Chapter 41 Musculoskeletal Flashcards
Fracture definition
Break in the continuity of a bone
Open vs Closed Fracure
- Open: passes through skin
- Closed: does not pass through skin
Compound fracture
Broken in multiple places
Types of Fractures (11)
- Linear -Bowing
- Oblique -Pathological
- Spiral -Stress
- Transverse -Fatigue
- Greenstick -Transchondral
- Torus
Symptoms of Fractures (7)
- Unnatural alignment
- Swelling
- Muscle spasm
- Tenderness
- Pain
- Impaired sensation
- Decreased mobility
Fracture Treatments
- Immobilization
- Closed manipulation
- Traction
- Open reduction
- Internal and external fixation
- Improper reduction
- Immobilization
Fracture Complications (8)
- Shock
- Fat embolism
- Delayed union
- Nonunion
- Malunion
- DVT
- Nerve injury
- PE
Compartment Syndrome
Decreased perfusion to muscle tissue from construction by a cast or dressing
6 P’s of Assessing Compartment Syndrome
- Paresthesia
- Pallor
- Pain
- Pressure
- Paralysis
- Pulselessness
Dislocation
Displacement or one or more bones in a joint
Subluxation
-Contact between articular surfaces is only partially lost
RICE
- Rest
- Ice
- Compression
- Elevation
If a sprain is severe enough it may require what?
Surgical repair or casting
Rhabdomylosis defined as…
-Rapid breakdown of muscle that causes the release of intracellular contents
Rhabdomyolysis can cause what (2)
- Acute renal failure
- Electrolyte imbalances
How is Rhabdomyolysis diagnosed?
When CK/Trop levels are 5-10x the upper limit of normal (1000units/L)
Osteoporosis is defined as…
Poorly mineralized bone and increased risk of fractures due to alterations in bone micro architecture
Osteoporosis bone is describes as what?
Spongy
Causes of osteoporosis (
- Endocrine dysfunction
- Medication
- Vitamin D deficiency
- Underlying diseases
- Abnormal BMI
Causes/Risk Factors for Osteoporosis (6)
- Small bone structure
- Sex hormone deficiency (menopause)
- Cigarette smoking
- Alcohol abuse
- Low calcium and Vitamin D
- Sedentary lifestyle or immobility
Osteoporosis Symptoms
- Fractures (vertebrae, wrists, hips)
- Low back pain
- Neck pain
- Bone pain or tenderness
- Loss of height over time
- Stooped posture
Osteoporosis treatment (2)
- Weight bearing exercise
- Increase calcium
Post menopausal osteoporosis (4)
- Middle-aged and older women
- Estrogen deficiency
- Increased Ned for Calcium and Vit D
- Remodeling imbalance
Glucocorticoid-induced osteoporosis (2)
- Type of secondary osteoporosis
- Glucocorticoids improve osteoclast survival
Osteoporosis Diagnostic Testing Gold Standard
Dual X-Ray Absorptionmetry (DXA)
DXA Normal Range Normal Bone
833mg/cm2
Osteopenic bone DXA range
833-648 mg/cm2
Osteoporosis DXA range
<648 mg/cm2
Piaget Disease of Bone definition
- Chronic accelerated remodeling of spongy bone
- Symptomless
- Bowing of legs
- Fractres
Causes of Piaget Disease of Bone
-Early viral infection and genetic causes likely
Symptoms of Pagets Disease (9)
- Bone pain -Fracture
- Joint pain -Neck pain
- Headache -Reduced height
- Bowing of the legs -Hearing loss
- Warmth of skin
Osteomyelitis definition
- Bone infection often caused by bacteria
- Stahylococcus aureus
Hematogeous Osteomyelitis
Pathogens are carried through the bloodstream
Brodie abscesses
Characterize subacute or chronic osteomyelitis
Osteomyelitis treatment
- Antibiotics
- Debridement
- Surgery
- Hyperbaric oxygen therapy
Osteoarthritis where is the problem?
The cartilage that cushions the ends of bones
Osteoarthritis is characterized by (2)
- Loss and damage of articular cartilage
- New bone formation of joint margins
Two types of bone formations that are associated with osteoarthritis (2)
Heberden’s and Bushard’s
Osteoarthritis Risk Factors (3)
- Increased age
- Joint trauma
- Obesity
Symptoms of osteoarthritis (2)
- Pain that worsens with activity
- Stiffness that diminishes with activity
Rheumatoid Arthritis Definition
- Autoimmune disease
- Systemic damage to connective tissue, primarily in the joints (synovial membrane)
RA manifestations (8)
- Inflammation -Weight loss
- Fever -Generalized aching
- Fatigue -Siffness
- Weakness
- Anorexia
RA experiences what tell tale sign in the wrists?
Ulnar drift
RA is diagnosed with what lab values
Autoantibodies (RF)
RA Evaluation
- 4 or more of the following
- Morning stiffness lasting at least one hour
- Arthritis in 3 or more areas
- Arthritis of the hand joints
- Rheumatoid nodules
- Abnormal RF
- Radiographic changes
Gout definition (2)
- Inflammatory response to excessive quantities of úrico acid
- Elevated levels lead to formation of irate crystals in joints
Gout risk factors
- Males
- Increasing age
- High intake of alcohol, red meat, and fructose
Individuals with gout are 1000x more likely to develop what compared to the general population
Renal stones
Fibromyalgia definition
Chronic, widespread diffuse joint and muscle pain, fatigue, and tender points
Fibromyalgia symptoms
- Increased sensitivity to touch
- Fatigue and non restorative sleep
Fibromyalgia Manifestations
- Diffuse, chronic pain
- Profound fatigue
Diagnosis of fibromyalgia (4)
- Axial pain
- Left and right sided pain
- Upper and lower segment pain
- SS score
Bone Tumors can originate from where?
- Bone cells
- Cartilage
- Fibrous tissue
- Marrow
- Vascular tissue
Most common malignant bone forming tumor
Osteosarcoma
Osteosarcoma is predominantly found in what age people?
20 years and younger
Ewing sarcoma (2)
- Most lethal childhood bone tumor
- Penetrates the bone to form soft tissue mass
How to the foot turn in children with clubfoot?
Inward and downward
Hip Dysplasia Risk Factors (3)
- Female sex
- Positive family history
- Breech presentation
How can the hip present in individuals with hip dysplasia?
- Subluxated
- Dislocated
- Acetabular dysplasia
How is hip dysplasia managed? (4)
- Pavlik harness
- Closed reduction with spica casting
- Surgery
- Outcome becomes poorer with age
Scoliosis is defined as…
Rotational curvature of the spine
Symptoms of Scoliosis (4)
- Uneven shoulders
- Uneven waist
- One hip elevated compared to the other
- Leaning to one side
Scoliosis Complications
- Lung and heart damage
- Bone loss
- Back problems
- Emotional effects
What is the most common neuromuscular disorder in children?
Duchenne Muscular Dystrophy
Duchenne Muscular Dystrophy is what type of inheritance?
X-linked recessive gene
When to Duchenne Muscular Dystrophy manifestations begin to appear?
3-4 years old
Manifestations of Duchenne Muscular Dystrophy (6)
- Progressive weakness
- Respiratory insufficiency
- Cardiomyopathy
- Orthopedic complications
- Cognitive dysfunction
- Constipation
