Exam 1

Question 1

Purpose of the musculoskeletal system

Answer 1

Protect
Provide
Store
Coordinated movement
Blood cell production

Question 2

Aging on the musculo system

Answer 2

Function problems of self care.

Decreased bone density.

Decreased muscle mass/strength.

Decreased flexibility.

Loss of height.

Joint stiffness.

Question 3

What predisposes on tot musculo problems later in life?

Answer 3

Obesity and high impact sports.

Question 4

Musculo abnormalities.

Answer 4

Ataxic gait.

Atrophy.

Contracture

Feestinating gait (parkinsons).

Kyphosis

Lordosis

Myalgia

Valgum (Knock knees)

Varus (bowleg)

Question 5

Diagnostic studies used in musculo

Answer 5

X-ray: Most common
Diskogram: disc in spine
CT
Myelogram: looks in spinal canal
MRI:
Athrocentesis: take fluid from joint cavity
Arthroscopy: small incision
Bone scans:
DEXA

Question 6

Labs in musculo

Answer 6

ANA: for RA/SLE
ALK PHOS: osteoblast
Anti-DNA: SLE
Calc: bone
Uric acid gout
CRP
CK: specific to musc damage
K: releases in muscle trauma
Rheumatoid factor: seen in connective tissue disorder.

Question 7

Normal labs

Answer 7

Calcium
9.0-10.5 mg/dL

Phosphorus
3.0-4.5 mg/dL

Alkaline phosphatase
30-120 units/L

Creatine Kinase
Total CK
20-200 U/L

Myoglobin
<90 mcg/L

Uric Acid
Male
4-8.5mg/dL
Female
2.7-7.3mg/dL
ESR
Male- up to 15 mm/hr
Female up to 20 mm/hr
CRP
<1.0 mg/dL
<10 mg/L

Question 8

Spinal shock

Answer 8

Temporary! Flaccid paralysis, decreased reflex, loss of sensation, no thermoreg, brady.

Question 9

Neurogenic Shock

Answer 9

MEDICAL EMERGENCY!
Drastic sudden hypotension, brady, irreg circ, warm flsuhed skin.

Question 10

SCI Classifications

Answer 10

Mechanism of Injury

Skeletal Level

Neurologic Level

Degree of injury

Question 11

Tetraplegia

Answer 11

Quadraplegia, injury from C1 to T1.

Question 12

Paraplegia

Answer 12

Thoracic, lumbar, or sacral will lead to this. Injury at T6

Question 13

In what section of injury will mech ventilation be required.

Answer 13

C4 and higher.

Question 14

Diagnostic for SCI

Answer 14

CT preferred because fastes.

X-ray

MRI to see soft tissue.

Comprehensive neurologic exam

Question 15

Autonomic dysreflexia

Answer 15

Massive uncompensated CV reaction caused by SNS.

Question 16

What precipitates autonomic dysreflexia?

Answer 16

Full/distended bladder/rectum.

Question 17

S/sx of autonomic dysreflexia.

Answer 17

HTN SBP up to 300mm Hg
HA
Diaphoresis above injury
Brady 30-40
Piloerection
Skin flushing above injury

Question 18

Tx for dysreflexia.

Answer 18

Elevate HOB to 45 degrees.
Notify HCp
Cath if needed, disimpact stool if needed.
Remove constricted clothing
Monitor BP

Question 19

S/sx of acute soft tissue injury

Answer 19

Bruising
decreased movement
brady, coolness, >2 cap refill.
Decreased sensation
Edema
Musc Spasm
Pain Tenderness
Pallor

ICE FOR THE FIRST 24-48H

Question 20

Triad of Fat Embolus

Answer 20

Respiratory symptoms
Neurologic
Petechiae (neck, chest, chest wall, axilla, conjunctiva)

Question 21

Fat emboli

Answer 21

Short time skin can go from pallor tp cyanotic. Can become comatose.