Musculoskeletal Flashcards
Lateral curvature of the spine and spinal rotation that causes rib asymmetry
Scoliosis
Who is most likely to get scoliosis
Genetic tendency, more common in girls 8-15
Assessment findings for scoliosis
- asymmetry in scapula/ribs/hips, one pant leg shorts than the other, school screening
What can we do to slow the curvature caused by scoliosis?
Bracing
When do we do surgical interventions for scoliosis?
If >45 degrees
Surgical/post op considerations for scoliosis
go to ICU- rod placement surgery very invasive ◦ PCA pump ◦ Supine ◦ Log-rolling every 2 hours ◦ Skin integrity ◦ indications of bleeding/infection
Type of break that can result in altered bone growth
Epiphyseal plate injury
Type of fracture: compression of bone resulting in a bulge or raised area at the fracture site
Buckle( torus )
Type of fracture: bone is bent no more than 45 degree without breaking
Plastic deformation (bend)
Type of fracture: incomplete fracture of the bone
Greenstick
Type of fracture: break is straight across the bone
Transverse
Type of fracture: break is diagonal across the bone
Oblique
Type of fracture: breaks in spiral around the bone
Spiral
Type of fracture: small fractures/cracks in the bone due to repeated muscle contractions
Stress
Type of fracture: bone fragments are separated
Complete
Type of fracture: bone fragments are still attached
Incomplete
Type of fracture: fracture occurs with an open wound and bone protruding
Open or compound
Type of fracture :
fracture results in injury to other organs/tissues
Complicated
Type of fracture: includes small fragments of bone that lie in surrounding tissue
Comminuted
Priority assessments for fracture
Circulation, neuro (CMS from med surg)
How to provide a traumatic care for casting?
Place cast on doll first
What is skin traction?
No pins!
Weighs attached to skin with tape or straps
What is skeletal traction?
Continuous pulling force through rods/pins in bone
What is halo traction?
Halo screwed into skull bones, halo attached to vest or bed traction
Assessment for traction with pins
Infection!
5ps of compartment syndrome
‣ pain- unrelieved with elevations/ analgesics that worsens with passive movement
‣ pulselessness: distal to fracture (late finding)
‣ pallor- pale skin
‣ paralysis
‣ parasthesia - numbness (early finding)
Bone infection secondary to infection from outside source?
Osteomyelitis
A chronic autoimmune inflammatory disease affecting joint function and tissue
Juvenile idiopathic arthritis
When will pain worst with juvenile idiopathic arthritis ?
After rest/morning
Labs associated with juvenile idiomatic arthritis?
Elevated:
C reactive protein
ESR
WBC
Goal of managing juvenile idiopathic arthritis?
Preserve function, control pain and inflammation
Interventions for managing pain and inflammation with JIA
Warm moist heat
NSAIDS – take with food to minimize GI irritation
Prednisone
DMARDS
How do we dose prednisone for kids with JIA?
Lowest effective dose for short-term therapy b/c of adverse effects (ex. take on an alternate day schedule)
• weight gain, alteration in growth
What about psychosocial considerations with JIA?
encourage participation in school activities
Inherited disorders with progressive degeneration of symmetric skeletal muscle groups
• Causes progressive muscle weakness and wasting
Muscular dystrophy
Most common type of muscular dystrophy
Duchenne
Muscular dystrophy type: X recessive, onset b/w 3-5 yr, fat tissue replaces muscle in lower limbs, live into early adulthood
Duchenne
Type of muscular dystrophy :
autosomal dominant, onset adolescence, slow progression, facial weakness, inversion of shoulders
Facioscapulohumeral muscular dystrophy
Type of muscular dystrophy
autsomal dominant and recessive, later in childhood onset, slow progression
Limb girdle muscular dystrophy
