Musculoskeletal

Question 1

What is a transverse fracture?

Answer 1

Straight across the bone at 90 degree angle due to traumatic event

Question 2

What is a fracture?

Answer 2

Disruption or break in continuity of structure of bone

Question 3

What is a spiral fracture?

Answer 3

Spirals around the bone
Usually long bones - twisting from sport or physical assault

Question 4

What is an oblique fracture?

Answer 4

Diagonally across the bone

Question 5

What is a comminuted fracture?

Answer 5

Has 3 or more bone fragments

Question 6

What is a segmental fracture?

Answer 6

some bone is fractured in 2 places leaving a floating segment of bone

Question 7

what is a buckle fracture?

Answer 7

fracture of the shaft of a long bone that is characterised by bulging of cortex

Question 8

what is a greenstick fracture?

Answer 8

fracture on one side of the bone, causing a bend in the other side

Question 9

What is a stress fracture?

Answer 9

hairline/tiny crack often from overuse

Question 10

What is an avulsion fracture?

Answer 10

tendon or ligament pulls of a fragment of bone

Question 11

What are the S&S of fractures?

Answer 11

• localised pain + tenderness
• swelling + bruising
• decreased function
• NWB or WBAT
• guard against movement
• ?deformity

Question 12

What are the risk factors for fractures?

Answer 12

• elderly
• previous hx of fractures
• smoker
• low body weight
• excessive alcohol consumption
• medical diseases

Question 13

What is the 1st stage of fracture healing?
(Fracture Hematoma & Inflammation)

Answer 13

Bleeding creates hematoma & inflammatory process begins

Question 14

What is the 2nd stage of fracture healing?
(Granulation Tissue)

Answer 14

Phagocytosis of dead tissue & organisation of hematoma into fibrous network
granulation tissue consists of new blood vessels, fibroblasts + osteoblasts
(produces basis of new bone = osteoid)

Question 15

What is the 3rd stage of fracture healing?
(Callus formation)

Answer 15

chondroblasts & osteoblasts start to form collagen
callus primarily made of cartilage, osteoblasts, calcium & phosphorus (soft callus)

Question 16

What is the 4th stage of fracture healing?
(Callus Ossification)

Answer 16

Cartilaginous callus is reabsorbed & begins to calcify
osteoblast cells create new bone, adding mineral stop make it hard, new bone is built up (hard callus)

Question 17

What is the 5th stage of fracture healing?
(Consolidation)

Answer 17

Distance b/w bone fragments diminishes & eventually closes
ossification continues

Question 18

What is the 6th stage of fracture healing?
(Remodeling)

Answer 18

Excess bone tissue reabsorbed by osteoclasts & union completes
strength gradually returns

Question 19

What are the nursing responsibilities of fractures?

Answer 19

• pain management
• neuro obs
• risk assessment
• pre/post op management
• wound + cast management
• falls risk
• NWB + WBAT
• Help with ADLs
• MDT input
• Pt education

Question 20

What is the mangement of fractures?

Answer 20

• buddy strapping
• moon boot
• splint
• square toe shoe
• closed reduction
• ORIF
• external fixation

Question 21

What is compartment syndrome?

Answer 21

Swelling & increase of pressure with a confined compartment most commonly due to trauma or external compression e.g. cast

Question 22

What is the pathophysiology of compartment syndrome?

Answer 22

arterial blood flow compromised - ischemia - cell death - tissue not viable - can loose limb

Question 23

What are the S&S of compartment syndrome

Answer 23

• pain
• pressure
• paresthesia
• pallor
• paralysis
• pulselessness

Question 24

What is the treatment of compartment syndrome

Answer 24

Fasciectomy

Question 25

What is the signs someone needs a joint replacement?

Answer 25

- pain - decreased movement/function - decreased QOL

Question 26

What is the post op nursing management of joint replacement?

Answer 26

- stable post op - pain management - DVT prevention - neurovascular assessment - abx - risk = constipation + pressure areas - MDT input

Question 27

What is osteoarthritis?

Answer 27

Degenerative disease, worsens over time = chronic joint pain

Question 28

What is the cause of osteoarthritis

Answer 28

mechanical wear & tear on the joints

Question 29

What are the risk factors of osteoarthritis

Answer 29

- elderly - women - obesity - joint injuries - repeated stress on joint - genetics - bone deformities

Question 30

What are the S&S of osteoarthritis?

Answer 30

- joint stiffness [sitting down/early morning/periods of rest] - overactivity increases joint stiffness - asymmetrical joints - creaking - deformity

Question 31

What is the nursing management of osteoarthritis?

Answer 31

- health promotion + pt education - out pt management - health assessment - enc. non-drug intervention - maintain joint function

Question 32

What is rheumatoid arthritis?

Answer 32

Autoimmune disease that the bodies own immune system attacks the bodies joints

Question 33

What is the pathophysiology of rheumatoid arthritis

Answer 33

inflammation of connective tissue in diarthrodial (synovial) joints

Question 34

What are the risk factors of rheumatoid arthritis?

Answer 34

- age/sex - genetics - smoking - obesity

Question 35

What are the S&S of rheumatoid arthritis?

Answer 35

- insidious onset - fatigue/anorexia/weight loss/stiffness - specific articular involvement (pain, red, swelling, decreased movements, inflammation) - symmetrical symptoms - SMALL JOINTS

Question 36

What is the nursing management of rheumatoid arthritis

Answer 36

- health promotion - comprehensive programme = balance rest + activity/joint protection/heat + cold application/exercise - ambulatory + home care

Question 37

What medications are used for rheumatoid arthritis?

Answer 37

- abx - immunosuppressants - penicillamine - corticosteroid therapy - NSAIDs & salicylates