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Med surg Exam 3 > Muscoskeletal lec 2 > Flashcards

Muscoskeletal lec 2 Flashcards

1
Q

what is Dupuytren contracture

A

thickening of the palmar fascia which causes flexion contracture of the 4th and 5th digits

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2
Q

what is a ganglion

A

round benign cyst, found on wrist, foot joint, or tendon

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3
Q

what is plantar fascitits

A

inflammation of the plantar fascia/arch of the foot

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4
Q

what are some ss of plantar fascitits

A

Severe pain in the arch of the foot

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5
Q

how do you treat plantar fascitits

A

ice, rest, stretching exercises, strapping of the foot arch, shoes with good support or with inserted orthotics

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6
Q

what meds can you use for plantar fascititis

A

NSAIDS and/or Steroids

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7
Q

what kind of surgical interventions can you do for plantar fascitits

A

Endoscopic surgery to remove inflamed tissue

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8
Q

what is hallux valgus deformity

A

great toe drifts laterally, first metatarsal head enlarges - Results in bunion

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9
Q

what surgical interventions can you do for hallux valgus deformity and what is the post op

A

bunionectomy: assess neurovascular status/pain post-op

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10
Q

what is the cause of knee injuries

A

Often the result of sports or strenuous physical activities

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11
Q

what age group do knee injuries normally affect

A

younger adults

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12
Q

what should you always assume for a knee injury

A

Always assume the injured body part is broken until Xray confirms otherwise

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13
Q

what does RICE mean for knee injury interventions

A

Rest (immobilize or splint the joint above and below the injury)
Ice (immediately for the first 24 to 48 hours)
Compression (elastic wrap for the first 24 to 48 hours)
Elevate (above level of heart)

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14
Q

what is the preferred surgrey for knee injuries

A

Arthroscopy

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15
Q

what should you do post op after a knee Arthroscopy

A

Analgesics, physical therapy, bracing or splinting
Neurovascular checks!!!!!!!!!!!!!!

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16
Q

what does a rotator cuff do

A

Rotator cuff stabilizes the humerus head

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17
Q

what are some ss of a rotator cuff injury

A

shoulder pain, unable to easily abduct the arm at the shoulder

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18
Q

what are some diagnostic testing for rotator cuff injuries

A

Drop arm test (unable to abduct arm)
Diagnosed: X-ray, MRI, Ultrasound, CT scan

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19
Q

what is the treatment for rotator cuff injury

A

NSAIDS, Steroid injections, PT, ice, heat, activity limitations

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20
Q

if the rotator cuff injury is full thickness or non healing then what is the treatment option

A

Surgery: Arthroscopic procedures

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21
Q

what are the post op interventions for Arthroscopic procedures for rotator cuff injuries

A

immobilization, exercises (progressing as time goes on), rehab (PT)
Neurovascular checks!!!!!!!!!!!!!!

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22
Q

what is a complete fracture

A

breaks across the entire width of the bone divided into 2 distinct sections

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23
Q

what is an incomplete fracture

A

the break does not divide the bone into two parts

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24
Q

what is a displaced fracture

A

bone alignment is altered

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25
Q

what is an open/compound fracture

A

skin surface is disrupted=open wound

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26
Q

what is a closed/simple fracture

A

skin surface isn’t disrupted= no open wound

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27
Q

what is a fragility fracture

A

pathologic or spontaneous fracture (bone cancer)

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28
Q

what is a fatigue/stress fracture

A

excessive stress on the bone (sports)

29
Q

what is a compression fracture

A

caused by a loading force (osteoporosis)

30
Q

what are some ss of hip fractures

A

Older adults may experience pain in groin or behind the knee of injured side, May have no pain at rest, but pain with standing

31
Q

what are some complications of chest fractures

A

Major concern is multiple ribs and or sternal fractures, Potential to puncture (what lies behind them), High risk for pneumonia from shallow breathing from pain

32
Q

what is the first thing you should do for a chest fracture

A

ABCs

33
Q

what are some ss of pelvic fractures

A

Internal hemorrhage: Venous oozing/arterial bleeding, Hypovolemic shock, Assess for bleeding (internal abdominal trauma), Blood in urine/stool, Abdominal rigidity or distention
Ultrasound, peritoneal lavage, CT scan

34
Q

what are some causes of compression fracture of the spine

A

Osteoporosis, bone cancer, multiple myeloma, Severe pain: possible deformity (kyphosis), neurologic compromise

35
Q

what are some non surgical treatment options for compression fracture of the spine

A

bed rest, analgesics, nerve block, PT

36
Q

what are some surgical interventions for compression fractures of the spine

A

Vertebroplasty/Kyphoplasty

37
Q

what is a med used for spinal compression fractures

A

IV Toradol (Ketorolac to provide pain relief and reduce inflammation
May be given prior to surgical procedure- (common for this to occur) – check kidney levels

38
Q

how long does it take healthy people for bones to heal

A

4-6 weeks

39
Q

how long does it take older adults for bones to heal

A

often takes 3 months or longer for bone to heal in age 70+

40
Q

what are some things that could affect bone healing

A

type of bone fracture, treatment at time of injury, infection, medical history

41
Q

what is acute compartment syndrome

A

increased pressure within one or more compartments (that contains muscle, blood vessels, and nerves) reduces circulation to the area

