Musculoskeletal assessment and diagnostics Flashcards
Scoliosis
Abnormal lateral curvature to the spine
Kyphosis
Abnormal curvature of the thoracic spine
Lordosis
abnormal curvature of the lumbar spine
Ligaments
bone to bone
Tendons
muscle to bone
5 Ps of Neurovasc Assessment
Pain, Pulse, Pallor, Paresthesia, Paralysis (also edema, cap refill, nailbeds and skin)
Crepitus
cracking or grating sound due to abnormal joint motion; TMJ, dislocation, fracture
Contracture
resistance of movement of joint or muscle, results from fibrosis of supporting soft tissue, immobilized extremity
Effusion
excessive fluid collection in joint, arthritis, injury, infection
Dislocation
separation of 2 bones from normal position within a joint
Subluxation
partial dislocation of joint
Ankylosis
stiffness and fixation of the joint, chronic joint inflammation (RA)
Atrophy
flabby appearance of muscle with decreased tone- prolonged disuse, chronic immobilization
Xray
1d- front to back, 2d- lateral, evaluates structure and functional changes of bone, excessive exposure to radiation
CT scan
3d, IDs soft tissue and bony abnormalities, claustrophobia, injection of IV contrast
MRI
view soft tissue w/ magnetic field (tumors, osteomyelitis, ligament and cartilage tears)
consider claustrophobia, no metal, open v closed, can inject gadolinium to enhance visualization
DXA scan indications
Measure bone mass density
* of spine, femur, forearm, total body
– Diagnose & monitor osteoporosis
– Predict fracture risk
– Diagnose presence of bone disease
* minimal exposure to radiation
* no discomfort
Bone scan
Indications:
– detect metastatic & primary tumors
– detect osteomyelitis
– diagnose stress fracture not evident on x-ray
– May take up to 1 hour to perform
* Requires IV injection of Radioisotope
– a.k.a. “tracer”
– 2-4 hrs. before scan
– May “sting” when injected
– Encourage oral fluids afterward to eliminate radioisotope
* Results:
– Increased bone uptake of radioisotope = skeletal disease, metastasis, osteomyelitis,
fracture
Arthroscopy
visualization of joint with fiberoptic endoscope, sterile technique in OR w/ general or local anesthesia
Arthroscopy complications
infection, thrombophlebitis, neurovascular compromise, effusions
Arthroscopy post op
compression dressing, ice packs, elevate leg, check pulses, color, sensation, temperature, assess for pain and administer analgesics, assess for infection and bleeding
Arthrocentesis
to obtain synovial fluid for testing, to relieve pain due to effusion, can inject NSAIDs and steroids into joint for temporary pain relief
Arthrocentesis post op
sterile dressing applied, ice packs to decrease swelling, may require antibiotics after procedure, assess for s/s of infection, effusion, bleeding, assess pain
Myelogram
to detect nerve impingement within spinal canal, injection of radiopaque contrast into sac around nerve roots, NPO 4-6 hrs. before test
EMG
test to diagnose muscle weakness
CK
enzyme found in skeletal muscle (heart muscle as well), serum levels elevated with muscle damage: rhabdo, MI, traumatic injury, myositis
M- 20-200 F-20-180
Myoglobin
protein found in striated muscle (h&s), serum and urine levels elevate with muscle injury, N- <90
Alkaline phosphatase
Enzyme produced by osteoblasts and liver, elevated levels found in healing fractures, bone cancer, osteoporosis, Paget’s disease, liver disease (also during normal periods of growth) N- 38-126
Uric acid
Forms as a result of purine metabolism, elevated amounts indicate gout or uric acid kidney stones
M-4.5-8.0 F- 2.5-6.2
