What about 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 frame 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 repeats its shape. Displacement of the skull bones at birth can cause cerebral palsy, 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 set.

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 and 1 in the lumbar region. The deflections of the spine allow you to remove the load from the vertebral discs. Between the vertebral discs is the nucleus pulposus, which acts as a shock absorber.

Inside the cervical vertebrae are openings through which the cervical veins and cervical arteries pass. This connection provides cerebral circulation. The habit of sleeping on a high pillow and any movements that permanently displace the 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 fall on the vertebral discs, which will eventually 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 can cause confusion in the pelvis.

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

Everything that becomes numb or hurts in the muscular system, if it is not associated with direct injuries, is most often the result of a general asymmetry of the body and pinched current, pinching of 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 a foundation.

When a person constantly shifts body weight to one side, the foot flexes a lot. In order for a person not to fall on the thumb, a bone grows, then there will be cartilage and compaction. If the bone has grown on both legs, this means that the person first stood on one leg, then it began to hurt, and he began to stand on the other.

You can align the pelvis with gymnastics and manual therapy.

Inflammatory processes in the joints, if there were no injuries, this is a consequence of diseases. Under each joint are lymph nodes. If the body is affected by any infection (streptococcus, chlamydia, etc.), thrombosis of the lymph nodes occurs. Fluid will accumulate and collect 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 struck will thin out.

In this case, you need to go through antibacterial, antiviral and antifungal programs.

The fluid in the joint must be clear. You can determine the quality of the joint fluid by the condition of the nails. Nails are a hardened joint fluid that flows out and hardens evenly every day. Nails should be transparent and hard. If the nails are corrugated, 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 whole body for a fungal infection.

If the nails exfoliate, there is a deep violation of mineral metabolism, plus the remains of fungi are washed out.

White dots on the nails are undigested protein. Impaired protein metabolism means that proteins are not absorbed and digested

If there are white or slightly pinkish stripes on the nails, this may indicate poisoning with heavy metal salts and liver contamination.

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

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

Strabismus and crooked teeth may be the result of 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 can be affected. The diet must be complete.

3. Water.

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

4. Psychology.

Does not affect

5. Injuries.

They are of great importance. Damage to one of the elements of the system causes others to adjust. The harmony is broken.

6. Heredity.

Deformed bones can be inherited, especially teeth, as the shape of the skull and proportions of the face are transmitted.

Scoliosis is not inherited.

The appearance, the internal structure, and not the disease, is transmitted.

7.Medicine.

Does not affect.

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

9. Movement.

It has a very strong influence. It is necessary to observe the correct technique for performing exercises and avoid unsuccessful postures. It is desirable to sleep only on the back and with a roller under the neck.

Algorithm for restoring the musculoskeletal system

1. Movement. Find out how well physical activity is given.
2. Water. Increase the amount of water in the body.
3. Injuries. Remove the effects of each injury.

As a result of injury, bone deformity occurs. There is an infringement of blood vessels and nerve conductors. After a concussion, nausea can be felt throughout life.

Trauma to the back of the skull can result in loss of . There are visual puffs on which an unset bone can press.

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

With an injury to the cervical vertebrae, the arteries responsible for the blood supply to the brain will be clamped. The same can be obtained if you do not sleep properly.

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

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

Diseases of the musculoskeletal system are extremely diverse. They can be conditionally divided into diseases of the skeletal system, joints and skeletal muscles.

Diseases of the skeletal system

Diseases of this group can have a dystrophic, inflammatory, dysplastic and tumor character. Dystrophic bone diseases (osteodystrophy) are divided into toxic (for example, Urov's disease), alimentary (for example, rickets - see below). avitaminosis), endocrine, nephrogenic (see kidney disease). 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 disease is 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 often occur bone tumors(cm. Tumors).

