Orthopedics

Scientists grow living muscle in the lab that heals by itself - a significant step in tissue engineering.  

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Inspiration is an active process, but normal expiration is a passive process. Forced expiration recruits the abdominal muscles to help force out air.   Muscles of breathing Diaphragm – this is the main muscle of inspiration. It flattens out. During normal quiet breathing it is only really the diaphragm that does any work (other muscles are often not involved). It is controlled by the phrenic nerve which has nerve roots in C3-5.  

Monoarthritis This is a neuropathic arthropathy it is a progressive degeneration of a weight bearing joint – usually in the ankle. There is usually bone destruction, remodelling and resorption, with ultimately results in deformity. Usually gradual slow onset Can also result in ulceration  

Osteoarthritis is a condition that results from the loss of cartilage at synovial joints, and is often accompanied by degeneration of the underlying bone.   Radiologically there are: osteophytes Joint space narrowing   Epidemiology most common type of arthritis 80% people >60 will have some radiographic features  

Spondyloarthritides (aka spondyarthritis, SpA, seronegative spondylarthropathy) – these are inflammatory joint diseases of the vertebral column and sacro-iliac joints. These conditions tend to mimic rheumatoid conditions (e.g. rheumatoid arthritis), but are serologically different, as rheumatoid factor is usually negative.  

This is a syndrome that results from swelling of a muscle. The muscle is retained in its fixed volume fascia, however, and thus the swelling of the muscle causes occlusion of the blood supply. this can result in infarction, and can cause an ischaemic contraction known as Volkmann’s Ischaemic Contracture.   It typically occurs in the forearm and calf, but can also occur in the thigh and foot.    

These are essentially the same disorder. In children, the disease is rickets but after fusion of the epiphyseal plates it is known as osteomalacia. The most common cause is vitamin D deficiency. The condition is characterised by normal bone formation with abnormal bone mineralisation, thus there is excess osteoid and cartilage, and insufficient bone.   Causes  

Along with osteoporosis, this is a common degenerative bone disease   Epidemiology and Aetiology This is the second most common bone disorder (after osteoporosis), and affects >5% of the over 55’s in the UK. The prevalence varies between countries and races. The UK has the highest incidence. It is rare in Scandinavia, China and Japan. Increased incidence in Pet Owners Genetic susceptibility  

ADH (/vasopressin) is synthesised in the hypothalamus. From there it migrates in neurosecretory granules along axonal pathways to the posterior pituitary gland. Secretion of ADH is principally in response to changes in plasma osmolality. It acts on the collecting duct of the kidney to cause water reabsorption via the translocation of aquaporin channels in the CD lumen, and is therefore stimulated when we need to conserve water volume. It is stimulated by large falls in blood pressure or volume. At high concentrations, ADH also causes vasoconstriction.