bones test Flashcards
Osteoblasts are for
bone formation
Osteocytes
Mature bone cells that function in bone maintenance
Osteoclasts
function in destroying, resorbing, and remodeling bone
Bone Healing Stage I
Hematoma formation
1 to 2 days after fracture
Bone Healing Stage II
Fibrocartilaginous callus formation
Fibroblasts and osteoblasts migrate to fracture site
Bone Healing Stage III
Bony callus formation
Ossification begins during 3rd or 4th week
Bone Healing Stage IV
Remodeling
Osteoclasts remove necrotic bone
Compact bone replaces spongy bone
fracture pain will be described as
sharp pain, immobilization relieves it
Flaccid
May have some muscle reaction
Spastic
clonus/twitchy. Rhythmic contraction of muscle
Atonic
no tone, no muscle reaction
Hypertrophy
overgrowth/very muscular
Atrophy
shrinkage-like decrease in size of muscle
Crepitus
grating or crackling sound or sensation
bone pain will be described as
a deep, dull ache
Fliculation
twitching
assess the peroneal nerve by
Prick the skin midway between the great and second toe.
Ask the patient to dorsiflex the foot and extend the toes
assess the tibial nerve by
Prick the medial and lateral surface of the sole.
Ask the patient to plantar flex toes and foot.
assess the radial nerve by
Prick the skin midway between the thumb and second finger
Ask the patient to stretch out the thumb, then the wrist, and then the fingers at the metacarpal joints.
assess the ulnar nerve by
Prick the distal fat pad of the small finger.
Ask the patient to abduct all fingers.
assess the median nerve by
Prick the top or distal surface of the index finger.
Ask the patient to touch the thumb to the little finger. In addition, observe whether the patient can flex the wrist.
Ankylosis
stiffness/immobility of joint
Effusion
fluid build up in joint. Tx is arthrocentesis to drain fluid
Ganglion
cyst
Dupuytren’s
pinky looks hella weird. Due to long term phenytoin use or liver disease
Scoliosis
lateral curvature, may have uneven shoulder blades
Subluxation
partial dislocation, not complete
Valgus
bow legs
Varus
knock knees
Swan neck / ulnar deviation
in the thumb and is due to rheumatoid arthritis
Most common issue w bone biopsy
pain
leading cause of musculoskeletal-related disability
arthritis
parathyroid hormone increased can lead to
hypocalcemia
Diaphysis of femur is made up of
cortical bone
Increased thoracic curvature
kyphosis
Impingement syndrome
repetitive overhead movement or inflammation of rotator cuff/bursa
Carpal tunnel syndrome
affects medial nerve, overuse. Tinel’s and Phalen’s tests to assess
Dupuytren Contracture
progressive contracture of 4th and 5th fingers. Tx = stretching, steroid injections, surgery
Pes Planus
flat foot
planus - planet - flat earthers ahha
Pes cavus
claw foot
cavus - caw - crow
Morton’s neuroma
inflammation of certain nerve
Osteoarthritis
Noninflammatory degenerative DO of joints. Articular cartilage breaks down → progressive damage to the underlying bone and eventual formation of osteophytes (bone spurs) that protrude into the joint space
osteoarthritis risk factors
old, female, obese
Joint arthroplasty
CSM risks and complications pt aware, IMP: bleeding or dislocation or VTE, INF, heel pressure injuries
hip replacement big notes
Avoid internal rotation, use abduction pillows when turning, and adduction when transferring. Don’t flex hip <90 degrees.
normal amount of drainage for a hip replacement
200-500 mL within 24 hr is normal
calcium + vit D. biphosphates (increase bone mass) administration notes
sit up for 30 minutes and drink a full glass of water
Osteomalacia
metabolic bone disease characterized by inadequate bone mineralization
Softening and weakening of long bones causes pain, tenderness, and deformities, causes: bowing of bones and pathologic fractures
TX: vit D + Ca++, and sunlight exposure
Paget
localized bone turnover: skull, femur, tibia, pelvic bones, and vertebrae. Genetic
Excessive bone reabsorption from osteoclasts. Alkaline phosphatase ALP is elevated
Tx: antineoplastic, NSAIDs, Calcitonin, biphosphates
osteomyelitis
INF down to the bone. More likely to attack an area that has been previously traumatized
MRSA most common
Risks: DM, IV drug use, obese, malnourished, impaired immune systems, soft tissue INF,
Chronic osteomyelitis: chronic low grade fever in evening is typical
most common bone cancer
Osteosarcoma, often fatal
Contusion
soft tissue injury produced by blunt force
Pain, swelling and discoloration: ecchymosis
Strain
pulled muscle injury to the musculotendinous unit
Pain, edema, muscle spasm, ecchymosis
Get xray
Sprain
Joint is tender and movement is painful, edema, pain increases within 2-3 hr
Grades 1, 2, or 3
PRICE: protection, rest, ice, compression, elevation
Steroids not given bc will worsen the inflammation
Dislocation
articular surfaces of the joint are not in contact
Traumatic dislocation is an emergency w pain
Rotator cuff injury
Causes: aging, poor posture, repetitive stress
Fat emboli
12-72 hr - comes from the bone, occludes small vessels
Respiratory distress: tachypnea, dyspneic, tachycardic, wheezing, hypoxia, chest pain, large amounts of thick, white sputum. We want an ABG
Compartment syndrome
Neurovascular assessments, esp. For pts w distal humerus, proximal tibia fractures
6 P’s: paresthesia, pain, pulselessness, pressure, pallor, paralysis
Can cut a window in the cast, remove the cast, or if tissue is extremely compromised…Fasciotomy to tx
Prompt dx, don’t elevate above heart level bc high venous pressure, cold compress, may decrease traction wt, amputation
Delayed complications
Delayed union, malunion, nonunion
Avascular necrosis of bone
Complex regional pain syndrome (CRPS)
Heterotrophic ossification
what nurses can do with traction
- add weight, never remove
- unless the patient codes then fuck it remove them if they’re in the way
treatment for phantom limb pain
Opioids, gabapentin, tylenol, NSAIDs
