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Adults > MusculoSkeletal > Flashcards

MusculoSkeletal Flashcards

1
Q

Long Bones

A

Femur, Arm

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2
Q

Short Bones

A

Fingers and Toes

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3
Q

Ends of long bones

A

Epiphysis

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4
Q

Diaphesis

A

Middle part of the bone made of compact bone

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5
Q

Epiphiseal Plate

A

Separates the ends from the shaft

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6
Q

Articular Carteladge

A

Covering after a bone grows

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7
Q

Irregular Bones

A

Odd shape: jaw and vertebrate

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8
Q

Flat bones

A

Protect underlying structures

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9
Q

Composition of Bones

A

Cells, protein, and membrane

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10
Q

Periostium

A

Fiberous membrane that nourishes the bone itself

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11
Q

Endostium

A

Vascular membrane that covers the marrow

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12
Q

Red Bone Marrow

A

Sternum, Ilieus, ribs, and vertebrate

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13
Q

Bone Marrow

A

Highly vascular, located in the shaft of bones

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14
Q

Resorption

A

Removal or destruction of bone influenced by dietary intake, hormones, physical activity, thyroid hormone

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15
Q

Important nutrients for bone health

A

Calcium and Vitamin D

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16
Q

How much Vit D

A

20-30 minutes of sun exposure 3x a week
Young Adults: 600 units
50+: 800-1000 units

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17
Q

PTH

A

Regulates calcium in the blood. Pulls from the bone to the blood when calcium in the blood is low. This promotes demineralization of the bone

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18
Q

Calcitonin

A

Stops bone resorption and causes calcium in the bone

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19
Q

Calcitriol

A

Increases serum calcium by promoting absorption in the GUT

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20
Q

Increased Cortisol

A

Breaks down the bones

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21
Q

Increased TH4

A

Too much bone absorption and breakdown

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22
Q

Estrogen

A

Stimulates osteoBLASTS and inhibits osteoPLASTS. This is needed to build bone.

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23
Q

Testosterone

A

Helps to grow bones. Greater muscle mass=greater weight bearing for the bones=stronger bones
Testosterone converts to estrogen in older males and preserves their bones

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24
Q

Articulation

A

The junction of two or more bones

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25
Q

Synovial Fluid

A

Fluid between the joints

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26
Q

Flaccid

A

Without tone

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27
Q

Spastic

A

Greater than normal tone

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28
Q

Atonic

A

Flabby

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29
Q

Hypertrophy

A

Increased size and of muscle fibers generally from working out

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30
Q

atrophy

A

Decrease in the size of the muscle from lack of use

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31
Q

Osteoporosis

A

Excessive bone loss

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32
Q

Kyphosis

A

Forward curvature of the spine

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33
Q

Lordosis

A

Exaggerated curve of lumbar (swayback)

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34
Q

Scoliosis

A

Lateral curvature of the spine

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35
Q

Arthography

A

Identifies cause of pain in a joint
Determines progression of joint disease
Contrast agent into joint cavity
Joint ROM through study

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36
Q

Arthroscopy

A

visualize joint with endoscope
dx of joint disorders
can biopsy
can treat tears, defects, and disease processes
General anesthesia and sterile procedure
Check for s/sx of infection

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37
Q

Arthrocentesis

A

Obtain sample of synovial fluid and see if there is something causing inflammation
Receive pain from effusion
look for hemarthrosis

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38
Q

Synovial Fluid Characteristics

A

Straw colored, clear, pale

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39
Q

Nursing Considerations for Tests

A

Pt. must lie still (sometimes we need to give a sedative)
allergies or contraindications (COPD, Pregnancy)
KIDNEY FUNCTION (contrast agent is excreted by the kidney)
Extend extremity to reduce swellings

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40
Q

High Calcium

A

Could indicate bone destruction
Osteoporosis
Parathyroid disfunction

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41
Q

Alkeline Phosphatase (ALP)

A

Found throughout body
Concentrated in liver, GI, bones, and kidneys
High levels can indicate bone disorders

