Ch. 43 Disorders of Musculoskeletal Function: Trauma, Infection, and Neoplasms Flashcards
What connects muscle to bone?
Tendons
What connects bone to bone?
Ligaments
What are acute musculoskeletal injuries?
- Soft tissue
- Fractures
Tennis elbow is an example of what type of injury?
Overuse musculoskeletal injury
What is the treatment for soft tissue injuries?
RICE
What does R.I.C.E stand for?
- Rest
- Ice
- Compression
- Elevation
Stretching or partial tear of a muscle or muscle-tendon unit is what type of injury?
Strain (“pulled muscle”)
What are the manifestations of a strain?
- Painful
- Stiff
- Swelling
- Localized tenderness
What type of injury involves the joint ligaments or capsule surrounding the joint?
Sprains
Where are sprains most common?
Ankle
What are the manifestations of sprains?
- Pain
- Swelling
- Heat
- Disability
- Discoloration
- Limited Function
Which resolve slower a strain or sprain?
Sprain
What are the treatments for sprains?
RICE
-if severe immobilizers
What is the displacement or separation of bone ends from their position in the joint?
Dislocation of joint
What are symptoms of a displaced joint?
- Pain
- Deformity
- Limited movement
- May have fracture
How do you treat a dislocated joint?
- Manipulation
- Immobilization for weeks
- Surgery
A shoulder injury which is made up of muscles and tendons is what?
Rotator cuff injury
Shoulders are commonly injured from excessive use, a direct blow, or stretching injury causing what type of injury?
Rotator cuff injury
What are the signs and symptoms of a rotator cuff injury?
- Pain especially at night
- Tenderness
- Decreased ROM
Knee injuries predispose individuals to what?
OA later in life
What is the most common site of injury?
Knee
What four ligament injuries are there?
- MCL
- LCL
- ACL
- PCL
A pop or tearing is commonly described with what ligament injury?
ACL
What are ligament injury treatments?
- Rest
- Ice
- Crutches
A meniscus tear is what type of injury?
Traumatic
What are the manifestations of a meniscus tear?
- Edematous
- Painful
- Possible locking and instability
A patellar subluxation and dislocation are what common types of injuries?
- Sports
- Congenital variations
A “popping out” sensation or the knee giving out is a sign of what?
A patellar subluxation or dislocation
What are manifestations of a patellar subluxation or dislocation?
- Swelling
- Crepitus
- Stiffness
- Decreased ROM
Dislocation of the hip is due to what?
Severe trauma
Dislocation of the hip is a medical what?
Emergency
Why is dislocation of the hip a medical emergency?
Due to avascular necrosis (lack of blood flow to hip)
A hip replacement is needed regardless of age is what situation?
Hip dislocation
What type of fractures are there?
- Sudden injury
- Fatigue or stress (repeat wear on bone)
- Pathologic
Pathologic fractures are caused by what?
- Bone weakened by tumor or disease
- Cyst
- Tumor
- Osteoporosis
- Paget’s Disease
What types of Pathological fractures are there?
- Proximal
- Midshaft
- Distal
- Open (compound)
- Closed
- Complete
- Incomplete
Which type of fracture can lead to infection?
Open (compound)
Besides pain, swelling, and decreased function. What are other manifestations of fractures?
- Deformity
- Grating
- Bleeding with open fracture
- “Local Shock” (brief numbness of fracture)
- Muscle Spasms
Fracture pain is commonly described as what?
Burning
What are signs and symptoms of a hip fracture?
- Severe groin pain
- Inability to ambulate on affected extremity
- Shorten leg
- Externally rotated
- ADDuction
What is the ultimate treatment of a hip fracture?
Surgery/ Hip Replacement
What does CMS stand for?
- Circulation
- Motor
- Sensory
What is the key assessment of fractures?
CMS
What are complications of fractures?
