Musculoskeletal Flashcards
1
Q
When assessing a patients musculoskeletal system what should you always do?
A
Compare L and R side
2
Q
Wrenching or twisting injury to ligaments surrounding joints
A
Sprain
3
Q
Joint tenderness and increased pain with movement are symptoms of what type of injury
A
Sprain
4
Q
Muscle pull or overuse
A
Strain
5
Q
Gradual soreness, sudden pain, or local tenderness are symptoms of what type of injury
A
Strain
6
Q
What is the management for strains and sprains
A
- RICE (rest and ice)
- NSAIDs
- Wraps (towards heart)
7
Q
Complete displacement
A
Dislocation
8
Q
Partial or incomplete displacement
A
Subluxation
9
Q
Carpal tunnel syndrome is an example of what type or injury
A
Repetitive Strain injury (overuse)
10
Q
Repetitive use of injury to the 4 muscles that generally stabilize the head of the humerus
A
Rotator cuff injury
11
Q
ACL injury
A
Anterior Cruciate Ligament injury
12
Q
Sports injury or injury that chips/damages the knee cartilage
A
Meniscus injury
13
Q
Bursa (cushion) becomes inflamed due to trauma, friction, or extra pressure on the joints
A
Bursitis
14
Q
Should you use ice or heat 24-48 hours after an injury occurs
A
Ice
15
Q
Break in bone caused by stress greater than it can absorb
A
Fracture
16
Q
-crushing force
-sudden twist in motion
-extreme muscle contraction (rare)
-pathological
…can all be causes of what?
A
A Fracture
17
Q
-Pain (tenderness at the site)
-Swelling and ecchymosis
-Loss of function
-Crepitus
-Deformity
-Muscle spasm
-Shock with blood loss
… are all manifestations of what?
A
Fracture
18
Q
-Traction
-Surgical
-Manipulation
-Cast
-External fixation
… are all interventions for what?
A
Fractures
19
Q
Closed reduction is what type of intervention?
A
Manipulation
20
Q
What do casts do?
A
Maintain alignment and immobilization
21
Q
When is external fixation used?
A
with a soft tissue injury
22
Q
An open reduction is what type of intervention?
A
Surgical
23
Q
What is the purpose of traction?
A
- Decrease muscle spasm
- Immobilize and reduce fracture
24
Q
What are the two type of traction?
A
- Skin
- Skeletal
25
-Hazards of immobility (ex: foot drop)
-Delayed or nonunion of healing
-Infection (ex: osteomyelitis)
... are potential complications of what type of intervention ?
Traction
26
Osteomyelitis is especially a risk with what?
External fixation
27
Counter traction
maintain opposite pull
28
What interferes with traction and should be avoided/prevented?
Friction
29
Should the line of pull when using traction ever be interrupted?
No
30
Should continuous traction ever be removed without physician ok?
No
31
What should you maintain when positioning a patient with traction?
Correct body alignment
32
Weights attache to adhesive and applied to the skin is what type of traction?
Skin
33
What type of traction exerts a straight pull on limb (most common)?
Buck's
34
Is Buck's traction often used temporarily to immobilize a hip fracture prior to the OR?
Yes
35
What type of traction involves both lower limbs extended vertically?
Bryant's
36
Bryant's traction is used to do what?
Align a fracture
37
What type of traction is balanced traction?
Russell
38
Russell traction used ropes and pulleys and is commonly used for what?
Fractured femurs
39
Traction that is applied to bone using pins and wires with weights to both ends of pins or wires is called what?
Skeletal traction
40
What may also be used when using skeletal traction?
a cast
41
Internal fixation and external fixation are both what types of fixation?
Surgical
42
Aligning the bone with plates and screws to hold fracture in alignment is what type of surgical fixation?
Internal
43
Fracture with soft tissue injury or the need of limb-lengthening uses what type of surgical fixation?
External (more complex)
44
What type of surgical fixation is often used when attempting to save an extremity from being amputated?
External fixation
45
What is the purpose of a cast?
- maintain alignment
| - Immobilize
46
What is it extremely important to monitor for when using casts?
Compartment syndrome (decreased blood flow to affected area)
47
What needs to be assessed when someone has a fracture?
- pulses
- CRT
- appearance
- sensation
- etc
48
You will likely see shortening and external rotation of a limb with what type of fracture?
Hip
49
-Immobilize
-Cover wounds
-Treat for shock
... are interventions for what?
Fractures
50
-Emboli
-Compartment syndrome
-Venous thromboembolism
-Infection
... are potential complications with what type of injury?
Fractures
51
What is it called when the skin is cut open to reduce edema/pressure for healing?
Fasciotomy
52
-monitor for signs or local and systemic
-major concern for osteomyelitiss
...are things that need to be assessed for what type of fracture complication?
Infection
53
-AMS
-Chest pain, dyspnea, SOB
-Petechiae
-Pallor, diaphoresis
... are things to assess for with what type of complication that can arise from a fracture?