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42
Q

CK and AST

A

Elevated with muscle damage

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43
Q

Urine Calcium

A

increased with bone destruction

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44
Q

Indications for Casting

A

o Immobilize fracture
o Correct and prevent deformity
o And to support weakened joints

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45
Q

Complications of Casting

A

o Pressure Ulcers
o Compartment Syndrome

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46
Q

Nursing Priority for Casting

A

N/V assessment

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47
Q

6 Ps

A

 Pain
 Pallor
 Paralysis
 Paresthesia
 Pulses
 Temperature

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48
Q

Compartment Syndrome

A

Every muscle compartment has facia. It is intended to keep the muscle in its compartment and does not allow for much expansion. When we have bleeding or trauma, there is bleeding in the compartment, but the facia is not letting things expand so it all stays in the compartment and this constricts the blood vessels. This can lead to limb death because the blood has stopped perfusing

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49
Q

Sx of Compartment Syndrome

A

**Pain disproportionate to injury is a huge indicator that this is occurring
o Numbness
o Nothing helps pain
o Skin will be tight

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50
Q

Stryker

A

Tests for compartment syndrome by sticking a needle into your muscle to determine the pressure

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51
Q

Interventions of Compartment Syndrome

A

Remove the cast so swelling can occur
Removing the facia (Fasciotomy)

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52
Q

Faciotomy Care

A

Negative pressure wound therapy with instillation has been used effectively to assist in granulation in acute wounds

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53
Q

External Fixation Indications

A

Holding a fracture in place until surgery is able to happen

54
Q

External Fixation Process

A

Inserting pins through skin and bone to hold proper alignment

55
Q

External Fixation Complications

A

External Fixation
Pin loosening
Osteomyelitis or infection

56
Q

External Fixation Considerations

A

Clean pins
N/V checks
Cover sharp edges

57
Q

Skeletal Traction Indications

A

Short term fx management
Decrease muscle spasms
Maintain alignement before surgery
Prevent deformities

58
Q

Skeletal Traction MOA

A

Uses pt. weight as a counterbalance to create traction which reduces muscle spasms

59
Q

Nursing Considerations Muscle Traction

A

Check Skin
Check NV
Pain control
Pin Care
ROM + PROM

60
Q

Skeletal traction Complications

A

Pneumonia
Constipation
Anorexia
Infection
CAUTI

61
Q

Complications of Orthopedic Surgery

A

Blood loss (1500ml)
Post op bleeding
Post op anemia
infection

62
Q

Arthroplasty

A

Replacing an old joint with a new one

63
Q

Nursing Considerations for Arthroplasty

A

Give antibiotic 60 minutes before incision
WATCH FOR COMPLICATIONS OF IMMOBILITY
assess N/V
pain management
Promote ambulation

64
Q

Meds for Lower Back Pain

A

TCAs (Amitriptyline)
SSRIs (duloxetine)
Atypical Anticonvulsants (Gabapentin)
NSAIDS (Ibuprofen / Motrin / Naproxen / ASA / Aleve)

65
Q

Complications of Lower Back Pain

A

loss of bowel or bladder

66
Q

Percocet

A

Acetaminophen + Oxy

67
Q

Vicodin

A

Hydrocodone + Acetaminophen

68
Q

Foods high in Calcium

A

Cheese, Dairy products, Broccoli, Canned
Salmon
Dark green leafy veggies
Soy products
Ca fortified cereals & OJ

69
Q

Causes of Osteoporosis

A

Smaller frame
* Postmenopausal
* Malnutrition
* Bariatric surgery
* GI malabsorption disorders
* Immobilization
* Corticosteroids
* Medications
* Tobacco / Alcohol use
* Sedentary lifestyle
* Reduced Calcitonin
* Reduced Estrogen
* Increased PTh

70
Q

Osteoporosis Presentation

A

back pain
Shortened frame
Stooped posture
bones fracture easily

71
Q

Pharm for Osteoposis

A

Biphosphates (Alendronate, risedronate, ibandronate, zolidronic acid)
Estrogens (raloxifene)
Antineoplastics (denosumab)

72
Q

Osteomalacia

A

Soft and weak skeletal bones

73
Q

Causes for Osteomalacia

A

Lack of Vitamin D
Renal failure
GI disorders
Hyperparathyroidism
Medications
Malnutrition

