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Medical Surgical Nursing - Second Sem > Intro to Musculoskeletal Disorders > Flashcards

Intro to Musculoskeletal Disorders Flashcards

1
Q

What are the 6 functions of the skeletal system? (FSPMMS)

A 
Framework - solid structure
Support organs
Protect organs, function safely
Movement
Manufacture blood cells - hematopoiesis
Storage of minerals - calcium, phosphorous
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2
Q

What are the 3 main components of bones?

A

CCM

Cells - osteocytes
CHON matrix - collagen + ground substances
Mineral deposits

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3
Q

What makes up the ground substances?

A

glycoCHON (glycoprotein) and proteoglycans

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4
Q

Ground substances are made by ____. These type of cells are known to be ___

A

Osteoblasts

Bone forming cells

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5
Q

Total body calcium: %

Mineral deposits: %

A

Total body calcium: 98%

Mineral deposits: <2%

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6
Q

What makes up mineral deposits?

A

Phosphorous, magnesium, fluoride

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7
Q

What are the 4 guidelines to Calcium? (IKLA)

A

Intake thru milk and dairy products
Calcium tablets can cause Kidney stones
Lose 1% calcium starting from age 30
Calcium is also an Antacid = dont take w/other meds

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8
Q

How long should a patient on Calcium tablets wait before taking other meds? Why is this necessary?

A

2-4 hrs

To avoid hindering absorption since Ca is also an antacid

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9
Q

How many bones do we have?

A

206

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10
Q

Name the 5 types of bones acc to shape and describe (FLSIS)

A

Flat – hematopoiesis and protect vital organs (skull, sternum)

Long – weight bearing and mobility (arms, legs)

Short – wrist, ankle

Irregular – facial, vertebra

Sesamoid – within tendon (kneecap/patella)

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11
Q

Name the 2 types of bones acc to composition and describe (CC)

A

Cancellous/trabecular/spongy – epiphysis (end) + red marrow

Cortical/compact – diaphysis (mid) + yellow marrow

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12
Q

Red marrow = function + in what bone

Yellow marrow = function + in what bone

A

Red marrow = hematopoiesis (flat and long – epiphysis)

Yellow marrow = fat (long only – diaphysis)

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13
Q

Describe the ff

Medullary cavity
Periosteum
Epiphyseal line

A

Medullary cavity – canal that holds yellow marrow

Periosteum – outer covering of bone, like envelope

Epiphyseal line – closes at 21-22 y/o = wont grow taller

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14
Q

Bone marrow suppression refers to?

A

Red bone marrow

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15
Q

Which marrow do we get medications and transplants from?

A

Yellow bone marrow

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16
Q

What are the 3 bone cells? Describe acc to location and function

A

Osteoblasts – bone forming by secreting CHON matrix, located in periosteum (outer)

Osteoclasts – bone resorption/destroy, located in endosteum (inner)

Osteocytes – mature bone cells for bone maintenance

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17
Q

How do osteoclasts work “from inside out”?

A

Inside: destroy bone

Outside: secrete new bone

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18
Q

Osteoblastic activity = calcium ____

Osteoclastic activity = calcium ____

A

Osteoblastic activity = calcium goes to Bones (B-B)

Osteoclastic activity = calcium goes to Cells/outside (C-C)

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19
Q

What promotes osteoblastic activity?

A

Movement

Intake of Ca rich food

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20
Q

What happens if a px does not eat Ca rich food, is bed bound/ has a cast?

A

This promotes osteoclastic activity = bone gets thinner, weaker, smaller, brittle

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21
Q

Brittle bones are prone to?

A

Fractures

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22
Q 
Differentiate 
Cartilage
Ligament
Tendon
Joint
A

Cartilage – thick flexible connective tissue usually seen in the joints

Ligament – connects bone to bone (LBB)

Tendon – connects muscle to bone (TBM)

Joint – where bones meet

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23
Q

Damage of cartilage can be caused by?

A

Chronic use and abuse (sports players, elderly)

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24
Q

Describe the 7 types of joints (PBEH SGC)

A

Pivot – circular neck mvt

Ball and socket – shoulders and hips

Ellipsoid – wrist 180 deg

Hinge – knee and elbow, like a door

Saddle – thumb, up down and around (more than one axis)