Parathyroid osteodystrophy(Recklinghausen's disease, generalized osteodystrophy) is a disease caused by hyperfunction of the parathyroid glands and accompanied by a generalized lesion of the skeleton. 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 parathyroid adenoma or hyperplasia of their cells (cancer is very rare). Primary hyperparathyroidism should be distinguished from secondary hyperparathyroidism that develops in chronic renal failure, multiple bone metastases of cancer, etc. The significance of hyperfunction of the parathyroid glands in the development of bone pathology was first substantiated by A.V. Rusa-

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

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. In the bone tissue, osteoclasts are activated, foci of lacunar bone resorption appear. Along with this, diffuse fibroosteoclasia is growing - bone tissue is replaced by fibrous connective tissue. These processes are most intensively expressed in the endosteal parts of the bones. In the centers of intensive restructuring, bone structures do not have time to mature and calcify; osteoid tissue, cysts, cavities filled with blood and hemosiderin are formed. Bone deformity, osteoporosis progress, pathological fractures often occur. Formations appear in the bones, indistinguishable from giant cell tumors (osteoclastoma, according to A.V. Rusakov). Unlike true tumors, these are reactive structures that are giant cell granulomas in the foci of organizing 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. Violations of mineral metabolism (mineral dystrophies). Often develops nephrocalcinosis, combined with nephrolithiasis and complicated by chronic pyelonephritis.

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

Skeletal changes in parathyroid osteodystrophy depend on the stage and duration of the disease. In the initial stage of the disease and with low parathyroid hormone activity, external bone changes may be absent. In an advanced stage, deformation of the bones is found, especially those that are subjected to physical stress - limbs, spine, ribs. They become soft, porous, easily cut with a knife. Deformation of the bone may be due to multiple tumor-like formations, which have a variegated appearance on the cut: yellowish areas of the tissue alternate with dark red and brown, as well as with cysts.

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

Death patients more often comes from cachexia or uremia due to wrinkling of the kidneys.

Rice. 243. Parathyroid osteodystrophy. Lacunar bone resorption (shown by arrows) and neoplasm 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 flow - on spicy And chronic, according to the mechanism of infection of the bone marrow - on primary hematogenous And secondary (a complication of trauma, including a gunshot wound, during the transition of the inflammatory process from the surrounding tissues). Primary hematogenous osteomyelitis is of the greatest importance.

Primary hematogenous osteomyelitis may be acute or chronic. Acute hematogenous osteomyelitis, as a rule, it develops at a young age, 2-3 times more often in men. is usually an acute outcome.

Etiology. In the occurrence of osteomyelitis, pyogenic microorganisms play the main role: hemolytic staphylococcus (60-70%), streptococci (15-20%), coliform bacilli (10-15%), pneumococci, gonococci. Less frequently, fungi can be the 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 with minor intestinal trauma, dental diseases, and upper respiratory tract infections.

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

the flow is slow. In the future, it tends to spread, causes extensive necrosis and passes to the cortical layer of the bone, periosteum and surrounding tissues. Purulent inflammation also spreads through the bone marrow canal, affecting all new areas of the bone marrow. In children, especially newborns, due to the weak attachment of the periosteum and the characteristics 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 inflammation has the character of phlegmonous (sometimes serous) and captures the bone marrow, haversian canals and periosteum; foci of necrosis appear in the bone marrow and compact plate. Pronounced 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 thrombi are found in the vessels of the compact plate. Abscesses are often found under the periosteum, and phlegmonous inflammation is found in the adjacent soft tissues.

Chronic hematogenous osteomyelitis associated with the chronicity of the suppurative process, the formation bone sequesters. A granulation tissue and a capsule form around the sequesters. Sometimes the sequester floats in a cavity filled with pus, from which fistulous passages go to the surface or cavities of the body, to the cavity of the joints. Along with this, bone formation is noted in the periosteum and the medullary canal. The bones become thick and deformed. Endosteal bone growths (osteophytes) can lead to obliteration of the medullary canal, the compact plate thickens. At the same time, there is focal or diffuse irritation of the bone due to its resorption. Foci of suppuration in soft tissues in the chronic course of hematogenous osteomyelitis are usually scarred.

A special form of chronic osteomyelitis is Brodie'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. There are many plasma cells and eosinophils in the granulation tissue. Fistulas are not formed, deformation of bones is insignificant.

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

fibrous dysplasia

fibrous dysplasia(fibrous osteodysplasia, fibrous bone dysplasia, Liechtenstein-Braytsev disease) is a disease characterized by the replacement of bone tissue with fibrous tissue, which leads to bone deformity.

