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NURS 212A > Musculoskeletal Conditions > Flashcards

Musculoskeletal Conditions Flashcards

1
Q

fracture

A
  • break in the CONTINUITY of a bone
  • occurs when the FORCE applied exceeds the TENSILE or COMPRESSIVE STRENGTH of the bone
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2
Q

complete vs. incomplete fracture

A
  • COMPLETE FRACTURE
    • bone is broken entirely
  • INCOMPLETE FRACTURE
    • bone is damaged - in one piece
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3
Q

open vs. closed fracture

A
  • OPEN/COMPOUND FRACTURE
    • skin is open
  • CLOSED/SIMPLE/ FRACTURE
    • skin is not open
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4
Q

comminuted fracture

A

fracture where bone breaks into more than two fragments

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5
Q

linear fracture

A

runs parallel to long axis of bone

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6
Q

oblique fracture

A

slanted angle fracture to shaft of bone

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7
Q

spiral fracture

A

encircles the bone

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8
Q

transverse fracture

A

straight across the bone

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9
Q

torus fracture

A

cortex buckles but does not break; bone begins to buckle or buldge out, opposite side remains intact

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10
Q

greenstick fracture

A
  • perforates one cortex/splintering of spongy bone
  • outer surface is disrupted / inner surface is intact
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11
Q

bowing fracture

A
  • seen when longitudinal force is applied
  • seen often in pairs of bones; radius-ulna / fib-tib
  • causing a COMPLETE DIAPHYSEAL FRACTURE in one of the bones of the pair - causes a bow due to prevention of fracturing the second bone (forces one of the bones to bend to the direction of the fracture)
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12
Q

pathologic fracture / stress fracture/ fatigue fracture / transchondral fracture

A

pathologic:

  • break at the site of a preexisting abnormality
    (comes from bone weakness caused by another disease - ex. arthritis, OM, OP, rickets, paget dz)

stress:

  • common in sports; from repetitive strain / can also have fatigue fractures *from strenous activities that the patient is not used to

transchondral:

fragmentation & separation of the portion of articular cartilage/ can have multiple sites affected

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13
Q

fracture symptoms

A
  • unnatural alignments
  • swelling
  • muscle spasms
  • tenderness
  • pain
  • impaired sensations
  • decreased mobility
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14
Q

how do we treat fractures?

A
  • immobilization (proper alignment of bone to close gaps)
  • closed manipulation (bone is moved/manipulated into place w/o opening skin)
  • traction (use of weights to apply steady pull or traction towards long axis of bone/closing)
  • open reduction (surg. that exposes fracture site)
  • internal & external fixation
    (int. - screws, nails, wires used to maintain reduction//ext. - use of pins & rods onto uninjured bone near fracture site for stability)
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15
Q

nonunion

A
  • failure of bone ends to grow together
  • bone fills with dense fibrous tissue; creates a false joint or pseudoarhrosis
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16
Q

delayed union

A

union that does not occur until approximately 8 - 9 months after a fracture

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17
Q

malunion

A

healing of the bone in an INCORRECT anatomic position

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18
Q

how do fractures heal?

A

DIRECT (primary) HEALING vs. INDIRECT (secondary) HEALING

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19
Q

direct healing

A
  • seen most often when surg. is done to repair
  • process of INTRAMEMBRANOUS BONE FORMATION
  • does NOT HAVE CALLUS FORMATION
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20
Q

indirect healing

A
  • seen more often when the fracture is treated with a CAST or NONSURGICAL methods
  • process of INTRAMEMBRANOUS & ENDOCHONDRAL BONE FORMATION (starts with cartilage scaffolding)
  • does have development of CALLUSES
  • have REMODELING of solid bone
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21
Q

what are our METABOLIC bone diseases?

A
  • osteoporosis
  • osteomalacia
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22
Q

what are our INFECTIOUS BONE DISEASES?

A
  • osteomyelitis
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23
Q

what is OSTEOPOROSIS?

A
  • have POOR mineralized bone (bones become brittle and weak)
  • different changes in bone microarchitecture
  • OLD BONE is reabsorbed faster than NEW BONE is made > loss of bone mass & increases risk of spontaneous fractures
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24
Q

what causes osteoporosis?

