MSK

Question 1

In the case of external fixation of a fractured femur describe the following:

• Assessments
• Pin care
• Mobilization

Answer 1

Perform neurovascular assessments and monitor for pin site infection
Perfom daily pin care with sterile cleaning solution (NS or chlorhexidine) and gauze
- do not manipulate loose pins, call HCP if loose
Promote early mobilization - PT may walk patient the day after surgery

Question 2

Medications used to treat osteoporosis as they prevent the breakdown of bone.

Answer 2

Biphosphanate medication (alendronate, risedronate, zoledronic)

Question 3

Osteoporosis

• supplementation?
• Behaviour modification?

Answer 3

Calcium and Vitamin D supplementation
Smoking cessation, alcohol avoidance
Engaging in weight-bearing exercise 3+ times a week for 30 minutes

Question 4

Chronic, bilateral MSK axial pain (above and below the waist), multiple tender points, fatigue and sleep/cognitive disturbances

Answer 4

Fibromyalgia

Question 5

Describe the use of duloxetine (Cymbalta) in fibromyalgia.

What other drugs are commonly used for treatment of FM pain and sleep disturbance?

Answer 5

SNRI that relieves chronic pain that intereferes with normal sleep patterns in FM

Pregabalin, Amitriptyline (Elavil)

Question 6

Describe the process for getting up stairs using crutches

Answer 6

(Lead with the good leg up the stairs)

1. Assume tripod position and place body weight on crutches
2. Place the unaffected leg onto the step
3. Transfer body weight to unaffected leg
4. Advanced the affected leg and crutches up the step
5. Realign the crutches

Question 7

Following a hip replacement, what is used to prevent hip disclocation?

Answer 7

Abductor pillow - maintains hip in straight and neutral position

Question 8

Immobilizes hip and femur fractures.

Patient is placed in supine position with the foot of the bed raised to maintain counter-traction.

Answer 8

Buck traction

Question 9

Describe teaching for a lower limb amputation for the following:

• Exercise
• Inspection/monitoring of limb
• Cleaning
• Positioning

Answer 9

Exercise - Daily ROM exercises

Inspection/monitoring of limb: - inspect for signs of infection - redness, irritation, skin breakdown

Cleaning - Clean the limb daily with soap and water and thoroughly dry to prevent maceration

Positioning - lie prone several times each day and avoid sitting in a chair for 1 hour+