Musculoskeletal Conditions Flashcards by Conner Hoff

What are the 3 types of joint surgeries?

Synovectomy
Osteotomy
Debridement

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What is arthroplasty?

Reconstruction or replacement of a joint to relieve pain, improve or maintain ROM, and correct deformity

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Describe an open fracture

Skin is broken
Bone is exposed
Causes soft tissue injury

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Describe a closed fracture

Skin is intact over break site

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Describe a complete fracture

Break goes completely through the bone

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Describe an incomplete fracture

Occurs partly through the bone shaft
Bone is still intact

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Describe the 5 different types of fracture lines

Linear
Oblique
Transverse
Longitudinal
Spiral

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Describe the different between a displaced fracture and a nondisplaced fracture

Nondisplaced: Bone fragments stay in alignment

Displaced: Two ends of the bone are separated from each other and out of their normal positions

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What is crepitation?

The audible crunching of bone fragments

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What are the 6 stages of bone fracture healing?

1) Fracture hematoma; first 72 hours

2) Granulation Tissue; 3-14 days

3) Callus formation; end of 2nd week

4) Ossification 3 weeks - 6 months

5) Consolidation; up to 1 year

6) Remodeling

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What is angulation in fracture healing?

A complication that occurs when fracture heals in an abnormal position in relation to midline

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What is malunion in fracture healing?

A complication that occurs when heals on time but in the wrong place (angulation is a type of malunion)

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What is myositis ossificans?

A complication that occures when calcium is deposited into the muscle tissue

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For which reason would traction be used in the care of a patient with a bone fracture?

-Reduce a fracture
-Immobilize a joint
-Prevent muscle spasms
-Treat a pathological joint condition

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What type of cast would be used for a child with a fractured femur?

Hip spica

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What is the Tinel sign and the Phalen sign?

Tinel Sign: Positive when you tap where the median nerve enters the wrist and tingling feeling is felt through the hand

Phalen Sign: Let the wrist freely fall to allow maximum flexion. Positive when tingling is felt in the hand

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What are osteophytes?

Extra, lumpy bone growths

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What is hemiarthroplasty?

Replacement of the femur head with a prothesis

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What is mesenteric artery syndrome?

Gastrovascular disorder when the duodenum is compressed between the abdominal aorta and the superior mesenteric artery

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What body part is at risk for superior mesenteric artery syndrome when sustaining a fracture?

Vertebrae

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What is a greenstick fracture?

An incomplete fracture with one side splintered and the other side bent

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What is footdrop?

A condition that makes it difficult to raise the from part of the foot

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What action does the nurse take to prevent footdrop in a patient who has a long leg cast?

Apply a splint to keep the foot in a neutral position

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What condition can potentially displace a fracture?

Muscle spasms

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A patient with a knee fracture reports an increase in muscle spasms. What does the nurses suspect that the patient is doing to cause the spasms?

Massaging the muscle

What are 3 functions of the Buck traction?

1) It immobilizes the fracture 2) It reduces muscle spasms 3) It prevents or reduces pain

What is bursitis?

Painful condition that occurs when the fluid-filled sacs that cushion joints become inflamed

What does subluxation mean?

Dislocation

What is impingement syndrome?

Entrapment of soft tissue structures under the coracoacromial arch of the shoulder

What is the McMurray test?

A test done to diagnose a torn meniscus

What condition can occur if a torn meniscus is left untreated for a long period of time?

Quad atrophy

What is the Homan sign?

A test where the foot is dorsiflexed while the knee is extended to check for pain in the calf. Used to diagnose Deep Vein Thrombosis

When performing a physical examination of a patient, how does the nurse assess the function of the peroneal nerve?

Assess dorsiflexion of the foot Assess sensation in the web space between the first and second toes

What is the Lachman test?

Test done to evaluate the integrity of the ACL

How does smoking contribute to lower back pain?

Tobacco use impairs circulation to the intervertebral discs

What is cada equina?

