Musculoskeletal Conditions Flashcards
What are the 3 types of joint surgeries?
Synovectomy
Osteotomy
Debridement
What is arthroplasty?
Reconstruction or replacement of a joint to relieve pain, improve or maintain ROM, and correct deformity
Describe an open fracture
Skin is broken
Bone is exposed
Causes soft tissue injury
Describe a closed fracture
Skin is intact over break site
Describe a complete fracture
Break goes completely through the bone
Describe an incomplete fracture
Occurs partly through the bone shaft
Bone is still intact
Describe the 5 different types of fracture lines
Linear
Oblique
Transverse
Longitudinal
Spiral
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
What is crepitation?
The audible crunching of bone fragments
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
What is angulation in fracture healing?
A complication that occurs when fracture heals in an abnormal position in relation to midline
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)
What is myositis ossificans?
A complication that occures when calcium is deposited into the muscle tissue
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
What type of cast would be used for a child with a fractured femur?
Hip spica
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
What are osteophytes?
Extra, lumpy bone growths
What is hemiarthroplasty?
Replacement of the femur head with a prothesis
What is mesenteric artery syndrome?
Gastrovascular disorder when the duodenum is compressed between the abdominal aorta and the superior mesenteric artery
What body part is at risk for superior mesenteric artery syndrome when sustaining a fracture?
Vertebrae
What is a greenstick fracture?
An incomplete fracture with one side splintered and the other side bent
What is footdrop?
A condition that makes it difficult to raise the from part of the foot
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
What condition can potentially displace a fracture?
Muscle spasms
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
