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med surg 2 > back ingury > Flashcards

back ingury Flashcards

1
Q

CONCEPT OF MOBILITY

A

provides form,support, stability and movement to the body.it is made up of the bones of the skeleton, muscles,tendons,ligaments, joints, and other connective tissue that supports and binds tissues and organs

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2
Q

GENETIC/LIFESPAN CONSIDERATIONS

A
  • bones and muscles adapt as individual ages
  • some bones fuse during infancy while others grow as child developes
  • this growth is then turned off during adulthood (bones undergo remodeling)
  • older adults undergo physiologic changes(decrease strength and mobility)
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3
Q

ALTERATIONS TO MOBILITY

A

CHANGES IN THE FUNCTION OF THE MUSCULOSKELETAL:

  • back problems (back pain)
  • fractures
  • osteoarthritits
  • multiple sclerosis
  • Parkinson disease
  • spinal cord injury
  • amputations
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4
Q

BACK PROBLEMS -PAIN

A

BACK PAIN- most common medical problem in America

BACK PAIN MAY RESULT IN:

  • decreased quality of life
  • decreased mobility
  • increased pain and frustration
  • loss of work hours

back pain often results from years of improper body mechanics with incident acting as “the straw that broke the camel’s back”

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5
Q

BACK PAIN CAUSES

A
  • bad posture
  • low fitness level
  • pregnancy
  • obesity
  • athletic injuries
  • degenerative disorders
  • occupational risk factors
  • referred pain from GI/GU/AAA
  • backpack use
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6
Q

PREVENTION

A
  • posture
  • lifting
  • body mechanics
  • rest
  • exercise
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7
Q

WHEN STANDING FOR LONG PERIODS OF TIME

A

shift weight frequently from side to side if required to stand for long periods of time

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8
Q

VERTEBRAL SEGMENTS AND INNERVATIONS

A
  1. CERVICAL: c1- c7, head and neck, diaphragm, upper limbs
  2. THORACIC: t1-t12, chest muscles, abdominal muscles, some back muscles
  3. LUMBAR:l1-l5, lower abdomen and back parts of lower limbs
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9
Q

HERNIATED DISC

A
  • refers to a problem of the rubbery cushions between the individual bones that make up your spine
  • occurs when nucleus pulposus ruptures and protrudes
  • allowing fluids to leak out and irritate nerves
  • compression of the nerve roots and cord shrinking the disc
  • results in pain, numbness, or weakness in arm or leg
  • most people do not need surgery
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10
Q

DISC HERNIATION TYPES

A

ABRUPT:

  • nerve root compression
  • severe pain
  • muscle spasms

GRADUAL:

  • slow onset pain
  • associated with neurological symptoms(weakness/tingling)
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11
Q

RISK FACTORS

A

-most common between ages 30-50

  • heavy lifting
  • bending /twisting improperly
  • overweight
  • smoking
  • genetic factors
  • previous back problems
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12
Q

CLINICAL MANIFESTATIONS: LUMBAR

A
  • low back pain
  • radiating down the buttock and below the knee
  • sciatic nerve pain
  • weakness of the leg, foot, or toes
  • bowel and bladder incontinence
  • impotence
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13
Q

CAUDA EQUINA SYNDROME (CES)

A
  • latin for “horse’s tail”
  • compression of the nerve roots of this part of the spine
  • may be permanent neurological impairment
  • urinary incontinence and paralysis
  • caused by massive lumbar disc herniation, spinal stenosis and trauma

MEDICAL EMERGENCY!!!

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14
Q

STRAIGHT LEG TEST

A

-back or leg pain may be reproduced by raising the leg and flexing the foot at 90 degrees

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15
Q

DIAGNOSTIC STUDIES

A
  • L-spine x-ray
  • MRI
  • CT
  • EMG: nerve irritation/neuropathy
  • myelogram
  • blood tests
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16
Q

CHRONIC LOW BACK PAIN TREATMENT

A
  • low back exercises/PT
  • rest
  • local heat/cold application
  • pain relievers
  • weight reduction
  • surgery
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17
Q

NON- PHARMACOLOGIC TREATMENT

A
  • brace
  • massage
  • traction
  • physical therapy
18
Q

PHARMACOLOGIC THERAPY

A
  • salicylates
  • NSAIDs
  • skeletal muscle relaxants (Baclofen,methocarbamol)

-neuropathic pain: gabapentin,pregabalin, and duloxetine

  • corticosteroids
  • epidural injections
19
Q

INTRATHECAL MORPHINE PAIN PUMP IMPLANT

A
  • intrathecal drug delivery, or “pain pump” is a method of giving medication directly to your spinal cord
  • because of this, symptoms can be controlled with a much smaller dose than is needed with oral medication
  • the goal of a drug pump is to better control your symptoms and to reduce oral medications thus reducing associated side effects
  • risk for the intrathecal pain pump is low
20
Q

