Pathophysiology of Acute Renal Failure in Rhabdomyolysis

Module 10: Musculoskeletal System & Integumentary System

Introduction

Module 10 will include a review of the structure and function of the musculoskeletal system. The major focus of this Module will include alterations of musculoskeletal function. There will be an emphasis on common disorders of musculoskeletal function in the adult and child.

The musculoskeletal systems function is to hold the body together, permit movement of the body, and protect and support the internal organs. The parts of the musculoskeletal system that provides structure and support are the bones, joints, capsules, and ligaments. Those that allow the body to function or move include muscles and tendons along with the central and peripheral nervous systems. When changes occur in these components pain or disease results.

Bone tissue loss occurs in the aging adult. Bones become less dense, weaker, and more brittle. In women bone density decreases leading to deformity, pain, stiffness, and high risk for fractures. Men also experience bone loss but a t later ages and at slower rates than women. Strength declines slowly with age. Most people loose about one third of a pound of muscle every year after age 40 and gain at least as much body fat.

Module 10 will also include a review of the structure and function of the integumentary system. The primary focus will include alterations of the integumentary function. There will be an emphasis on disorders of the integumentary system in the adult and child.

The integumentary system is the largest system in the body. It consists of skin, hair, nails,

and various glands. The skin covers the entire body and accounts for about 20% of the body’s weight. The integumentary system is made up of two parts: skin and accessory structures. There are 5 functions of the integumentary system: protection, temperature maintenance, synthesis and storage of nutrients, sensory reception, and excretion and secretion. Normal microorganisms of the skin protect against pathologic bacteria.

Objectives

Discuss the structure and function of the musculoskeletal system.

Identify clinical manifestations of disorders of the musculoskeletal system.

Discuss pathophysiology of the common adult and childhood disorders of the musculoskeletal.

Review current treatment options for various common adult and childhood disorders of the musculoskeletal system.

Discuss the structure and function of the integumentary system.

Identify clinical manifestations of disorders of the integumentary system.

Discuss pathophysiology of the common conditions of the integumentary system.

Review current treatment options for various common conditions of the integumentary system.

Readings

Chapter 40 ppt.

Chapter 41 ppt.

Chapter 42 ppt.

Chapter 43 ppt.

Chapter 44 ppt.

Huether et al. 2020

Chapter 40

Please review this chapter; there are no required readings from this chapter.

Chapter 41

Skeletal Trauma

Fractures

Dislocation and Subluxation

Sprains and Strains

Tendinopathy, Epicondylopathy, and Bursitis

Muscle Strains

Rhabdomyolysis

Compartment Syndrome

Malignant Hyperthermia

Osteoporosis

Osteomalacia

Paget Disease

Osteomyelitis

Osteoarthritis

Rheumatoid Arthritis

Ankylosing Spondylitis

Gout

Fibromyalgia

Myopathy

Bone Tumors

Patterns of Bone Destruction

Types

Rhabdomyosarcoma

Chapter 42

Clubfoot

Developmental Dysplasia of the Hip

Osteogenesis Imperfecta

Osteomyelitis

Septic Arthritis

Juvenile Idiopathic Arthritis

Legg-Calve-Perthes Disease

Osgood-Schlatter Disease

Scoliosis

Duchenne Muscular Dystrophy

Spinal Muscular Atrophy

Facioscapulohumeral Muscular Dystrophy

Myotonic Muscular Dystorphy

Osteochondroma

Osteosarcoma

Ewing Sarcoma

Fractures in Nonaccidental Trauma



Chapter 43



Review Structure and Function of the Skin

Inflammatory Disorders

Allergic Contact Dermatitis

Irritant Contact Dermatitis

Atopic Dermatitis

Stasis Dermatitis

Seborrheic Dermatitis

Psoriasis

Pityriasis Rosea

Lichen Planus

Acne roseacea

Lupus Erythematosus

Pemphigus

Erythema Multiforms

Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

Bacterial Infections

Viral Infections

Fungal Infections

Urticarial

Scleroderma

Seborrheic Keratosis

Actinic Keratosis

Cancer

Basal Cell Carcinoma

Squamous Cell Carcinoma

Cutaneous Melanoma

Kaposi Sarcoma

Alopecia

Paronychia

Onchomycosis



Chapter 44

Acne Vulgaris

Atopic Dermatitis

Diaper Dermatitis

Impetigo Contagiosum

Tinea Capitis

Tinea Corporis

Thrush

Molluscum Contagiosum

rubeola

Roseola

Small Pox

Chickenpox

Scabies

Pediculosis

Discussion

Module 9

Discussion 1

A 28-year-old male presents to the primary care office for evaluation of left calf pain, swelling, and redness. He reports that this started one day ago and worsened today. He ran a 27-mile marathon 2 days ago and traveled for 3 hours in a car today. He reports slight pain on walking and a swollen red calf. He took Ibuprofen 600 mg twice today without relief. Patient reports being an experienced runner, running 3-5 miles daily. He trained for the marathon for 4 months. Patient also reports a history of exercise induced asthma and uses albuterol sulfate HFA as needed.

On physical exam patient appears in good health T 99 P 68 R 18 BP 118/78 wt. 175 lb, height 72 in. BMI 23.1. Heart rate is regular without murmurs, rubs, or gallops. Lungs clear bilaterally. HEENT WNL. Strength lower extremities +5 and DTRs + 2. Left calf erythematous, edematous, warm and tender on palpation. Pulses 3+.

Two possible diagnoses were considered: deep vein thrombosis (DVT) and rhabdomyolysis.

Stat ultrasound of left leg to rule out DVT was ordered and read as normal

CBC WNL

Creatine Kinase (CK) 23,000 U/L (normal 24-170 U/L)

BUN and Creatinine WNL

A diagnosis of rhabdomyolysis was made.

1. Discuss the pathophysiology of acute renal failure in rhabdomyolysis.

Module 10: Discussion

Post your initial response by Wednesday at midnight. Respond to one student by Sunday at midnight. Both responses must be a minimum of 150 words, scholarly written, APA formatted, and referenced. A minimum of 2 references are required (other than your text). Refer to grading rubric for online discussion.

Special Guidance on APA formatting in Discussion Posts

APA formatting is required in discussion posts with the following two exceptions (due to limitations with the text editor in LIVE): double line space and indent 1/2 inch from the left margin. Discussion posts will NOT be evaluated on those two formatting requirements. All other APA formatting guidelines should be followed. For example, in-text citations must be formatted with the appropriate information and in the correct sequence (Author, year), reference list entries must include all appropriate information following guidelines for capitalization, italics, and be in the correct sequence. Refer to the APA Publication Manual 7th ed. for each source type's specific requirements. Please let your instructor know if you have any questions.

Please note include a summarized table with the pathophysiology, test, diagnosis, Treatment, as indicated in the writing sample as attached to this assignment.