- Hemorrhage
- Compartment Syndrome
- Fat Embolism
What fractures should be monitored for hemorrhage?
- Humerus
- Femur
- Especially Pelvic (Hypovalemic shock)
Increased pressure from swelling in the area of fracture, causing nerve and blood vessel damage is what syndrome?
Compartment Syndrome
What syndrome from a fracture is life-threatening and limb-threatening?
Compartment Syndrome
Death of nerve and muscles cells is seen in what fracture syndrome?
Compartment Syndrome
Loss of perfusion is seen in what fracture syndrome?
Compartment Syndrome
What are factors affecting compartment syndrome?
- Pressure elevation
- Metabolic rates of tissue
- Vascular tone
- Local Bp
What are symptoms of compartment syndrome?
- Severe pain
- Change in sensation
- Decreased reflexes
- Decreased motor function
- ** Decrease in CMS
What is the treatment for compartment syndrome?
- Loosen dressings/remove cast
- Fasciotomy
A nurse determines a client understands the teaching regarding compartment syndrome if he reports which early symptom?
Paresthesia
Fat droplets released and act as emboli, becoming impacted in pulmonary microvasculature and other microvascular beds, especially the brain is known as what syndrome?
Fat Embolism
Fat Embolisms are caused by what?
Trauma/Large bone fractures
What are signs and symptoms of a fat embolism?
- Tachypnea
- Tachycardia
- Dyspnea
- Petechial rash on chest and neck
What is the treatment for a fat embolism?
- No immediate treatment, fat needs to be reabsorbed by body.
- Potentially oxygen or even ventilator
While a women with a fractured femur is being prepared for surgery, she exhibits cyanosis, tachycardia, dyspnea, and restlessness. What should the nurse do first?
Place in Semi-fowlers position
What is acute or chronic infection of the bone? (usually bacterial)
Osteomyleitis
Acute contiguous spread of osteomyelitis is caused by what?
Direct contamination of bone from open wound
What are signs and symptoms of acute osteomyelitis?
- fever
- tachycardia
- increased pain
- poor healing
- drainage
Acute osteomyelitis is even more concerning if what happens?
infection reaches bloodstream
A chronic osteomyelitis infection lasts how long even adequately treated?
greater than 6-8 weeks, may last years
What is a potential complication of chronic osteomyelitis?
Bone dies due to lost blood supply
A client with an open fracture is at risk for developing osteomyelitis. Which classes symptoms would the nurse assess for to detect development of this complication?
- Increased pain at fracture site
- Elevated temperature
- Increased swelling at the fracture site
Death of bone and marrow in absence of infection due to ischemia is called what?
Osteonecrosis
What are the common causes of osteonecrosis?
- hip fracture
2. idiopathic
Where is osteonecrosis most common?
Femur
What is the major sign and symptom of osteonecrosis?
PAIN that becomes progressively worse
What are neoplasms?
Bone tumors
What is the most common primary malignant bone tumor?
Osteosarcoma
What is the 3rd most common cancer in children and adolescents?
Osteosarcoma
Why is osteosarcoma the 3rd most common cancer in children and adolescents?
Because it develops during period of rapid growth
Osteosarcoma is seen what bones?
Large bones but can occur in any bones
What are symptoms of osteosarcoma?
- Pain (worse at night)
- Decreased ROM
- Swelling
- Redness
How can osteosarcoma spread?
Via blood vessels
Osteosarcoma commonly metastasis to where?
Lungs
Osteosarcoma can spread to where?
Soft tissue
Is osteosarcoma an aggressive/fast spreading cancer?
Yes
What is the primary goal of osteosarcoma treatment?
Disease free survival
What is the secondary treatment goal of osteosarcoma?
Preserve limb
Surgery and chemotherapy are treatments for what bone disease?
Osteosarcoma
Which of the following would suggest to the nurse at an urgent care center that a client may have an ankle sprain?
The client has a twisting injury while running bases during baseball game.
