Alterations in mobility Flashcards
Complete v. incomplete fracture
complete fractures extend through the bone whereas incomplete extend partially through the bone.
Simple fractures
those that do not break through the skin
Compound fractures
open fractures that break through the skin
Fractures
break in the bone that results from trauma, osteoporosis, stress from physical activity, or insufficiency fractures which are the result of other causes (RA, Paget disease..). There is bleeding, inflammation and a fibrin clot that develops at the site. Osteoblastic activity is stimulated and immature new bone (callus) is formed. True bone then replaces the callus over several weeks-months. S&S= pain, unnatural position of the bone/limb, swelling around the site, impaired sensation or tingling which indicates nerve damage, crepitus with movement.
Osteoporosis
metabolic bone disease C/B a reduction in bone density leading to easy bone fracture, where bone resorption exceeds the rate of bone formation. This is caused by post menopausal decreases in estrogen, decreased physical activity, and calcium and VIT D deficiencies. S&S= symptomless until fracture, weakness and collapse of vertebrae– kyphosis (hump back), and decreased ht.
Paget disease
idiopathic bone disorder usually seen after age 40, and C/B accelerated patterns of bone remodeling resulting in thickened and soft bones that are deformed and weak. This often affects vertebrae, skull, sacrum, sternum, pelvis and femur. S&S= changes in the shape of the skull– headaches, hearing abnormalities and mental deterioration. Pain and deformity of the long bones, spine or pelvis, and frequent pathological fractures.
Osteomyelitis
acute infection of the bone usually from bacteria that may occur from the spread of a blood-borne infection or following contamination of an open fracture or reduction (exogenous osteomyelitis). Exogenous symptoms= injury and inflammation at the site of pain, fever and lymphadenopathy. Endogenous symptoms= fever chills and reluctance to move limb (in children). fever, fatigue, malaise, with preceding urinary, resp, ear or skin infection (in adults).
Osteoarthritis (OA)
most prevalent non-inflammatory joint disease C/B progressive deterioration and loss of articular cartilage over the years, primarily in weight bearing joints. S&S= bony outgrowths around joint margins, impaired mobility, deep and aching pain in afflicted joints especially in hips, knees, neck and back. morning stiffness, joint thickening and effusion, hand disfigurement with heberden’s nodes at distal interphalangeal joints and bouchard’s nodes at proximal interphalangeal joints. ***Destruction of the joint space and ankylosis do not occur.
Rheumatoid Arthritis (RA)
idiopathic and chronic multisystem, autoimmune disease C/B chronic synovitis that leads to destruction and ankyloses of affected joints. May affect skin, eyes, heart, and lungs as well. There are self directed Abs called rheumatoid factors present which destroy joint capsules. S&S= nonlocalized pain with fatigue and malaise, stiff, enlarged, tender joints that are painful when moved and red/warm, ankylosis with permenant immobility, joints appear fusiform/tapered with atrophy of surrounding muscles, radial deviation of the wrist with ulnar deviation of the fingers. May also dvlp skin nodules, glaucoma, pericarditis, pleuritis.
Ankylosis
abnormal stiffening and fusion of joints with immobility that occurs with rheumatoid arthritis.
Gout
metabolic disorder C/B altered uric acid production or excretion causing hyperuricemia and high uric acid levels in other body fluids (synovial). Can be either primary idiopathic which is genetic, or secondary gout in which hyperuricemia is caused by another disorder like renal disease, drugs, anemias or leukemias. Gout is R/T increased purine metabolism and decreased renal function. S&S= acute- sudden pain in peripheral joints, mostly great toe and LEs, stress precedes events, alcohol or dietary indulgence. Chronic tophaceous gout- 3-40 years, limitation of motion, evidence of renal disease and presence of soft tissue tophi (pockets of uric acid), renal stones 1000x more likely.
Scoliosis (pediatric)
abnormal curvature of the usual concave-convex-concave vertebral presentation seen in descent from shoulder to buttocks. P. will also exhibit prominent ribs on the convex side, uneveness in the ht of the iliac crest, unequal LE length, asymmetry of the thoracic cage and misalignment of the spinal vertebrae. May result from an actual, congenital structural deformity or may develop from neuromuscular disease like cerebral palsy. Can be idiopathic.
Muscular Dystrophy (pediatric)
An inherited disorder involving an enzymatic or metabolic defect which causes wasting of muscles. Duchenne’s is the most common/severe form and is passed on the X chromosome; seen most exclusively in males (sex linked). With Duchenne’s, the gene producing dystrophin is mutated and muscle cell membranes are not maintained. Manifests as clumsiness, waddling gait and falls in toddlers. Anterior tibial weakness–walking on toes, decreased deep tendon reflexes, pseudohypertrophy of calf muscles, weakness of postural muscles–curvature of spine, decreased lung expansion and frequent resp. infections.