Emboli (fat or blood)
54
Edema from a fracture causing increased pressure in fascial compartment, and a decrease in capillary perfusion is called what?
Compartment Syndrome
55
-Pain
-Pallor
-Parathesia
-Pressure
-Pulselessness
-Paralysis
... are the 6 P's used to assess for what syndrome?
Compartment Syndrome
56
Early detection and treatment of compartment syndrome is necessary in order to prevent what type of longterm damage?
neurovascular
57
Avascular necrosis is seen commonly with what type of frequent medication use?
Steroids
58
-Relieve pain
-Improve mobility
-Correct deformity
... are indications for what type of surgery?
Joint replacement
59
What type of fracture is at risk of avascular necrosis?
Intrascapular
60
-Maintaining abduction depending on anterior or posters approach is important for what type of surgery?
```
Joint replacement
(posterior need to maintain abduction)
```
61
-Pillows
-Raised toilet seat
-high straight back chair
... are all ways to avoid what with a joint replacement?
Adduction and flexing the hip (ex: no crossing legs or low sitting)
62
Ability to bear weight after a joint replacement is dependent on what?
MD ok
63
-Circulatory impairment
-Trauma
-Infection
-Congenital disorders
... are indication for what to happen to a limb?
Amputation
64
Arterial insufficiency can be a result of what conditions?
- DM
- Heart disease
- Traume
- Injury
- Etc
65
Does a persons psychological health need to be assessed prior to and after and amputation?
Yes
66
"Phantom sensation" in which an individual feels pain in part of the limb that was removed is most often after what?
Above knee amputation (AKA)
67
What is the drug treatment for Phantom limb pain?
- Opioids
- Beta blockers (for dull burning)
- Anticonvulsants (for knife-like pain)
* *Gabapentin
68
What type of therapy can also help with phantom limb pain?
Mirror
69
After an amputation the limb should be elevated for 12-24 hours to decrease edema, but flat after this time to do what?
- Promote functional alignment
| - Prevent flexion contractures
70
After amputation the patient should lie prone how often?
Every 3-4 hours for 20-30 minutes
71
-Shrinking
-Shaping
-Toughening
... is called what?
Stump conditioning
72
Is ambulation important after an amputation?
Yes with assistive devices if necessary
73
Should a amputation stump be evaluated daily for irritation and pressure injuries?
yes
74
Washing every NOC with bacteriostatic soap should be done for the management of what?
A amputation stump
75
Should lotions and powders be avoided with a amputation stump unless ok'd by the MD?
Yes
76
Should a stump sock be changed daily?
Yes
77
The use of a prothesis should be avoided if what occurs?
Irritation of the stump
78
-Lumbosacral strain
-Osteoarthritis
-Herniation or intervertebral disk degeneration
... can be causes of what type of pain?
Low back
79
Acute low back pain is typically due to what?
- Stress
| - muscle spasm
80
-Analgesics
-NSAIDS *
-Steroids
-Muscle relaxants
-Local ice or heat
-PT
... are forms of conservative treatment of what type of low back pain?
Acute
81
Chronic low back pain is typically due to what?
- Structural
| - Disease
82
Radiating pain in the buttocks and the leg commonly experienced with positive straight leg raises (passive ROM where leg is lifted above 60 degrees) is seen with what type of low back pain?
Chronic
83
Epidural injections in addition to the conservative treatment used for acute low back pain is also used for what?
Chronic low back pain
84
Prior to back surgery what is it essential to have done?
Baseline assessment
85
A baseline assessment should be compared with what after a patient has back surgery?
Post op assessment
86
-Peripheral neurovascular/sensory status
-Maintaining alignment
-Bone graft or fusion may need brace, monitor donor site
-Log-roll
-Pain management (PCA)
-Monitoring for CSF leak
... are all things that should be done postoperatively for what type of surgery?
back surgery
87
Yellowish drainage accompanied by a headache raise concern for what?
CSF leak
88
What is the name for a chronic progressive metabolic bone disease, "silent disease"?
Osteoporosis (decalcification)
89
Low bone mass and density is seen in what disease?
Osteoporosis
90
The strength and structure of bones is ruined in what disease?
Osteoporosis
91
-Long-term use of steroids*
-Thyroid hormone
-Heparin
-Long-acting sedatives
-Anti-seizure meds
... are risk factors for what bone disease?
Osteoporosis
92
-Advanced age (>65)
-Female
-Low body weight
-White or asian
-Current cigarette smoking
-Inactive lifestyle
-Family history
-Low calcium diet or vit D deficiency
-Excessive alcohol intake (>2 drinks a day)
-Postmenopausal
... are all risk factors for what bone disease?
Osteoporosis
93
Why does menopause place a women at higher risk for osteoporosis?
Reduction in estrogen, estrogen helps keep vitamin C in the bone
94
-Bone loss w/o symptoms
-Fractures
-Collapsed vertebrae
-Height loss
-Sinal deformities (ex: kyphosis)
-Stooped posture
... are manifestation of what bone disease?