A
  • endocrine fxns (parathy., cortisol, thyroid, growth hormones)
  • meds
  • VITAMIN D deficiency
  • low exercise or physical activity
  • abnormal BMI
25
postmenopausal osteoporosis
- middle aged & older women - estrogen deficiency / secondary causes - imbalance b/w osteoclasts & osteoblasts
26
secondary osteoporosis
- caused by other conditions - hormonal imbalances - meds - disease
27
regional osteoporosis
- OP seen only on a segment of the appendicular skeleton - association with disuse - can be transient
28
glucocorticoid-induced OP
- type of SECONDARY OP - glucocorticoids > improves more osteoclast survival but inhibits osteoblasts
29
age-related bone loss
- unclear cause - reduced exercise/physical activity - men have later manifestations (have 30% greater bone mass vs. women)
30
osteoporosis symptoms
- pain & bone deformities - KYPHOSIS; hunchback - vertebral collapse
31
diagnostics for OP
- DUAL X-RAY ABSORPTIOMETRY (DXA) * gold standard - trabecular bone score (TBS) *assesses pixels in lumbar spine images from DXA scans--helps predict fracture risk
32
what is osteomalacia (OM)?
- the INADEQUATE or delayed mineralization of OSTEOID - calcification does not happen > creates SOFT BONES !
33
osteomalacia symptoms & causes
symptoms: - pain - bone fractures - vertebral collapse - bone malformation causes: - vitamin d deficiency
34
what is osteomyelitis?
- type of BONE INFECTION caused by bacteria (S. aureus) *also fungi or parasites/viruses - it is hematogenous or contiguous
35
hematogenous vs. contiguous osteomyelitis
H: - spreads via bloodstream; cut, sinus, ear or dental infections - symptoms: fever, malaise, anorexia, weight loss, pain C: - spreads to adjacent bone; from open fractures, wounds, surg. - symptoms; similar to soft tissue infections - low-grade fever, lymphadenopathy, local pain or swelling
36
brodie absecesses
- characterizes subacute or chronic osteomyelitis - cricsumscribed lesions - seen at ends of long bones
37
how do we treat osteomyelitis?
- antibiotics - debridement - surgery - hyperbaric oxygen therapy
38
septic arthritis
- bacterial infection of the JOINT SPACE - surgical emergency - often is primary or secondary to osteomyelitis (infection spreads to joint space) - commonly seen; knees, hips, ankles, or elbows - commonly caused by; staph. aureus or kingella kingae
39
diagnostics & treatment for septic arthritis
diagnostics: - WBC, ESR, CRP, and fever treatments: - surgical debridement/antibiotics
40
septic arthritis manifestations (children)
- severe joint pain - "pseudo paralysis" - marked guarding of joint - non-weight bearing - malaise/anorexia
41
noninflam vs. inflam joint disorder
noninflam - OA (studies have shown potential inflam. pathways in OA) inflam - gout
42
what is OA?
- loss and damage of the ARTICULAR CARTILAGE - thickening of the JOINT CAP - some mild synovitis and inflammation - subchondral bone changes *gets more common with age
43
risk factors for OA
- obesity - older age - joint trauma/mechnical stress
44
symptoms of OA
- pain *gets worse with movement - stiffness *gets better with movement - HERBERDEN & BOUCHARD NODES - limited ROM - tenderness - muscle wasting - deformities/partial dislocation
45
treatment for OA
- exercisng - analgesics/NSAIDS - nutritional supp. - surgical treatment (for any deformities/imprving movement)
46
what is GOUT?
- an inflammatory response due to having a lot of uric acid (ex. hyperuricemia - blood) - elevated lvls. of monosodium urate crystals in the joints - creates painful inflammation, gouty arthritis, TOPHI (crystals under tissues)
47
risk factors for GOUT
- male - older age - increased intake of alcohol, red meats, sugar/fructose
48
manifestations of gout
- severe pain (night) - hot, red, tender joints - systemic inflam; increased sed. rate, fever, leukocyotsis - limited ROM/deformities - great toe** tophi (can be seen on heel, foot, knees, wrists etc..) - increased risk of renal stone development
49
degenerative disk disease (DDD)
- wear and tear of joints/hip/spine - type of arthritis - increases risk with age
50
DDD causes
- lifting - family history - spine injury
51
DDD cues, diagnostics, treatment
cues: - pain - numbness & tingling - muscle weakness - decreased strength diagnostics: - CT/MRI - EMG - nerve conduction study (NCS) treatments: - analgesics/NSAIDS
52
spinal stenosis
- the NARROWING of the spinal canal > causes pressure on the SPINAL NERVES or CORD - can occur in any part of spine - can be either congenital or acquired - often is also. with trauma or arthritis
53
spinal stenosis cues & treatment
cues: - numbness & tingling in neck, hands, arms or legs - weakness - difficulty walking treatment: - PT - braces - CAM - surgical decompression (chronic) - laminectomy or spinal fusions - NSAIDS
54
cauda equina syndrome
- latin for horse tail - compression; pressing of the CAUDA EQUINA NERVE ROOTS (at bottom of spine - L1 - L5) - needs immediate treatment
55
cauda equina syndrome cues, diagnostics, treatment
cues: - sciatica - leg weakness - numbness/burning or prickling sensations - paresthesia - urinary or fecal incontinence - urainry retention diagnostics: - PE. MRI, CT, myelogram treatment - lumbar laminectomy
56
complications of cauda equina
- sexual dysfxn. - loss of bladder control - paralysis of legs
57
amputation
- surgery to remove a body part - caused often by injuries or diseases; DM, PAD, ulcers, gangrene, frostbite, cancer, severe crushing or burns - need of surgery > often to help preserve HEALTH of the rest of the body - can often experience PHANTOM PAIN
58
lyme disease
- caused of BORRELIA BURGDORFERI (DEER TICK) - can evolve thrgh phases (skin, joints, heart, nervous sys)
59
lyme disease cues, diagnostics, treatment
cues: - red rashes, fever, headaches, nuchal rigidity, joint/body aches. fatigue, swollen lymph nodes diagnostics: - physical assessment, ELISA, western blot test treatments: - use of ANTIBIOTICS; DOXYCYCLINE and AMPICILLIN

NURS 212A (32 decks)

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