Etiology and pathogenesis. The reasons for the development of fibrous dysplasia are not clear enough, the role of heredity is not excluded. Think that

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

Classification. Depending on the spread 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 skin melanosis and various endocrinopathies. (Albright syndrome). The monoosseous form of fibrous dysplasia can develop at any age, the polyossal form - in childhood, therefore, in patients with this form of fibrous dysplasia, diffuse deformity of the skeleton is expressed, and there is a predisposition to multiple fractures.

Pathological anatomy. In the monoosseous form of fibrous dysplasia, the ribs, long tubular bones, shoulder blades, and skull bones are most often affected (Fig. 244); with a polyostotic form - over 50% of the bones of the skeleton, usually on one side. The lesion may involve a small area or a significant portion 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. In the future, foci of "bloating", deformation of the bone, its elongation or

shortening. Under the influence of a static load, the femurs sometimes take the form of a shepherd's crook. On the cut of the bone, clearly defined foci of a whitish color with reddish blotches are determined. They are usually rounded or elongated, sometimes merge with each other; in places of "bloating" the cortical layer becomes thinner. The medullary canal is enlarged or filled with newly formed tissue, in which foci of bone density, cysts are determined.

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

Complications. Pathological bone fractures are the most common. In young children, often during the first attempts to walk, the femur is especially often broken. Upper limb fractures are rare. Usually, fractures heal well, but the deformation of the bones increases. In a number of observations, a sarcoma, more often osteogenic, develops against the background of fibrous dysplasia.

Osteopetrosis

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

Etiology and pathogenesis. The etiology and pathogenesis of osteopetrosis are not well understood. Undoubtedly, the participation of hereditary factors, which are associated with a violation of the development of bone and hematopoietic tissue. In this case, excessive formation of functionally defective 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 development of anemia, thrombocytopenia, the appearance of foci of extramedullary hematopoiesis in the liver, spleen, and lymph nodes are associated with the increasing displacement of the bone marrow, which leads to their increase.

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

form osteopetrosis manifests itself at an early age, has a malignant course, often ends in death; late form runs better.

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 a characteristic appearance: it is wide, with widely spaced eyes, the root of the nose is depressed, the nostrils are deployed, and the lips are thick. In this form, hydrocephalus, increased hairiness, hemorrhagic diathesis, 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, only a cone-shaped expansion of the lower parts of the femur is characteristic. Bones become heavy, sawn with difficulty. On cuts in long bones, the medullary canal is filled with bone tissue and is often not defined. In flat bones, the medullary spaces are also barely defined. In place of the spongy substance, a dense homogeneous bone tissue is found, resembling polished marble (marble disease). The growth of bone in the area of ​​holes and channels can lead to compression and atrophy of the nerves. It is with this that the most common atrophy of the optic nerve and blindness in osteopetrosis is associated.

Microscopic picture extremely peculiar: pathological bone formation occurs throughout the entire bone, the mass of the 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. Chaotic accumulation of bone structures (according to A.V. Rusakov)

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

Complications. Often there are fractures of the bones, 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 neoplasm 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 osteitis deformans.

Later, the inflammatory nature of the disease was rejected, 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 older than 40 years, progresses slowly, 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, bones of the skull (especially facial), pelvic bones, vertebrae. A lesion can only affect one bone (mono-ossal form) or several often paired or regional bones (polyossal form), but 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 a possible cause of Paget's disease is excluded, but the family nature of the disease is noted. The dysplastic nature of bone lesions in Paget's disease is evidenced by the afunctional nature of bone remodeling and the frequent development of sarcoma against this background.

Patho- and morphogenesis. The processes of bone tissue restructuring in Paget's disease proceed continuously, there is no connection between them and the functional load. Depending on the ratio of 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 the processes of bone resorption with the participation of osteoclasts predominate, and therefore deep gaps are formed in the bone tissue. IN active phase deforming ostosis, along with osteolysis, bone neoplasm is also pronounced; osteoblasts appear, gaps are filled with newly formed bone substance. Wide, clear lines of gluing appear at the junctions of the old and new bones. Due to the constant repetition and change of the processes of osteolysis and osteogenesis, bone beams turn out to be built from small fragments that form a characteristic mosaic. For inactive phase predominance of process of an osteosclerosis is characteristic.

