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LCCC Nursing > Chapter 62: Med Surg > Flashcards

Chapter 62: Med Surg Flashcards

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1
Q

bone remodeling

A

removal of old bone by osteoclasts (resorption) and deposition of new bone by osteoblasts (ossifcation)

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2
Q

epiphysis

A

widened area at the end of a long bone (cancellous bone) location of muscle attachment

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3
Q

diaphysis

A

main shaft of the bone, structural support and composed of compact bone, marrow is in the center

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4
Q

metaphysis

A

flared area of cancellous bone between the epiphysis and diaphysis

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5
Q

osteons

A

also called haversian systems fit closely together in compact bone, creating a dense bone structure (cylinder shaped)

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6
Q

epiphyseal plate

A

aka growth zone, cartilaginous area between the epiphysis and metaphysis, allows longitudinal growth in children and injury can result in a shorter extremity and significant functional problems

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7
Q

medullary

A

marrow is the center of the diaphysis and contains red and yellow bone marrow

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8
Q

hinge joint

A

allows flexion and extension e.g. elbow

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9
Q

ball and socket joint

A

spheroidal; flexion, extension, abduction, adduction, circumduction e.g. shoulder

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10
Q

pivot

A

rotary; rotation e.g. atlas-axis, proximal radioulnar joint

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11
Q

condyloid

A

flexion, extension, abduction, adduction, circumduction e.g. wrist joint

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12
Q

saddle

A

flexion, extension, abduction, adduction, circumduction, thumb-finger opposition e.g. thumb

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13
Q

gliding

A

one surface moves over another surface e.g. between tarsal bones and carpal bones

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14
Q

hyaline cartilage

A

moderate amount of collagen, trachea, nose, epiphyseal plate

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15
Q

elastic cartilage

A

collagen and elastic fibers, more flexible, ear, epiglottis

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16
Q

fibrous cartilage

A

collagen fibers, tough, shock absorber, pelvic girdle, knee, shoulder

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17
Q

cardiac muscle

A

striated, involuntary

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18
Q

smooth muscle

A

nonstriated, involuntary, found in airways, arteries, GI

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19
Q

skeletal muscle

A

neuronal stimulation, half a person’s weight, striated, voluntary

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20
Q

muscle contraction

A

thick and thin filaments slide past each other and cause sacromeres to shorten; acetylcholine activates

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21
Q

skeletal contraction

A

allows posture maintenance, body movement, and facial expressions

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22
Q

isometric contractions

A

increase the tension within a muscle but do not produce movement, repeated contractions make muscles grow larger and stronger

23
Q

isotonic contractions

A

shorten the muscle and produce movement

24
Q

what happens to muscles when calcium is low?

A

tetany occurs (involuntary contractions of skeletal muscle)

25
Q

tendons

A

attach muscles to bones

26
Q

ligaments

A

connect bones to bones

27
Q

fascia

A

layers of connective tissue that can withstand limited stretching, provides strength to muscle tissue

28
Q

bursae

A

small sacs of connective tissue that are lined with synovial fluid located at bony prominences or joints to relieve pressure and decrease friction between moving parts

29
Q

gerontologic changes in musculoskeletal

A

increased bone resorption and decreased bone formation leading to osteoporosis, tendons and ligaments become less flexible

30
Q

subjective data needed for muscoloskeletal

A

s/s pain, weakness, deformity; questions should be focused on past medical problems, surgeries, med use, ask about secondary bacterial infections including the ears, tonsils, lungs etc because these can enter the bones and result in osteomyelitis or joint destruction

31
Q

objective data needed for musculoskeletal

A

head to toe assessment, observe skin lesions, palpation, active ROM, passive ROM, assess gait, unequal shoulder and scapula indicates scoliosis

32
Q

how to assess for scoliosis

A

ask pt to put hands together as in diving into a pool and slowly bend forward, if the deformity is greater than 45 degrees, lung and cardiac fx is greatly impaired

33
Q

straight leg raising test

A

pt lays supine and passively raise leg 60 degrees, if pt complains of pain along the distribution of sciatic nerve, test is confirmed positive

34
Q

x ray

A

determines density of bones, bone deformity, joint congruity, and calcification in soft tissue, useful in fracture diagnosis

35
Q

nursing responsibility of x rays

A

avoid excess exposure for pt and self, before procedure remove any radiopaque objects, explain procedure, and verify not pregnant

36
Q

computed tomography (CT) scan

A

x ray beam used to provide 3D image of soft tissue and bony abnormalities

37
Q

nursing responsibility of CT scan

A

inform pt procedure is painless, pt must remain still, pt has no shellfish allergy, and pt cannot be pregnant

38
Q

magnetic resonance imaging (MRI)

A

views soft tissue, useful for diagnosis of osteomyelitis

39
Q

nursing responsibility of MRI

A

inform pt procedure is painless, pt cannot have on metal, must remain still

40
Q

dual energy x ray absorptiometry

A

DEXA; measures bone mass, allows assessment of bone density with minimal radiation, painless

41
Q

quantitative ultrasound (QUS)

A

evaluates density, elasticity, and strength of bone using ultrasound rather than radiation, painless

42
Q

bone scan

A

involves injection of radioisotope that is taken up by the bone, uniform uptake is normal, but increased uptake is seen with osteomyelitis, osteoporosis, malignant tumors of bone, and certain fractures and decreased uptake is seen with avascular necrosis

43
Q

nursing responsibility of bone scan

A

radioisotope is given 2 hours before procedure, bladder must be emptied, procedure requires 1 hr while pt lies supine and no pain or harm will occur, no follow up scans required, increase fluids after examination, pt cannot be pregnant

44
Q

arthroscopy

A

involves insertion of arthroscope into joint for visualization of structure and contents, diagnostic for abnormalities of meniscus, ACL, ligaments, or joint capsule

45
Q

nursing responsibilities of arthroscopy

A

can be performed in outpatient setting with either local or general anesthesia used, after the procedure cover the wound with sterile dressing

46
Q

alkaline phosphatase

A

produced by osteoblasts and elevated levels are found in healing fractures, bone cancers, osteoporosis, osteomalacia, and paget’s disease (38-126 normal)

47
Q

calcium

A

decreased found in osteomalacia, renal disease, and hypothyroidism, increased found in hyperparathyroidism and some bone tumors (8.6-10.2 normal)

48
Q

phosphorus

A

decreased level found in osteomalacia, increased found in chronic kidney disease, healing fractures, and osteolytic cancer (2.4-4.4 normal)

49
Q

erythrocyte sedimentation rate (ESR)

A

nonspecific index of inflammation, measures rapidity with which RBCs settle out of unclotted blood in 1 hr, elevated levels are seen in inflammatory process <30 normal

50
Q

nursing responsibility for alkaline phosphatase, calcium, phosphorus, and ESR

A

obtain blood samples by venipuncture, observe site for bleeding or hematoma formation, procedure does not require fasting

51
Q

arthrocentesis

A

incision or puncture of join capsule to obtain samples of synovial fluid from joint cavity to remove excess, 18 G or larger usually used, local anesthesia, useful in diagnosis of joint inflammation, infection, meniscal tears, and subtle fractures

52
Q

nursing responsibility of arthrocentesis

A

usually done at bedside or in examination room, send samples of synovial fluid to lab, apply compression dressing, observe for leaking of blood or fluid on dressing

53
Q

what do you observe synovial fluid for?

A

volume, color, clarity, viscosity, and mucin clot formation, floating fat globules indicate bone injury, uric acid crystals indicate gout

LCCC Nursing (15 decks)

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