Pathophysiological changes are always a hallmark of any disease, syndrome, or group of conditions affecting a particular distinct body physiologic system. These changes give rise to the various accompanying symptoms and thus manifest conspicuously when they affect the patient bodily functions. The changes associated with musculoskeletal, metabolic, and multisystem health dysfunctions abound.
In the case of musculoskeletal disorders, the most common pathophysiologic process is the impact of mechanical stress on the system. The body muscle system, skeletal elements such as the bones, tendons, and other connective tissue all come into play when any bodily activity happens. An example is in the case of osteoarthritis, where joints are continuously worn due to activity. Besides, there is a weakening of the bone due to remodeling leading to individuals being prone to fractures. This is also explained by metabolic changes that occur as a result of multisystem organ changes where cases of renal failure and parathyroid gland failure all impair calcium metabolism, which is critical in skeletal tissue integrity.
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Physiologically, the body will respond in different ways, a factor that is influenced by age, gender, body build, and skills. However, it is essential to mention the essential physiologic response occurs at the cellular response in myofibrils. This requires the production of energy, Adenosine Triphosphate for muscle respiration that is cumulative. When there is an adequate supply of oxygen, no lactate accumulation occurs, but in cases of anaerobic supply, cellular damage occurs, leading to acute inflammation. If the process is chronic, fibrous tissue formation occurs (Barbe & Barr, 2006) .
Inflammation, a process that occurs in any form of injury, is naturally protective as it is a response to harmful agents. It can be both acute and chronic and is a central figure in the musculoskeletal and metabolic systems. In the event the offending agent is removed, recovery takes place, but chronic inflammation sets in if the agent persists. Some of the systems affected are the immunologic and vascular systems. With the activation of the immunologic system, inflammatory cells such as macrophages and later fibroblasts cell that lead to abundance in collagen hence scar tissue formation. This has been seen in cases of deep burn wounds. Besides, scarring at joint decreases mobility of the particular angle (Kumar, Abbas, & Aster, 2017) .
Inflammation has also been seen to result in the development of autoimmune diseases that are usually systemic and have musculoskeletal manifestation. An example is a rheumatoid disease and systemic lupus erythematous. Such rheumatologic conditions have system-specific symptomatology of chronic pain in joints, joint stiffness, bony outgrowths, and tenderness in extremities. This may be due to the vascular system's effect where vasculitic changes occur, impeding blood flow.
Systemically clinical presentation is wide. This may include chronic pains such as the lower back. There are also sensations of generalized body malaise accompanied by loss of appetite and thus loss of weight. Occasional fevers may also present due to the inflammatory cytokines and the fact that these patients are prone to infectious ailments.
One of the apparent effects on the patient is reduced functioning. This may be occasioned by restrictive symptoms such as pain in arthritis or loss of function, such as in end-stage renal disease necessitating organ transplant for the restoration of the same. Another effect on the patient is that it may lead to multisystem failure. This is seen in kidney disease that may cause hypertension, which may lead to pulmonary and cardiac changes that, over time, lead to cardiopulmonary collapse. In hepatorenal syndrome, liver failure occurs as a result of the renal shutdown. Such patients are usually hospitalized hence generally immobilized (WHO, 2019). With chronic fatigue, these patients are unable to do activities and hence decreased productivity that may even involve activities of daily living.
References
Barbe, M., & Barr, A. (2006). Inflammation and the pathophysiology of work-related musculoskeletal disorders. ScienceDirect . Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1552097/
Kumar, V., Abbas, A., & Aster, J. (2017). Robbins Basic Pathology. Saunders.
World Health Organization. (2019). Musculoskeletal conditions . Retrieved from World Health Organization: https://www.who.int/news-room/fact-sheets/detail/musculoskeletal-conditions