The cada equina is a bundle of nerve nerves at the end of the spinal cord. When they are compressed or disrupted, it is known as cada equina syndrome and it is a medical emergency

What is Sjorgen syndrome?

Chronic autoimmune disease that attacks body's glands that produce saliva and tears. Can also cause dr

How is Fibromyalgia diagnosed?

-Widespread Pain Index: Pain in11/18 tender points over past week Criteria: -WPI score of 7+ and Symptom Severity Index (SSI) of 5+ OR -WPI 3-6 & SSI 9+ -Fatigue -Cognitive symptoms

What is SEID?

Systemic Exertion Intolerance Disease; disease in which exertion of any sort (physical, emotional, cognitive) is impaired and accompanied by profound fatigue

Why do women rarely develop gout?

Estrogen promoted renal excretion of uric acid

What is the difference between Primary and Secondary Hyperuricemia?

Primary: Genetic lack of uricase Secondary: Increased uric production, Decreased uric acid excretion, Drugs

What is the normal range of uric acid levels?

2.7-8.5mg/dL

What are 3 ways that gout can be diagnosed?

1) Uric acid levels 2) Synovial Fluid Aspiration 3) X-rays

How is the symmetry in osteoarthritis symptoms?

Is usually asymmetric

What is Systemic Lupus Erythematosus?

Autoimmune disease caused by genetic, hormonal, environmental, and immune factors mostly affecting women

What is the most common symptom of SLE?

Skin lesions like butterfly rash

What is Scleroderma?

Chronic autoimmune disease that causes the skin to thicken and harden

What is CREST syndrome?

Symptoms of scleroderma: C: Calcinosis R: Raynaud Phenomenon E: Esophageal Dysfunction S: Sclerodactyly (tightening of skin on fingers and toes leading to semi flexed positions) T: Telangiectasia (red spots on skin from capillary dilation)

What clinical manifestation is associated with osteoarthritis?

Crepitation in the weight-bearing joints

Which synovial fluid analysis finding is suggestive of rheumatoid arthritis?

-Presence of fibrin flecks -Elevated WBC count -Increased matrix metallopeptidase (MMP-3 enzyme)

What is a varus deformity?

Condition where the distal part of a bone or joint angulates inwards

What is Reiter syndrome?

Reactive arthritis that usually activates after a bacterial infection

Which symptoms are associated with Reiter syndrome?

Urethritis Cervicitis Conjunctivitis Mucocutaneous lesions

Which factors can precipitate gout?

Starvation & dehydration Niacin Aspirin

Fatigue and fever are present in what kind of arthritis?

Rheumatoid

What is Felty Syndrome?

A combination of an enlarged spleen and a low white blood cell count due to rheumatoid arthritis

What medication can be prescribed for a patient recently diagnosed with rheumatoid arthritis

Methotrexate

Which assessment findings may be associated with rheumatoid arthritis?

Joint stiffness Dry itchy eyes Rheumatoid nodules Atherosclerosis High WBC count

What diagnostic tests might be the same for RA and OA?

High erythrocyte sedimentation rate (ESR) Narrowed join space in x-ray

What is the Gottron sign?

A characteristic skin rash, appearing as red or purple, scaly patches on the back of the hands, elbows, and knees, typically seen in patients with EARLY dermatomyositis

What can a positive Gottron sign indicate?

Dermatomyositis

What condition is common is long-standing dermatomyositis?

Calcinosis cutis

What type of medication may be prescribed as an alternative to an antimalarial drug for a patient with systemic lupus erythematosus?

Antileprosy

What is malar rash also known as?

Butterfly rash

What clue would indicate that a patient has ankylosing spondylitis?

AS primarily affects the axial skeleton so increasing lower back pain, stiffness, and limited motion would be indicators

Why is Tylenol not used for inflammation?

Decreased pain and fevers but does not provide an antiinflammatory effect

What is the antidote for acetaminophen toxicity?

Acetylcysteine

How can the common side effects of morphine be minimized?

Increased fluid and fiber in diet