74
Q

Osteomalacia presentation

A

pain and tenderness to bones that is worse when ambulating
bowing of bones
possible pathologic fx
waddling gait
possible Steatorrhea
Pain not relieved by rest

75
Q

Which organs activate vitamin D

A

Liver then kidneys

76
Q

Osteomyelitis

A

Infection of the bone

77
Q

Causes of osteomyelitis

A

bloodstream (like staph)
Complicated DM
nearby tissue infection
open fractures
poor circulation

78
Q

Symptoms of osteomyelitis

A

fever
tachycardia
swelling over infected joint
fatigue
pain

79
Q

Labs to test for osteomyelitis

A

CBC/Blood cultures
CT/MRI
ESR

80
Q

Meds for osteomyelitis

A

Strong oral or IV antibiotics
Longer term: three-six weeks for both

81
Q

Interventions for osteomyelitis

A

Surgery
ORIF

82
Q

Nursing considerations for Osteomyelitis

A

quit smoking
monitor worsening infection
prolong elective orthopedic surgery
remove urinary catheters ASAP
Aseptic wound care
Management of soft tissue infections
Inspect feet of DM pts

83
Q

Subluxation

A

Partial dislocation

84
Q

Complications of joint dislocation

A

avascular necrosis

85
Q

Fracture s/sx

A

pain with movement and less when not
muscle spasm
deformity
Ecchymosis and swelling

86
Q

Open Fracture Treatment

A

cover and prepare for surgery

87
Q

open reduction

A

Opening the wound and fixing it in on the inside with screws

88
Q

Avascular necrosis

A

death of a joint

89
Q

Complications from Complicated Fracture

A

Hemorrhage, Fat embolus, osteomyelitis, avascular necrosis

90
Q

disseminated intravascular coagulation

A

You bleed so much that you use up all your clotting factors. Happens with hemorrhage. This is treated with heparin

91
Q

Malunion

A

Not healing exactly like it should

92
Q

Nonunion

A

does not heal at all

93
Q

Hematoma block

A

reducing the amount of people getting sedated. Taking lidocaine and putting a needle it right into the fracture and then put the lidocaine in it to numb it so that they can maneuver it all they can

94
Q

1 priority for pelvic fractures

A

HEMORRHAGE
get CT and CBC to monitor blood

95
Q

Complications for pelvic fracture

A

severe back pain because all the blood is going to the back
Hemorrhage
Fat Emboli
Unstable pelvis upon rocking

96
Q

Nursing considerations with pelvic fractures

A

Monitor with bed rest and assess for complications of immobility
Painful to poop and sit!
early mobilization (weight bearing in 3 months)

97
Q

Paralytic Ileus

A

you will hear no bowel sounds due to a pelvic fracture where the muscles do not let food pass through resulting in a blocked intestine. Tell doc right away

98
Q

Hip Fracture Manifestations

A

Affected leg will be shorter
Pain in hip, groin, and knee upon slightest movement

99
Q

Nursing considerations for a hip fracture

A

 Standard post-op care
 Complications of immobility
 Abductor pillow; less than 90 degrees
 Elevated toilet seat
 Ambulate first day post-op (in most cases)

100
Q

Femur Fracture Presentation

A

Edema, deformity, and pain to thigh/knee

101
Q

Femur Fracture Considerations

A

Immobilize
Assess NV function to extremity
Skeletal Traction
takes longest time to walk after! 6 months

102
Q

Fat Embolism

A

Fat emboli enter the microcirculation
Induce Systemic Inflammatory Response Syndrome: this is the body’s reaction to a fat emboli

103
Q

Presentations of a Fat Embolism

A

 Confusion
 Petechial rash

 Tachypnea
 Tachycardia
 Fever
 Respiratory depression (75%) mild to ARDS to mechanical ventilation

104
Q

Treatment of Fat Emboli

A

 Largely supportive. We cannot do anything about this
 Fix long bone fractures early=decreased likelihood of developing FES
 Corticosteroids? Studies show that these are minimally effective

