the wear and tear of our bones and joints that occurs with age. Obesity is one of the important factors which can precipitate osteoarthritis, especially in the knees and hips. All bone joints are lined with cartilage and synovial fluid, which help lubricate the joint during movement. Over time, these tissues break down and wear away, leading to bone spur formation, joint narrowing, inflammation and pain. Treatment for severe osteoarthritis involves painkillers and steroid injections. In advanced cases, joint replacement is required.

Autoimmune arthritis occurs when the body attacks and damages its joints. Rheumatoid arthritis is one example of such diseases. Over time, they lead to joint destruction and chronic weakness. Treatment is aimed at pain management and modulates immune system, which allows limiting its further destruction.

Osteoporosis: a disease of the skeletal system characterized by decreased bone density

Osteoporosis is a decrease in bone strength and mineral density. Age, hormonal status and diet play a vital role important role in the development of osteoporosis. The bones gradually become weak and prone to fractures with minor injuries.

Rickets: a skeletal disease associated with vitamin D deficiency

Rickets/osteomalacia occurs due to severe deficiency of calcium, vitamin D and phosphate. Bones soften and become weak, losing their normal shape. Bone pain, cramps and skeletal deformities are noted.

Tendinitis: a disease of the skeletal system caused by injury to tendons

Tendon injury leads to inflammation and pain. Tendons “connect” muscles to bones and facilitate movement. Painful areas include the knee, elbow, wrist and Achilles tendons. Treatment includes rest, icing, and modification of activities until pain and inflammation resolve.

Bursitis: a skeletal disorder associated with the accumulation of fluid around the joints

A bursa is a specialized fluid around our joints. It provides cushioning between joints and nearby muscles, tendons and ligaments. Known state"water in the knee" is an example of prepatellar bursitis. This condition causes pain, redness, swelling, and soft tissue. Treatment includes over-the-counter medications such as ibuprofen. You should also avoid putting pressure on the affected area of ​​tissue and rest.

Cancers of the skeletal system

Leukemia

White blood cells - leukocytes - are partially produced in the bone marrow. Usually, whole line types of blood cancer are called leukemia. The onset of leukemia is generally insidious. Until a critical mass of atypical cells has formed, most people are asymptomatic. Early symptoms of leukemia: bone pain, severe fatigue, night sweats, unexplained loss body weight and bleeding gums.

Bone cancer

Cancerous tumors can also develop in the bone. Bone cancer can be the main type of cancer, or it can also occur as a result of metastasis from a cancer located elsewhere (lung, breast, and prostate). The main types of bone cancer are osteosarcoma and Ewing's sarcoma.

Congenital diseases of the skeletal system

Clubfoot is a birth defect

Clubfoot is a congenital defect in the development of one or both legs that curve inward and downward. As a result of this disease, it is very difficult for a child to learn to walk. Specialized orthopedic therapy or surgery is often necessary.

Spina bifida

Spina bifida is a birth defect that is caused by incomplete closure of the vertebrae around the spinal canal. Many people have mild forms of this disease and don’t even know it. More severe forms The diseases are accompanied by nerve defects, difficulty walking, and problems with bowel and bladder function.

Other diseases of the skeletal system

Osteogenesis imperfecta is a spectrum of diseases of the skeletal system, ranging from mild to severe and life-threatening. People with these diseases are prone to fractures even with minor injuries. The most severe forms of these diseases also lead to intrauterine death. In people with these scleral diseases ( white part eyes) often have a bluish tint.

Osteopetrosis (marble disease) is a rare disease of the skeletal system in which the bones literally become petrified and can break easily.

Paget's disease causes bones to break faster than they can repair themselves. Usually in the body this process is in balance. However, with Paget's disease, bone tissue breaks down at an accelerated rate and the bones become brittle. This leads to an increased risk of fractures.

Thus, Diseases of the skeletal system can be classified into 4 main groups: 1) congenital/genetic (clubfoot, spina bifida, osteopetrosis, Paget's disease; 2) age-related (osteoporosis, arthritis, arthrosis); 3) cancer (bone cancer and leukemia); 4) caused by trauma (tendinitis, fractures).