Pathological anatomy. Bone changes in Paget's disease are quite characteristic. long tubular bones, especially the femoral and tibial, are curved, sometimes spiral, which is explained by the growth (lengthening) 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, a narrow medullary canal is determined on cuts, sometimes it is completely obliterated and filled with randomly alternating beams. When removing the periosteum, small numerous openings of the vascular channels are usually visible on the surface of the cortical layer (normally they are almost invisible). This is due to the fact that the restructuring of the bone is accompanied by intensive resorption of the bone walls of the vascular channels and a sharp expansion of the vessels. On sawing, the cortical layer of the bone loses its compact structure and becomes, as it were, spongy. However, this is only an external resemblance to the spongy tissue, since the restructuring in Paget's disease is afunctional.

When defeated skull bones only the bones of the cerebral skull are usually involved in the process. In the bones of the skull roof there is no division into the inner, outer plate and middle spongy layer; the entire bone mass has an uneven spongy structure with foci 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 on the cut can reach 5 cm, and the thickening of the bone can be both uniform and uneven. Despite the increased volume, the bones are very light, which is associated with a decrease in lime in them and the presence of a large number of pores.

IN spine the process captures one or more vertebrae in any of its departments, but the entire spinal column is never affected. The vertebrae increase in volume or, conversely, flatten, depending on the stage of the disease. On cuts, foci of osteoporosis are found and

osteosclerosis. Pelvic bones can also be involved in a pathological process that captures one or all of the bones.

microscopic examination convinces that the features of the structure 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 a 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 gluing lines, are determined. Sites of bone fragments of the mosaic are usually well calcified, their structure is disordered, fine-fibered or lamellar. Sometimes osteoid structures are found. In deep lacunae of bone structures, a large number of osteoclasts, cavities of axillary resorption are found. Along with this, there are signs of bone neoformation: the expanded bone spaces are filled with soft tissue. The processes of bone restructuring also capture the vascular bed, usually the caliber of the supplying 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 the active phase of the disease. Osteogenic sarcoma develops in 1-10% of patients with deforming ostosis. Sarcoma is localized more often in the thigh, tibia, pelvic bones, zygomatic bone, scapula; primary multiple sarcomas have been described.

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

Joint diseases

Joint diseases can be associated with dystrophic ("degenerative") processes of the structural elements of the joints (arthritis) or their inflammation (arthritis). The synovial membrane of the joint and cartilage can be the source of the tumor (see. Tumors). Arthritis may be associated with infections(infectious arthritis), be a manifestation rheumatic diseases(cm. Systemic connective tissue diseases), metabolic disorders(e.g., gouty arthritis, see Disorders of nucleoprotein metabolism) or other diseases (eg, psoriatic arthritis).

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

Osteoarthritis

Osteoarthritis- one of the most common diseases of the joints of a dystrophic ("degenerative") nature. Older women suffer more often. Osteoarthritis is divided into primary (idiopathic) and secondary (with other, for example, endocrine diseases). As you can see, osteoarthritis is a collective concept that combines a large number of diseases. However, there are no significant differences between primary and secondary osteoarthritis. The joints of the lower extremities are most often affected - the hip, knee, ankle, somewhat less often - the large joints of the upper extremities. Usually, the process simultaneously or sequentially captures several joints.

Etiology and pathogenesis. For the development of osteoarthritis, predisposing factors are important - hereditary and acquired. Among hereditary factors, particular importance is attached to a genetically determined metabolic disorder in the articular cartilage, especially a violation of the catabolism of its matrix. From acquired factors, the leading role is played by mechanical trauma.