42
Q

what are some ss of acute compartment syndrome

A

Edema causes increased pressure on nerve endings causing severe pain!!!, Pain is greater than expected after a fracture, Reduced perfusion results in ischemia, Serious, limb/life threatening condition

43
Q

what happens if you dont treat acute compartment syndrome

A

Cyanosis (lack of perfusion), Tingling, Numbness and paresthesia (sensory perception deficit), Necrosis (adequate perfusion not available)

44
Q

what are the early signs of fat embolism syndrome

A

Hypoxemia, Dyspnea, Tachypnea

45
Q

what are some late signs of fat embolism syndrome

A

Headache, Lethargy, Agitation, Decreased LOC/confusion, Seizures, Vision changes, Petechiae (usually the last sign)

46
Q

what is the risk of fat embolism syndrome - how does it work

A

Fat globules are released into the bloodstream within 12-48 hrs. after injury, Clog small blood vessels that perfuse vital organs (often the lungs), May cause respiratory failure or death by causingPulmonary Edema

47
Q

what are some chronic complications of bone infections

A

Avascular necrosis, Delayed bone healing, Complex regional pain syndrome

48
Q

what is complex regional pain syndrome

A

Often results from fractures or traumatic musculoskeletal trauma, Poorly understood, Severe and persistent chronic pain

49
Q

what are the ss of complex regional pain syndrome

A

Abnormalities of ANS (changes in color, temperature, and sensitivity of skin in affected are, excessing swelling, edema), Motor symptoms (paresis, muscle spasms, loss of function), Altered sensory perception (burning pain)

50
Q

how do you prevent shock

A

supine position & keep warm

51
Q

if your giving a patient med in emergency care what should you do

A

cardiac monitoring - espically over 50

52
Q

how much space should be allowed with a cast

A

a finger between cast and skin

53
Q

what are some interventions for casting

A

For home care: teach to assess skin and neurovascular status daily (at least)
Keep injured extremity elevated higher than heart
For plaster casts - gets warm with application; less common

54
Q

what could be some causes of impaired mobility

A

Skin breakdown (may lead to infection), Pneumonia, Atelectasis, Thromboembolism, Constipation- get them up ASAP, Osteoporosis/arthritis , Joint contraction, Muscle atrophy

55
Q

what is traction intervention

A

Pulling forces to a part of the body to provide reduction, alignment and rest , Also, can be a last resort to decrease muscle spasm for decreased pain, Weights should be freely hanging at all times

56
Q

what is skin traction

A

uses a Velcro boot (Buck’s traction), belt or halter usually secured around affected leg
Purpose is to decrease painful muscle spasms that are caused by hip and femur fractures

57
Q

what is skeletal fraction

A

screws are surgically inserted directly into the bone
Heavier weights are used with longer traction times
Pin site care is required to prevent infection
Monitoring neurovascular status for extremity is crutical

58
Q

what is open reduction surgrey

A

allows surgeon to directly view the fracture)

59
Q

what is internal fixation surgrey

A

Metal, pins, screws, rods, plates, or other prostheses immobilize the fracture

60
Q

what is external fixation

A

Metal is through the skin into the bone (visible from the outside)
Advantages- minimal blood loss, early ambulation & exercise, maintains bone alignment when casts can not

61
Q

what is Low-intensity Pulsed Ultrasound

A

uses mechanical waves to stimulate regeneration and anti-inflammatory effects on biological tissues, Used for slow healing fractures as an option to avoid surgery, 20 minutes per day

62
Q

who should not use Low-intensity Pulsed Ultrasound

A

No contraindications or adverse effects yet noted

63
Q

what is the first symptom of infection in older adults

A

The first symptom may be acute confusion or delirium

64
Q

what are risk factors of amputations

A

PVD/DM, trauma, MVC, occupation, military, thermal injury (frostbite/burns/electrocution), malignancy, age, PVD leading to ischemia/gangrene, osteomyelitis

65
Q

what is the nursing assessment before amputation

A

Pulses (doppler), color, temperature, cyanosis, wounds/drainage, gangrenous skin, capillary refill, edema, s/s suspected necrosis, lack of hair distribution due to poor perfusion

66
Q

what are some diagnostic tests done before amputation

A

Ankle-brachial index (ABI) difference of ankle and brachial systolic artery pressures, Doppler: Speed of blood flow in the limb, Transcutaneous oxygen pressure (TcP02)

67
Q

what are some complications of amputation

A

Hemorrhage/hypovolemic shock, Infection, Phantom limb pain (REAL), Neuroma (pinched nerve), Flexion contractures (teach range of motion exercises)

68
Q

what is needed for a lower extremity amputation

A

firm mastress

69
Q

what are the steps after someone cuts their finger off

A

Wrap the severed finger(s) in sterile gauze (if sterility is an option)
Place in watertight, sealed plastic bag, then place bag in ice water
Never place directly on ice (1 part ice to 3 parts water)
Avoid direct contact with ice/causes tissue damage

Med surg Exam 3 (6 decks)

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