Exam 1 Flashcards
1
Q
Types of connective tissue
A
Bones Cartilage Ligaments Tendons Fasciae
2
Q
Functions of the skeleton
A
Support Provide attachments for muscles and tendons Movement Production of RBCs Storage of vitamins and minerals
3
Q
Muscular system functions
A
Move or stabilize
Production of heat- regulate body temp
Aid in return of blood from the legs
4
Q
Osteoblasts
A
Produce bone matrix during growth and injury
Remember: Baby Bone cells Building Blocks
5
Q
Osteoclasts
A
Clean up old cells
6
Q
Osteocytes
A
Cycle of bone
Remember OsteoCYtes= CYcle of bone
7
Q
Compact vs. Spongy Bone
A
Compact- firm outer layer- forms shaft on long bones, covers and protects spongy bones
Spongy- Made of irregular and sparse osteons, soft inner bone, filled with yellow and red marrow
8
Q
What are long bones?
A
Long, muscles that act on them as rigid levers
9
Q
What are short bones?
A
Equal in width and length and clued across one another
10
Q
What are irregular bones?
A
Neither flat nor long
ex: Pelvis
11
Q
What are flat bones?
A
Protect soft organs and are curved
12
Q
How many bones are in the body?
A
206
13
Q
What makes up the axial skeleton?
A
Skull, hyoid, vertebras and rib cage
14
Q
What makes up the appendicular skeleton?
A
Arms, legs, shoulders, pelvic girdles, and synovial joints
15
Q
How many bones are in the skull/ face
A
8 cranial
14 facial
16
Q
What protects the heart, lungs, liver and spleen?
What does it consist of>
A
Thoracic cage
Consists of sternum, 12 pairs of ribs
17
Q
Name the sections of the vertebral column and how many vertebra are in each section
A
Cervical- 7 Thoracic- 12 Lumbar- 5 Sacrum- 5- fused Coccyx- 4, fused
Remember: Cereal, Turkey, Lasagna, Snack, Chocolate/ Candy
18
Q
Hip bone is also known as?
A
Os Coxae, provides stability and ambulation
19
Q
What are synovial joints and what is the function?
A
Small sacs of synovial fluid
provides cushion and lessens wear on areas of high friction
May become inflamed
20
Q
Tendons
A
Made of dense fibrous tissue.
Attach muscle to bone
21
Q
Ligaments
A
Made of dense fibrous tissue
attach bone to bone
22
Q
Antagonistic muscles
A
Extend, oppose action of another muscle
23
Q
Synergistic muscle
A
Balance and fine motor control
24
Q
What are the three types of muscle?
A
Cardiac, smooth, skeletal
25
Where are smooth muscles found?
Walls of hollow structures, airway, arteries, bladder and uterus
Involuntary
Movement is based on neuronal and hormonal influences and O2
26
Skeletal muscles
Voluntary, contracts based on neuronal stimulation
Requires nerve impulses to contract
27
Point of origin?
| Point of insertion?
origin- point of attachment, unmovable
insertion- point of attachment, moves when muscle contracts
28
Muscular atrophy?
| Muscular hypertrophy?
Atrophy- absence of contraction, results from immobility
hypertrophy- occur with increased muscular activity
29
Skeletal muscle contraction
Nerve impulse>brain/ spinal cord>skeletal muscle fiber>neuromuscular junction>acetylcholine>muscle contraction
30
Aging and MS System
Functional problems
Weight-bearing joints subject to damage
Decreased bone density, muscle mass, muscle strength and flexibility
shortening of vertebral column
Risk for falls
Osteoarthritis and osteoporosis- not a normal consequence
31
Physical Assessment
Health Hx- PMH, surgeries, med use, usual activities, occupation
Inspection/Observation: Posture, Movement, gait, balance, body symmetry, spine- contour, tenderness, warmth, injury
Palpate
Neurovascular assessment
Eval passive and active ROM
32
Labs for MS System
Calcium - 8.5- 10.5
Uric Acid- 2- 7 >7 indicates gout
ESR- Males up to 15
Females up to 20
33
Phantom Pain
Real, address and treat
34
Sprain
Stretch or incomplete tear of ligament
Results from twisting motion
Edema and localized pain
35
Strain
Tendon or muscle
Excessive stretching
Edema and localized pain
36
RICE
R- Rest- for the first 2-3 days
I- Ice- 15-20 minutes for 2-3 hours. ALWAYS the first action, do not use for longer than 30 minutes or directly on skin
C- Compress- helps limit swelling and movement, don't leave on while sleeping, neurovascular assess
Elevate- Above level of heart
After inflammation subsides use heat for 15-20 min at a time
37
Dislocation
End of bones are forced from normal positions
Occur at joints
Requires immediate treatment- splinting and ice
38
Clinical manifestations
Severe pain or tenderness
Deformities
Loss of full ROM
Swelling
XR determines extent
39
True/ False- If a dislocation occurs patients are more likely to have future dislocations
True
40
Dislocation Treatment
Reduce!