Gliding – ankle

Condyloid – fingers

25
Match the type of joint movement to its example ``` A. Gliding B. Inversion & eversion C. Abduction & adduction D. Rotation E. Plantar flexion & dorsiflexion F. Circumduction G. Protraction & retraction H. Extension, flexion, hyperextension I. Supination & pronation J. Elevation & depression K. Opposition ``` 1. Thumb to fingers 2. Arms away and towards trunk 3. Arms stretched and form circle 4. Face forward and double chin 5. Flapping of hands 6. Feet inward and outward 7. Head to left and right 8. Palm up and palm down 9. Tiptoe and babinski sign 10. Head up, head down, head up beyond 180 deg 11. Teeth together and teeth apart
``` 1K 2C 3F 4G 5A 6B 7D 8I 9E 10H 11J ```
26
What is osteogenesis? When does it begin?
Osteo: bone Genesis: begin Begins inside the womb
27
What occurs during ossification?
Bone matrix thickens + mineral deposits harden
28
Differentiate the 2 processes under ossification
Endochondral: hyaline cartilage is replaced by bone Intramembranous: bone forms inside a membrane (skull)
29
Bone maintenance requires a balance between ___ and ___
Bone maintenance requires a balance between bone resorption (osteoclastic) and bone formation (osteoblastic)
30
Describe the 6 regulating factors of bone maintenance (SDPCBH)
Stress – inc movement = inc calcium to bones = stronger Vit D – promotes calcium absorption Parathyroid hormone (PTH) – promotes bone resorption = calcium goes out to fix hypocalcemia (<8mg/dL) Calcitonin – inhibits bone resorption = calcium goes inside = stronger Blood supply – affects osteogenesis Hormones – inc corticosteroid = brittle bones + menopause/andropause = more osteoclastic activity
31
(T/F) Men lose more Ca than women
FALSE, women lose more
32
What time is it advisable to expose the skin to the sun for vitamin d?
before 9/10 am or after 4/5 pm
33
Where is PTH and Calcitonin produced?
PTH: parathyroid gland Calcitonin: thyroid gland (T3/T4)
34
What drug is used to elevate Calcitonin level? (MCC)
Miacalcin (Calcitonin) Nasal Spray – one spray per nares, for elders Calcitonin-Salmon – refrigerated Calcijex – activated vitamin D
35
Crepitus is?
cracking sound
36
Describe the 3 stages of bone healing (RRR)
Reactive – starts bleeding and inflammation immediately = angiogenesis and tissue granulation Reparative/ossification – granulation tissue is replaced by procallus (thickened cartilage) and lamellar bone Remodeling – mold new bone into former structure
37
What is angiogenesis
Create new small vessels
38
How long does it take for Procallus to replace granulation tissue Lamellar bone to form Remodeling of new bone into former structure
Procallus to replace granulation tissue – 3-4 weeks post injury Lamellar bone to form – months Remodeling of new bone into former structure – months-years
39
What are the 6 skeletal changes related to | aging (DPK CRA)
Decreased density – more bone resorption Inc bony prominence – decreased skin thickness Kyphotic – dec density = struggle to support weight = 1-2 dec in height Cartilage degeneration – causes crepitus Decreased ROM – slower Muscle atrophy – dec bone density = dec muscle attached to bone
40
What is the basic unit of muscles? What is it comprised of?
Sarcomeres Actin – thin Myosin – thick
41
A group of sarcomeres are called?
Myofibrils/myofilaments
42
How many muscles and joints do we have?
650 muscles 187 joints
43
Purpose of muscles (HMP)
Generate heat Mobility Postural support
44
Differentiate the 3 types of muscles (SCS) according to Involuntary/voluntary Appearance Attachment
Skeletal – voluntary, striated and long, attached to bones Cardiac – involuntary, has intercalated disc, attached to itself Smooth – involuntary, circular or long, attached to visceral organs
45
What muscle makes up 40% of body weight?
skeletal muscle
46
Differentiate the 2 muscle tones Flaccid Spastic
Flaccid – no muscular contraction, paralyzed Spastic – spasms, lots of tension
47
Isometric contraction: muscle ___ = ___ tension Isotonic contraction: muscle ___ = ___ tension
Isometric contraction: muscle lengthens = increase in tension (close fist) Isotonic contraction: muscle shortens = no tension (flex arm)
48
Isometric contractions lead to increase in? This is done for which pxs?
ICP and blood flow Those in a cast
49
Match the muscle strength rating to its description A. Up and down, 10 pounds B. Side to side C. Place hand over, can feel muscular contraction D. Put down (no gravity) = yes, put up = need help E. Up and down, 2-4 pounds F. No muscular contraction, flaccid
``` A5 = normal B2 = poor C1 = trace D3 = fair E4 = good F0 = zero ```
50
What are the 3 types of joints according to movability?
Immovable – skull Movable – knee Partly movable – ribs
51
Give at least 5 things we assess for in pxs with musculo problems
PQRST (pain/provoke, quality, radiate/relief, severity, timing) ADL Functioning Weakness, paresthesia, neurovascular (compartment) Past surgeries, injuries Assistive devices Diet (purine, calcium) Weight gain Meds (calcium, vit d) Deformity, edema, gait, posture, muscle strength and size, ROM/joint function
52
What are the 5 ADL's we assess for (GBDEF)
``` Grooming Bathing Dressing Elimination Feeding ```
53
Hand grip should be ___
symmetrical
54
Neurovascular assessment is done Q_? Why?
Q1 not greater than 4 hrs >4 hrs can lead to compartment syndrome and necrosis
55
Procedure done by making an incision to decrease pressure on blood vessels
Fasciotomy
56
What are the 4 components of a neurovascular assessment (CMST)
Circulation – color, temp, pulse, refill Motion Sensation – pain, paresthesia
57
what are the least and most reliable neurovascular tests
least: capillary refill most: transcutaneous oxygen pressure (TcPO2)
58
Match the assessment Muscle Joints Both 1. Tremors – after 15 mins 2. ROM – smoothness 3. Contractures – stiffness 4. Swelling – crepitus 5. Tonicity – at rest 6. Size – symmetry
``` 1M 2B 3M 4J 5M 6M ```

Medical Surgical Nursing - Second Sem (7 decks)

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