Classification. Guided by clinical and morphological manifestations, there are 3 stages of osteoarthritis. In stage I, there are pains in the joints during exercise, X-ray reveals a narrowing of the joint space, osteophytes. In stage II, joint pain becomes permanent, 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 insufficiency of the joints 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 defibration of the tissue appear along the edges of the articular cartilage. In the future (stage II), on the articular surface of the cartilage, patterns And bumps, bone growths are formed - osteophytes. In the advanced (III) stage of the disease, the articular cartilage disappears, on the bones of the joints

dents form, the joints themselves are deformed. Intra-articular ligaments are thickened and loosened; the folds of the articular bag are thickened, with elongated papillae. The amount of synovial fluid is sharply reduced.

Microscopic characteristic stages of osteoarthritis is well studied (Kopeva T.N., 1988). In stage I, the articular cartilage retains its structure; the content of glycosaminoglycans decreases in its superficial and intermediate zones. In stage II, shallow uzurs appear in the superficial zone of the cartilage, along the edge of which chondrocytes accumulate, the content of glycosaminoglycans in all zones of the cartilage decreases. If there are no uzuras in the superficial zone of the cartilage, then in the superficial and intermediate zones the number of "empty gaps", chondrocytes with pyknotic nuclei, increases. The subchondral part of the bone is also involved in the process. In the III stage of osteoarthritis, the superficial zone and part of the intermediate zone of the cartilage die, deep uzura 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 defeat of the subchondral part of the bone increases. In all stages of osteoarthritis in the synovial membrane of the joints are synovitis varying degrees of severity, lymphomacrophage infiltrate, moderate proliferation of fibroblasts are found in the synovium; in the outcome of synovitis, sclerosis of the stroma and vessel walls develops.

Rheumatoid arthritis

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

Skeletal muscle diseases

Among skeletal muscle diseases, the most common diseases are striated muscles of dystrophic (myopathy) 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 there is no damage to the spinal cord and peripheral nerves). The disease is characterized by increasing, usually symmetrical, muscle atrophy, accompanied by progressive muscle weakness, up to complete immobility.

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

Classification. Depending on the type of inheritance, age, gender of patients, localization of the process and course of the disease, 3 main forms of progressive muscular dystrophy are distinguished: 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 trunk. Erb muscular dystrophy(youthful form) has an autosomal dominant type of inheritance, develops from puberty. The muscles of the chest and shoulder girdle are mainly affected, sometimes the face (myopathic face - smooth forehead, insufficient closing of the eyes, thick lips). Possible atrophy of the muscles of the back, pelvic girdle, proximal limbs. Leiden muscular dystrophy with an autosomal recessive type of inheritance, it begins in childhood or during puberty and proceeds more rapidly compared to the juvenile form (Erba), but more favorably than the early form (Duchene). The process, starting with the muscles of the pelvic girdle and hips, gradually captures the muscles of the trunk and limbs.

Pathological anatomy. Usually the muscles are atrophic, thinned, depleted in myoglobin, therefore, on the cut, they resemble fish meat. However, muscle volume can also be increased due to the vacant growth of adipose tissue and connective tissue, which is especially characteristic of 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 transverse striation), their necrosis and phagocytosis are expressed. In individual muscle fibers, signs of regeneration are determined. Fat cells accumulate between damaged muscle fibers. In a severe course of the disease, only single atrophic muscle fibers are found among the 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 beginning of the disease, an expansion of the sarcoplasmic reticulum is found, foci

Rice. 247. Duchenne muscular dystrophy. Muscle fiber necrosis 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, autophagolysosomes appear. At the end of the disease, muscle fibers become denser, surrounded by a hyaline-like substance, macrophages and fat cells appear around necrotic muscle fibers.

Death patients with severe progressive muscular dystrophy occurs, as a rule, from pulmonary infections.

myasthenia gravis

myasthenia gravis(from Greek. myos- muscle, asthenia- weakness) - a chronic disease, the main symptom of which is weakness and pathological fatigue of the striated muscles. Normal muscle contraction after their vigorous activity decreases in strength and volume and may stop completely. After rest, muscle function is restored. In the advanced stage of the disease, the rest time increases, the impression of muscle paralysis is created. 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, swallowing. On the extremities, the proximal muscles of the shoulder and thigh are more often affected. Respiratory muscles may also be affected.

The disease occurs at any age (peak incidence - 20 years), 3 times more common in women than in men.