Osteoporosis
95
A bone mineral density test is used to diagnose what?
Osteoporosis
96
-Adequate Ca intake
-Vit D
-Moderate weight bearing exercise (walking)
... are all ways to prevent what bone disease?
Osteoporosis
97
How much calcium should be taken daily for premenopausal women?
1000mg/day
98
How much calcium should be taken daily for postmenopausal women not on estrogen?
1500mg/day
99
Bisphosphonates (Fosamax) is used in the treatment of what?
Osteoporosis
100
The risk of esophagitis is seen with what medication used in the treatment of osteoporosis?
Bisphosphonates
101
Hormone replacement therapy can also be used to treat what type of bone disease?
Osteoporosis
102
Can you use hormone replacement therapy is you have the risk for great cancer, CVD, or stroke?
No
103
Bone loss that is not as bad as osteoporosis but can be seen as a warning sign for osteoporosis is called what?
Osteopenia
104
What is the bone disorder that is seen with wear and tear/ use and abuse?
Osteoarthritis
105
-Increasing pain
-Progressive loss of function
-Joint stiffness after rest or static position
-Advanced: gross deformity and subluxation
-Herberden's nodes
-Bouchard's nodes
... are all manifestations of what bone disease?
Osteoarthritis
106
-Not smoking
-Maintaining a healthy weight
-Treating injuries as they arise
-Regular exercise
... are all ways to prevent what bone disease?
Osteoarthritis
107
What is the drug therapy for osteoarthritis?
- Acetaminophen (1gm 4x's daily)
- NSAIDS (oral or topical)
- Intraarticular hyaluronic acid
- Intraarticular corticosteroids
108
A systemic autoimmune disease with remission and exacerbations, that is more common in women is what?
Rheumatoid arthritis
109
-Pain
-Stiffness upon arising after inactivity
-Limited movement
-Joint inflammation
-Late deformities
... are all joint manifestations of what?
Rheumatoid arthritis
110
-Ulnar drift
-Swan neck
-Hallux valgus
-Boutonniere
... are all late deformities seen in what?
Rheumatoid arthritis
111
-Vasculitis
-Peripheral neuropathy
-Myopathy
-Cardiopulmonary
-Ischemic skin ulcers
... are systemic extraarticular (outside of joint) manifestations of what?
Rheumatoid arthritis
112
-NSAIDs
-Hydroxychloroquine
-Intraarticular or systemic corticosteroids
-Methotrexate
-Enbrel, Remicade, Humira: Biological response modifiers
... are drugs used in the treatment of what?
Rheumatoid arthritis
113
Hydroxychloroquine and Methotraxate are what types of drugs?
Disease modifying antirheumatic drug (DMRADs)
114
Hydroxychloroquine is also currently being used to treat what?
COVID 19
115
Disease that is caused by overproduction or inability to excrete excess amounts of uric acid? (defect of purine metabolism)
Gout
116
Uric acid crystalizes where causing gout to be painful?
At joints
117
If uric acid crystalizes in the renal tubules what can be caused?
Kidney problems
118
Can gout be primary meaning it is inherited?
Yes
119
Can gout also be secondary meaning it caused by another disease process?
Yes (cancer, alcoholism, obesity)
120
-Severe pain in joints and commonly the great toe
-Inflammation
-Urate crystals in synovial fluid
-Increase in uric acid in 24 hr urine
... are manifestations of what?
Gout
121
What is the drug of choice for acute gout attacks?
Indomethacine
122
What are other drugs besides indomethacin use in acute gout attacks?
- NSAIDs
| - Colchicine
123
What drugs are used in the maintenance therapy for gout?
- Allopurinl
| - Probenecid
124
People with gout should avoid what foods?
- Liver
- Wine
- Beer
- Red meat
125
Chronic multisystem inflammation of connective tissue is what disease?
Systemic Lupus Erythematosus (SLE)
126
Is Systemic Lupus Erythematosus (SLE) more common in women?
yes
127
Is Systemic Lupus Erythematosus (SLE) an autoimmune disease that has remissions and exacerbations?
Yes
128
-Skin
-Joints
-Membranes of lungs
-Pericardium
-Kidneys
-Eyes
... are examples of the mutlisystem inflammation seen in what?
Systemic Lupus Erythematosus (SLE)
129
Besides an H and P, what is the main way Systemic Lupus Erythematosus (SLE) is diagnosed?
Anti-DNA and ANA will be elevated
130
A butterfly rash is seen in what disease?
Systemic Lupus Erythematosus (SLE)
131
Immune deposits in skin and joints, trigger inflammation and then degeneration is seen in what disease?
Systemic Lupus Erythematosus (SLE)
132
What is the drug management for Systemic Lupus Erythematosus (SLE)?
- NSAIDs with mild disease (monitor GI and renal)
- Steroid-sparing drugs (methotrexate)
- Antimalarial drugs (Hydroxychloroquine)
- Corticosteroids (exacerbations and severe disease)
- Immunosupressive drugs (*azathiprine)