Pain management
surgery
41
What is bursitis and where does it occur?
Inflammation of the bursa
Common location - shoulders
Prevention is key- strengthen, stretch
42
S/sx of bursitis and treatment
Warmth, pain, stiffness, swelling, limited ROM- will worsen with activity
Treatment- RICE, NSAIDs, possible PT, switch to heat therapy after joint is no longer warm
Aspiration of bursal fluid and intra-articular injection of corticosteroids
43
Rotator cuff injury
S/sx
Diagnostics
Treatment
Injury occurs when tendon tears- related to repetitive movement or injury
S/sx- shoulder weakness, pain w/ movement, decreased ROM
DX- MRI
TX- RICE, sling, NSAIDs, PT
44
Minor Vs Severe Rotator cuff injury
If severe surgery, sling, then PT
45
What is the difference in rotator cuff and dislocation?
Rotator cuff you can still move but is limited
46
Carpal Tunnel
What is it?
S/sx?
Median nerve compression/ swelling within the tunnel
Can be caused by repetitive movement, edema, trauma
Pain, numbness, paresthesia, muscle weakness, possible fine motor deficits
47
Treatments for carpal tunnel
Splint, medication, education, NSAIDs, occasional steroids, surgical intervention: Carpal tunnel release
If surgery- assess 6P's, pain, rice
48
Fractures
Bones begin to repair immediately, take about 6 weeks to heal
49
True or False: Fractures are classified as an emergency?
True
50
Classifications of fractures
Open, Closed
Complete, Incomplete
Displaced, Nondisplaced
51
Things to remember about fractures
you may not see the deformity
Immobilize extremity and immediately rice
Diagnosing a fracture in a child can be difficult
52
Clinical manifestations of fractures
Pain- immediate and increase with movement
ROM- decreased
Non weight bearing
Edema
Limb shortening- if this occurs it is a complete or complex fracture
Children may be able to use the affected extremity because of the periosteum
53
Fractures: Labs and diagnostic imaging
H&H
ESR
Calcium- osteoporosis
XR, CT, MRI
54
Fractures: Assessment
```
Integumentary- skin lacs, temp, hematomas, edema
Cardiovascular
Neurovascular- delayed cap refill
Musculoskeletal- wiggle toes, circulation, loss of function, bone deformity, muscle weakness
Diagnostic findings
PMH and surgical Hx
Current meds
Mech of injury
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55
Fracture management
```
Reduce bone ends
Immobilize after reduction to maintain alignment
Restore normal function
Prevent deformity or further injury
Relieve pain
Elevate
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56
True or False after a cast has been applied you should monitor for compartment syndrome, hot spots and keep in a sling the entire time and avoid getting the cast wet
False.
You should monitor for compartment syndrome and hot spots- which indicate infection and avoid it from getting wet but the sling part is false
57
What is Bucks traction?
AKA Skin traction
It is a traction device used in femoral or hip fractures where legs are in an extended position and weights (5-10 pounds) are attached to a boot. Causes immobility, provide comfort , relieve muscle spasms and prevent further injury.
58
What are interventions for Bucks traction?
Frequent neurovascular, skin, pain and compartment syndrome assessments.