105
Q

Nursing considerations for Fat Emboli

A

watch for change in LOC
Watch for Petechial rash
watch for ARDS

106
Q

Causes of Amputations

A

DM
Osteomyelitis
Injuries
Surgery to remove tumor

107
Q

Levels of Amputation

A

Try to keep the distal joint because there is better prosthetic
BKA
AKA

108
Q

Complications from Amputations

A

 Hemorrhage
 Infections
 Joint contractures
 Phantom limb pain

109
Q

Rigid Cast dressing

A

uniform compression to shape the residual limb for a prosthetic

110
Q

Pharm for Amputation

A

 Beta blockers: manage pain
 Anticonvulsant: Gaba: used to help nerve pain
 TCA: helps with mood and anxiety and depression

111
Q

Position to avoid contractures

A

prone

112
Q

Rheumatoid Arthritis

A

Chronic Inflammatory Disorder
Auto immune disorder
Immune system attacks synovial linings of joints
Begins in distal joints (fingers and toes)
Lose movement of the joints

113
Q

RA Presentation

A

worse when you are NOT MOVING
Tender, warm, swollen and erythemic joints
Fatigue, fever, and loss of appetite.
Also attacks other places besides the hands and feet

114
Q

RA Labs

A

o Arthrocentesis: removal of fluid to do a test on it
o CT
o CBC, ESR elevation (indicating inflammation), CRP, Rheumatoid Factor positive

115
Q

Pharm for RA

A

NOT opioids
DMARDS: Disease modifying antirhematic drug
NSAIDS: cannot be on for a while
COX-2: Celecoxib
Corticosteroids: prednisone

116
Q

Nonbiological DMARD

A

methotrexate (horrible drug and you need blood tests done annually)

117
Q

Biological DMARD

A

adalimumab (injected, better, but only insurance will pay for it only if you fail non-biologic)

118
Q

RA Complimentary alternative medicine

A

Fish oils/plant oils

119
Q

RA Complications

A

Medication toxicity
Damage to skin, eyes, lungs, heart, blood vessels, kidneys, nerve tissue, salivary glands and bone marrow
CV disease

120
Q

Osteoarthritis

A

Not autoimmune and noninflammatory joint destruction. RA destroys the joint and will LEAD to this, but is not REQUIRED for this

121
Q

Osteoarthritis Presentation

A

o Pain, stiffness and functional impairment
o Joint pain aggravated by movement and exercise
 RELIEVED BY REST
o Morning stiffness
o Decreased ROM in affected joint
o Crepitus (air under the skin) over knee or grating sensation. Can happen anywhere

122
Q

Diagnostic Tests for OA

A

o X-ray/MRI
o Blood test to rule out RA

123
Q

Meds for OA

A

o NSAIDS (cannot be on these forever)
o COX-2 celecoxib
o Intra-articular corticosteroids
o Acetaminophen
o Diclofenac
o Glucosamine and Chondroitin

124
Q

Gout

A

high levels of uric acid in the blood (can also have uric acid stones)

125
Q

Gout Causes

A

o Alcohol consumption
o Fructose-rich beverages
o Age/BMI
o HTN meds
o Thiazide Diuretics

126
Q

Gout Pathophysiology

A

o Kidney cannot get rid of uric acid so it makes a bunch of deposits
o Hyperuricemia
o Uric acid loves to go into your joints
o Macrophages in joint space end up becoming crystalized into the joint. Eat the uric acid which turns them into crystals

127
Q

Gout Labs

A

o Joint fluid analysis (uric acid will show up)
o X-ray (see if there is a deformity in the joint space)

128
Q

Gout Meds

A

Acute Attacks:
 Colchicine
 NSAIDS
 Corticosteroids

Management:
 Xanthine (Allopurinol)
 Uricosurics (probenecid)

129
Q

Gout Prevention

A

Low Urine Diet
Weight loss
Lifestyle changes

130
Q

Fibromyalgia

A

Pain that we do not know where it is coming from. We rule out EVERYTHING else and then we diagnose this.

131
Q

Fibromyalgia Presentation

A

widespread pain
Fatigue
Cognitive difficulties
Other conditions usually co-exist

Adults (6 decks)

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