Etiology and pathogenesis. The etiology is unknown. There is a correlation between thymus anomalies and myasthenia gravis. Thymectomy often has a 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 the muscular plate, which is due to autoimmune reactions. Antibodies to acetylcholine receptors were extracted from the thymus, they were found in the blood serum (in 85-90% of patients), using the immunoperoxidase method, IgG and C 3 are 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 of patients with myasthenia often find follicular hyperplasia or thymoma. 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, lymphoid infiltrates are found.

Diseases of the musculoskeletal system and connective tissue

Gout is a disease associated with a violation of purine metabolism, manifested by the deposition of uric acid in the tissues and leading to a characteristic lesion of the joint and other organs. The disease is accompanied by periodic pain in the joints of the arms and legs. The causes of gout can be overeating, alcohol abuse, eating foods containing purine bases (meat, cottage cheese, fats, fish, red wine) and a sedentary lifestyle. 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 with tearing pain, in most cases the pain syndrome is formed in the first metatarsophalangeal joint of the thumb, but sometimes begins with several joints.

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

Diagnostics

On the part of the blood, an increase in uric acid, an acceleration of ESR and neutrophilic leukocytosis are noted. Radiological defects are determined in places of deposition of uric acid salts.

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

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

Coxarthrosis (deforming arthrosis of the hip joint) is the most severe form of arthrosis, characterized by pain when resting on the leg, the appearance of lameness and limitation of movement in the joint. At a later stage, subluxation of the femoral head occurs. With a bilateral lesion, a "duck" gait occurs.

Osteoarthritis of the knee joint - gonoarthrosis - is characterized by pain that occurs when descending the stairs, and pain on palpation of the knee joint.

Deformation develops due to changes in the bone. In addition, there is occasional slight swelling.

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

Diagnostics

The main criterion for diagnosis is persistent deformity of the joint without pronounced inflammatory changes in the blood. On the radiograph, the narrowing of the joint space and marginal osteosclerosis are determined.

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

Systemic connective tissue lesions

Connective tissue disease is a group of diseases characterized by autoimmune and immunocomplex inflammation of the connective tissue or increased fibrosis.

The cause of the development of connective tissue lesions is unknown. However, gender differences and non-specific environmental influences (infections, insolation, cooling, stress, unbalanced nutrition, family genetic predisposition to autoimmunity, etc.) can be etiological factors.

Main clinical symptoms

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

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

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

- antibodies to RNP (mixed connective tissue disease);

- 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. Plasmapheresis, 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 connective tissue disorders, including Behçet's disease and polymyalgia rheumatica.

Osteocondritis of the spine

Osteochondrosis of the spine 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 proliferation of marginal osteophytes.

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

Main clinical manifestations

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

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

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

Diagnostics

The final diagnosis is made on the basis of clinical data and the results of X-ray examination.

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

After the disappearance of pain, physiotherapy, hydrotherapy and physiotherapy exercises are carried out. In addition, it is necessary to wear an unloading orthopedic corset. With the ineffectiveness of conservative treatment, the cartilaginous hernia is removed and the fusion of 2 adjacent vertebrae is performed. To prevent complications, light work without a load 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 destruction of the vertebral bodies occurs, which leads to deformation of the spine. 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 body temperature. There is a 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 accelerated ESR. The disease can be chronic.

Surgery is being performed.

Spondylosis

Spondylosis is a chronic disease caused by degenerative changes in the outer sections 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 injuries of the spine.

Main clinical symptoms

At the end of the day there are wills in the back, sometimes lesions of the roots are observed.

Diagnostics

On the radiograph, there are 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, as well as exercise therapy, massage, etc. are prescribed.

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

Main clinical symptoms

The 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 in osteochondrosis of the spine, injuries and infections.

Complex therapy is carried out taking into account the underlying disease.

Myositis is a polyetiological disease, which 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 the connective tissue with the development of fibrosis in the inflamed muscle.

Perhaps the appearance of sclerosis of the intermuscular tissue and bone elements in it, when not only muscles are affected, but also tendons and muscle membranes.