EDU
Assess pulley and weight system but do not touch
Encourage activity and distraction, promote independence
59
What is skeletal traction?
Used to treat femur fractures or if bucks doesn't work. Used pins, wires or screws to aid in alignment which are placed when a patient is under general, spinal, or local anesthetic. Weights are used (20-40 lbs) and can be used for longer duration than Bucks.
60
What are interventions for Skeletal traction?
Neurovascular, traction, positioning, body alignment and comfort assessments
Pin site care- aseptic
Promote independence- trapeze bar
61
How often is pin site care performed?
1-3 times a day
Medicate patient up to 30 minutes prior to care.
62
What is commonly performed for a fractured hip?
ORIF- Open reduction w/ internal fixation
Bone ends are reduced through open reduction, they are then held together using internal fixation devices and rods, may or may not be removed after fracture heals
Nursing care- preop edu, assess
GOAL- early activity
63
When is external fixation used?
With severe bone damage- crush or numerous breaks
The fracture is reduced during surgery, screws or pins are used on both sides of fracture.
This immobilizes bones and allows the fracture to heal
Complications: Infections, osteomyelitis or loose pins
64
What medications can be used for fractures
```
Muscle Relaxants
Prevent spasms, decrease pain
Analgesics
Pain management
Sedatives
Reduction of joints
Tetanus
If significant crush, pins, screws, plates. Received IM
Antibiotics
Prophylactively, pins or open areas
```
65
What are abnormal findings during a neuro assessment?
```
Decreased pulses
cool skin
Dusky appearance
Numbness/tingling
Decreased sensation
Decreased mobility
```
66
What should you assess for hemorrhages?
S/sx of bleeding
| VS- decreased BP, Increased HR, Increased RR, color and changes in urine output
67
What are risk factors for infection?
Open fractures w/ soft tissue injury
Debridement
Greater risk- DM, Older, delayed healing
68
S/Sx of systemic infection
Fever, chills, increased Hr, Decreased BP
69
What are nursing interventions for thrombi?
```
PREVENTION!
Lovenox- prophylactic
Compression stockings
SCDs
ROM^
Early ambulation
```
70
True or false: Compartment syndrome is not considered a medical emergency
FALSE- impaired tissue perfusion
71
Compartment syndrome
Causes
Treatment
Decreased compartment size, increased compartment contents- bleeding, edema, tissue swelling, inflammation, Iv infiltration
*** swelling + pressure compromises function of blood vessel, nerves and tendons= reduction of circulation and capillary perfusion
TX: Prevention- Elevate and ICE, determine cause, fasciotomy may be necessary
72
S/SX of compartment syndrome
Earliest symptom is severe increasing pain
6Ps
If medicated with opiods and no relief of pain- red flag
73
Complications of compartment syndrome if not treated in time
1 Necrosis
2 Infection
3 Renal Failure
4 Rhadomyolsis
74
Is a fat embolism considered an emergency?
YES
75
Fat Embolism
Occur in most patients with long bone fractures, fat particles get distributed into tissues and organs, symptoms can occur up to 72 hours after injury
76
Which illness has the triad of symptoms and what are they?
Fat Embolism
Lungs- ^ RR, HR, hypoxia and cyanosis
Brain- confusion and drowsiness
Skin- petechiae in chest, neck, eyes
77
Nursing care for fat embolisms
Prevention- continuous pulse ox monitoring, immobilization
Notify provider immediately if suspected- ABCs
Provide O2, high fowlers, decrease movement, IV fluid
Labs and dx tests- CXR, MRI of brain, ABGs
78
Osteomyelitis
What is it?
S/sx?
Infection of the bone can be acute (<4 wks) or chronic, difficult to treat
S/sx- Fever, diaphoresis, malaise, inflammation, restricted movement
79
Diagnostics for osteomyelitis
CBC
ESR
BoneBiopsy, Blood cultures, Imaging
80
Nursing care for osteomyelitis
```
Meds - IV ABX, long term ABX 4-6 weeks
Immobilization
Hyperbaric Oxygen therapy
Surgery - debridement or amputation
PREVENTION
Sterile dressings
Assess neuro and pain
EDU- abx, wound care and hygiene
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