LAMINECTOMY

A

surgical removal of part of the posterior arch of the vertebrae to allow for removal of the disk

21
Q

DISCECTOMOY

A

-micro surgical procedure that allows the surgeon to visualize the disk and disk space better for easier removal of the herniated portion

22
Q

LASER DISCECTOMY

A
  • outpatient procedure

- the laser is used on the herniated portion of the disk

23
Q

SPINAL FUSION

A
  • TSOL while out of bed
  • surgical and graft site if used
  • avoid sitting or standing for long periods of time
  • encourage walking, lying down and shifting weight
  • no twisting the spine
24
Q

SPINAL FUSION OVERVIEW

A
  • used for unstable spinal areas by creating a connecting vertebrae with a bone graft
  • fibula or iliac crest
  • rods,plates and screws
  • infuse bone graft/cage (regeneration)
25
Q

VERTEBROPLASTY

A
  • outpatient

- used to stabilize vertebral bone fractures

26
Q

POST OP CARE

A
  • vital signs
  • signs of circulation
  • signs of bleeding
  • position
  • pain
  • emotional support
  • safety
  • sterile technique
  • signs of infection
  • compression dressings
  • paralytic ileus common,start Po intake slowly
27
Q

POST OP CARE

A
  • proper alignment at all times
  • log roll
  • pain control
  • pillows under legs
  • neuro checks q 2-4 hours
  • paralytic ileus
  • Turn cough deep breathe every hour while awake
28
Q

NEUROVASCULAR ASSESSMENT

A

CIRCULATION

  • color/temperature
  • capillary refill
  • pulses
  • edema

MOTOR FUNCTION

  • flexion
  • extension
  • abduction
29
Q

DISCHARGE INSTRUCTIONS

A
  • bathing/incision care
  • discomfort(pain control)
  • restrictions
  • activity
  • when to call the doctor
30
Q

SCOLIOSIS

A
  • diagnosed if the sideway curvature measures more than 10 degrees
  • congenital, acquired , idiopathic
31
Q

CLINICAL MANIFESTATIONS OF SCOLIOSIS

A
  • spinal curvature to one side
  • uneven shoulders and hips
  • differences in leg length
  • tiredness of the spine
  • prominent shoulder blade and rib bump
  • severe scoliosis( heart and lung problems)
32
Q

DIAGNOSTIC TESTS FOR SCOLIOSIS

A
  • school screening for children ages 10-15 Adam forward bend test
  • observation
  • x-ray cobb method
33
Q

CLINICAL MANIFESTATIONS OF SCOLIOSIS THERAPIES

A

MILD SCOLIOSIS
-observation every 3-6 months

MODERATE
-bracing 12-23 hours /day

SEVERE
-surgical correction

34
Q

SCOLIOSIS SURGERY

A
  • involves spinal fusion with insertion of metal rod

- infections can compromise outcome of the deformity correction and delay recovery

35
Q

POST OP CARE FOR SCOLIOSIS

A
  • TLSO BRACE
  • limit activity for 6-8 months post surgery
  • learn to perform simple task without bending or twisting
36
Q

FRACTURES

A
  • a broken bone
  • it can range from a thin crack to a complete break. bone can fracture crosswise, lengthwise, in several places, or into many pieces. most fractures happen when a bone is impacted by more force or pressure than it can support
37
Q

FRACTURE SYMPTOMS

A
  • most fractures are accompanied by intense pain when the initial injury occurs
  • a snap or grinding sound when the injury occurs
  • swelling, redness, and bruising in the injured area
  • difficulty supporting weight with the injured area
  • visible deformity in the injured area
  • in some cases , you may see broken bone exposed
38
Q

FRACTURE TYPES

A
  • OPEN
  • CLOSED
  • COMPLETE
  • INCOMPLETE
39
Q

CAUSES/RISK FACTORS OF FRACTURES

A
  • falls
  • direct body strikes
  • traumatic events, such as car accidents or gunshot wounds
  • injury from sports
  • bone density
  • age
  • osteoporosis
  • endocrine or intestinal disorders
  • smoker
  • alcohol
  • physically inactive
  • taking corticosteroids
40
Q

DIAGNOSTIC TESTS/TREATMENT FOR FRACTURES

A
  • X ray to determine fracture severity
  • traction/splint
  • surgery if necessary
  • pain control
  • healing time
41
Q

COMPLICATIONS OF FRACTURES

A
  • knees pain
  • compartment syndrome
  • DVT
  • fat embolism
  • infection
42
Q

PREVENTION

A
  • diet
  • exercise
  • supplements
  • education

med surg 2 (17 decks)

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