Main clinical symptoms

A set of disorders in various diseases are combined under the general name of myopathy. Distinguish:

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

- violation of coordination not only of whole muscles, but also of bundles inside the muscles;

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

Diagnostics

The final diagnosis is made on the basis of characteristic symptoms and the results of clinical studies, pus culture and electromyography.

Antibiotics and analgesics are used, according to indications - surgical interventions and physiotherapy. In addition, pain reduction and treatment of the underlying disease are carried out.

synovitis

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

The most commonly affected sites 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, observes pain on palpation. There is also a violation of the function of the joints: redness of the joint area.

Diagnostics

The final diagnosis is made on the basis of clinical symptoms and the results of a study of articular fluid punctate.

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

Tenosynovitis

Tenosynovitis is an inflammatory process that often affects the junction of the tendon into the muscle.

Tenosynovitis of the short extensor in the long abductor thumb muscle develops as a result of prolonged stress. It is manifested by pain in the region of the styloid process of the radius, which is aggravated by the movement of the thumb.

Tenosynovitis of the ulnar extensor of the wrist is characterized by pain in the region of the styloid process of the ulna, radiating to the elbow of the 4th and 5th fingers.

"Latching finger" occurs due to microtrauma of the superficial flexors of the fingers. It is manifested by pain and swelling on the palmar surface of the fingers. The feeling of blockage and snapping is overcome with the help of a good hand.

Carpal finger syndrome: sudden intense pain and paresthesia in the area of ​​fingers I and III on the side of the palm, 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 analgesics are prescribed orally or locally. When squeezing the nerve, surgical intervention is indicated.

Bursopathy

Bursopathy - inflammation of the synovial bags, located between the tendons and bone protrusions. They occur with injuries or microtraumas and accompany other injuries. The outcome of bursitis may be fibrosis. Most often, the elbow and trochanteric regions are damaged. There are ulnar, trochanteric, ischial and prepatellar bursitis, as well as goose foot bursitis in the tibia.

Cold is prescribed first, then heat, deep warming and anti-inflammatory drugs. With purulent bursitis, surgical intervention is performed.

Heel spur

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

Main clinical symptoms

When walking, running or wearing uncomfortable shoes, there is severe pain in the calcaneus.

Diagnostics

The final diagnosis is made on the basis of the identification of an outgrowth of a spiky, pyramidal or wedge-shaped form on the radiograph.

Conservative treatment is carried out, 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: reduced physical activity, diet, alcohol consumption, smoking, lack of vitamins, as well as reduced nutrition with a decrease in calcium and phosphorus. Osteoporosis can be local and 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 the thoracic vertebrae, and fractures of the femoral neck are also recorded. In secondary osteoporosis, the symptoms are due to the underlying disease.

Diagnostics

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

Vitamin D and calcitonin are prescribed. Currently, there are many complex drugs. The cure for secondary osteoporosis is to treat the underlying disease.

It should be borne in mind that the development of osteoporosis is hampered by physical activity and rational nutrition with sufficient calcium and phosphorus in equal proportions. The daily dosage of 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 the bones) is a syndrome that occurs when there is 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 a violation of their absorption in the intestines. At the same time, the volume of bone substance and its mineralization decrease, which is accompanied by softening of the bones and their curvature.

Main clinical symptoms

The most telling signs are bone deformity, bone pain, fractures, hypotonia, and muscle wasting. Osteopenia is seen on radiographs. In children, changes are localized in the metaphases of tubular bones.

Children are prescribed vitamin D, calcium and phosphorus preparations, deformity correction and restorative therapy. Treatment of adults is aimed at normalizing calcium-phosphorus metabolism to improve bone mineralization.

Osteomyelitis

Osteomyelitis is an inflammatory process with damage to all structural elements of the bone and bone marrow.

The main etiological factor is pyogenic microflora. The entrance gate of infection in hematogenous osteomyelitis can be the nasopharyngeal mucosa and foci of chronic infection.

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

Main clinical symptoms

There are 3 forms of osteomyelitis.

With a mild form, local symptoms prevail over the general ones. Intoxication is expressed moderately, body temperature does not exceed 38 °C. Local changes are localized in the affected areas, the 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 pains arise, forcing to restrict movement and take a forced position. Over the lesion, the skin turns red, the venous pattern is more clearly manifested. With an unfavorable course of the disease, the symptoms of intoxication increase.

