Musculoskeletal

Question 1

Geriatrics MSK

Answer 1

decrease bone density
decrease muscle mass and strength
decrease flexibility
functional problems

Question 2

ASSESSMENT OF MSK

Answer 2

Subjective, history,meds, surgery, trauma, COLD-SPA

Objective: vitals/lab/ physical exam/ measurments

Question 3

Diagnostic studies

Answer 3

x-ray- bone
mri- soft tissue
CT scan- 3D - soft tissues

Question 4

Disruption or break in continuity of structure of bone
Trauma injuries 
RT to disease processes
Cancer 
Osteoporosis

Answer 4

fracture

Question 5

CLASS I

Answer 5

complete /incomplete

Question 6

CLASS II

Answer 6

open / closed

Question 7

CLASS III

Answer 7

Fracture line direction
Linear/ transverse
oblique
comminuted (>2 fragment)
spiral (twisted)
greenstick

Question 8

CLASS IV

Answer 8

displaced/ nondisplaced

Question 9

CLINICAL MANISFESTATIONS:

Answer 9

localized pain
decreased function
non weight baring
ROM limit
Guarding
deformity

Question 10

What to do if suspected of fracture

Answer 10

IMMOBOLIZED IT

Question 11

Fracture manifestations:

Answer 11

Edema/swelling
pain/tenderness
muscle spasm
deformity
function loss
crepitation

Question 12

Factors influencing healing

Answer 12

fracture displacement
blood supply
immobilization
internal fixation devices
infection / nutrition
AGE
smoking

Question 13

Complications of fracture healing

Answer 13

delayed union
nonunion
malunion
angulation
pseudoarthrosis (false joints)
refracture

Question 14

Complication of fracture

Answer 14

death
infection (direct - deal with bone itself)
open fractures/ soft tissue

Question 15

Temporary
Performance of activities of daily living (ADL)
Includes joints above and below fracture
Synthetic casting materials
Lightweight, stronger, waterproof
Early weight bearing
Activated by submersion in cool or tepid water, then molded

Answer 15

cast

Question 16

Positioning
Padding of Axillary
Pressure on Posterior Neck
Contraindications
Movement encouraged

Answer 16

sling

Question 17

Elevate
Position
Assess for:
Unrelieved Pain
Increased Pressure
Compartment Syndrome

Answer 17

lower extremity mobilization

Question 18

Non-surgical
Manual realignment  
Traction and counter-traction applied
Local or general anesthesia
Immobilization

Answer 18

closed reduction

Question 19

Surgical incision
Internal fixation
Risk for infection
Early ROM prevents adhesions
Facilitates early ambulation

Answer 19

open reduction

Question 20

Complex Fractures
Traction application
Compresses  & Immobilizes fracture fragments 
Assess pins and perform site care  
Assess for infection
Requires patient education
Form of Open Reduction 
Long-Term 
Prevent Amputation

Answer 20

external fixation

Question 21

Purpose of traction

Answer 21

prevent or decrease pain and muscle spasms
immobilize joints
fracture reduction

Question 22

two most common types of traction

Answer 22

skin- short term only touches the skin
skeletal - long term
systemic skin assessment

Question 23

Pharmacological therapy:

Answer 23

central and peripheral muscle relaxants/ soma
tetanus/ dirty water
antibiotics

Question 24

Increase calcium uptake
Activate intracellular calcium stores
Increase bone growth factor production
Non-invasive, semi-invasive, and invasive methods

Answer 24

electric bone growth stimulation

Question 25

Nutritional therapy:

Answer 25

increase protein, Vitamins, B, C, D, calcium, phosphorous, and magnesium, fluids (2,000-3,000 ml/day), fiber, six meals a day

Question 26

Implement;

Answer 26

neuromuscular assessment, elevate above heart for 48 hrs | report unresponsive pain

Question 27

TRACTION IMPLEMENT:

Answer 27

assess exposed skin, monitor pin sites, pin care, assess for circulation/mobility

Question 28

Increased pressure within a confined space Two basic types of compartment syndrome ↓ Compartment size ↑ Compartment contents Edema → Arterial flow compromised → ischemia → cell death → loss of function Acute or Trauma Injury Ischemia can occur within 4 to 8 hours after onset

Answer 28

compartment syndrome

Question 29

SIX Ps of compartment syndrome

Answer 29

``` Pain pressure paresthesia pallor paralysis pulselessness ```

Question 30

Notify provider of ________. ASSESS

Answer 30

unrelieved pain/ urinary output and kidney function

Question 31

CARE FOR COMPARTMENT SYNDROME:

Answer 31

``` NO ICE SBAR NO ELEVATION LOOSEN BANDAGE REDUCE TRACTION WEIGHT ```

Question 32

``` Porous bone Chronic, progressive metabolic bone disease characterized by Low bone mass Structural deterioration Increased bone fragility ```

Answer 32

OSTEOPOROSIS

Question 33

more common in women?

Answer 33

``` Lower calcium intake Less bone mass Bone resorption Loss of Estrogen HO Pregnancy and breastfeeding Longevity ```

Question 34

RISK FACTORS

Answer 34

``` >65 FEMALE Sedentary lifesyle alcohol menopausal Vit. D deficiency ```

Question 35

Preventive factors

Answer 35

exercise fluoride, vitamin D (SUNLIGHT) calcium

Question 36

Peak bone mass

Answer 36

by age 20

Question 37

Bone loss after

Answer 37

age 35-40

Question 38

Initial bone scans: women

Answer 38

before age 65, | 15 years repeat

Question 39

Initial bone scans: | men

Answer 39

before age 70 or by age 50

Question 40

T- scores:

Answer 40

+1 to -1= normal < -2.5= osteoporosis -1 to -2.5= osteopenia

Question 41

OSTEOPOROSIS CARE

Answer 41

1000 mg/day premenopausal and postmenopausal with estrogen supplementation 1500 mg/day postmenopausal without estrogen supplementation Vitamin C and D combinations increase absorption 20 minutes of daily sunlight Calcium Rich Foods