With a lightning-fast form, severe intoxication develops on the first day with confusion, convulsions, symptoms of irritation of the meninges and cardiovascular insufficiency. Patients can die on the 1st day from the onset of the disease.

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

Diagnostics

The final diagnosis is made on the basis of the characteristic clinical symptoms and the results of an X-ray examination.

Surgical treatment of the local process is carried out, directed to the pathogen by prescribing an antibiotic and improving the body's resistance by increasing the calorie content of the diet. In addition, vitamins, microelements and immunomodulators are prescribed, as well as detoxification and symptomatic therapy.

Skeletal muscles provide all the 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. The human body has 222 bones and approximately 206 joints.

The musculoskeletal system performs a 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 is made up 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 permanent shape and allows it to take certain positions. The bones of the skeleton, within certain limits, protect the internal vital organs from external rough physical influences. So, the brain is 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 of the genitourinary system. In 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 blood 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 the 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. Arteries along the blood flow tree-like branches into ever smaller vessels and turn into arterioles, which in turn break up into a system of the thinnest vessels - capillaries. Capillaries have a lumen almost equal to the diameter of erythrocytes (about 8 microns). Venules begin from the capillaries, which merge into gradually enlarged veins. Blood flows to the heart through the largest veins.

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

The pulmonary circulation begins with the pulmonary trunk, which departs from the right ventricle. It carries blood to the pulmonary capillary system. From the lungs, arterial blood flows through four veins that empty into the left atrium. This is where the pulmonary circulation ends.

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

The human skeleton is made up of 206 bones that are connected together through ligaments and connective tissue. The skeleton not only provides motor function, but also protects vital 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. The following are some common diseases of the skeletal system.

General diseases of the skeletal system

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

Arthritis exists in two main forms. Osteoarthritis is the wear and tear on our bones and joints that occurs with age. Obesity is one of the important factors that can accelerate osteoarthritis, especially of the knees and hips. All joints of bones 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 the formation of bone spurs, joint narrowing, inflammation, and pain. Treatment for severe osteoarthritis is pain medication 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 destruction of the joints and chronic weakness. Treatment aims to manage pain and modulate the immune system to limit further damage.

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

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

Rickets: a disease of the skeletal system associated with vitamin D deficiency

Rickets/osteomalacia occurs due to a severe deficiency of calcium, vitamin D and phosphates. 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 trauma to the tendons

Tendon injury leads to inflammation and pain. Tendons "connect" the muscles to the bone and facilitate movement. Painful areas are the knee, elbow, wrist and Achilles tendons. Treatment includes rest, ice application, and changing activities until the pain and inflammation resolve.

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

Bursa is a specialized fluid around our joints. It provides cushioning between joints and nearby muscles, tendons and ligaments. The well-known "water in the knee" condition 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 also need to avoid pressure on the affected tissue area and rest.

Cancers of the skeletal system

Leukemia

White blood cells - leukocytes - are partly produced in the bone marrow. Generally, a number of blood cancers are referred to as leukemia. The onset of leukemia is generally insidious. Until a critical mass of abnormal cells has formed, most people are asymptomatic. Early symptoms of leukemia include bone pain, extreme fatigue, night sweats, unexplained weight loss, and bleeding gums.

bone cancer

Cancers can also develop in bones. Bone cancer can be the main type of cancer, and 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 feet that curve inwards and downwards. As a result of this disease, it is very difficult for a child to learn to walk. Often specialized orthopedic therapy or surgery is needed.

Spina bifida

Spina bifida is a congenital defect that is associated with incomplete closure of a vertebra around the spinal canal. Many people have mild forms of this disease and are not even aware of it. More severe forms of the disease 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 conditions, the sclera (the white part of the eye) often has a bluish tint.

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

Paget's disease causes bones to break faster than they can repair. Usually in the body, this process is in balance. However, in Paget's disease, there is an accelerated breakdown of bone tissue, 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) cancerous (bone cancer and leukemia); 4) caused by trauma (tendinitis, fractures).