Musculoskeletal Disorders 1

Question 1

any disruption in the continuity of the bone, when more stress is placed on it than it can absorb

Answer 1

fracture

Question 2

create massive spasms, the proximal portion remains intact while the distal portion can be displaced in response to force and spasm.

Answer 2

Large muscle groups

Question 3

break across entire cross-section of bone & often displaced

Answer 3

Complete

Question 4

though only part of the cross-section

Answer 4

Incomplete: (greenstick)

Question 5

simple) intact skin over site of injury

Answer 5

Closed

Question 6

produces several bone fragments

Answer 6

Comminuted

Question 7

Physical Assessment may reveal

Answer 7

Deformity (hemorrhage or spasm)
Shortening
Swelling
Ecchymosis
Muscle spasm
Pain, tenderness
Loss of function, altered mobility & crepitus
Neurovascular changes

Question 8

Characterized by neurologic dysfunction, pulmonary insufficiency, and petechial rash on chest, axilla & upper arms

Answer 8

Fat Embolism Syndrome

Question 9

occlude small vessels of lungs, brain, kidneys, & other organs in Fat embolism syndrome?

Answer 9

Fat globules (emboli)

Question 10

Fat Embolism Syndrome What to Look for:

Answer 10

Hypoxia PaO2 < 60 mm Hg
Tachypnea, tachycardia, pyrexia
Deterioration in LOC
Confusion , agitation

Question 11

Manifestations of fat emboli occur within

Answer 11

24-72 hours but may be up to a week after injury:

Question 12

Complications

Answer 12

Drainage through cast or cast opening
Sudden unexplained body temperature elevation
“Hot Spot” felt over cast lesion
May result in osteomyelitis

Question 13

What Helps? DVT

Answer 13

Bed cradle
Heat
Minimize compression
Active & passive exercises as ordered
Frequent change in position

Question 14

Fracture: Early Complications

Answer 14

Shock
Nerve damage, arterial damage
Infection
Cast syndrome
Compartmental Syndrome
Volkmann’s Contracture
Fat Embolism Syndrome
Deep Vein thrombosis & Pulmonary Embolism

Question 15

Closed reduction: usually done under

Answer 15

anesthesia

Question 16

Closed reduction: usually done under

Answer 16

anesthesia

Question 17

Usually performed with internal fixation devices (screws, pins, plates, wires)

Answer 17

Open Reduction: incision and realignment

Question 18

maintain position for unstable fractures & for weakened muscles, allow for use of contiguous joints while affected part remains immobilized

Answer 18

External Fixation

Question 19

application of a pulling force to an injured body part or extremity while a counter-traction pulls in the opposite direction.

Answer 19

Traction:

Question 20

Assess for complications following cast

Answer 20

Compartment syndrome
Fat emboli
Infection
DVT
Cast syndrome

Question 21

Edema from a fracture causes an

Answer 21

increase in compartmental pressure that decreases capillary blood perfusion.

Question 22

Pulselessness: slow nail bed capillary refill (>3sec)
Skin pallor, blanching, cyanosis or coolness
Increasing pain, swelling,pain on passive motion, painful edema peripheral to cast.

What complication of Fracture?

Answer 22

Compartmental Syndrome:

Question 23

Cast syndrome results to

Answer 23

from the compression of the duodenum between the aorta and the superior mesenteric artery. The external compression is usually caused by a tight body cast.

Question 24

If you diagnosed the cast syndrome, you correctly identified the clinical signs consistent with this syndrome. This is due to an extrinsic compression of

Answer 24

the third portion of the duodenum by the superior mesenteric artery

Question 25

what lab is ordered in Cast syndrome?

Answer 25

Abdominal flat-plate

Question 26

Can result in unresolved compartment syndrome. Arterial blood flow decreases, leading to ischemia, degeneration & contracture of muscle

Answer 26

Volkmann’s Contracture

Question 27

characterized by neurologic dysfunction, pulmonary insufficiency, and petechial rash on chest, axilla & upper arms

Answer 27

Fat embolism syndrome (FES)

Question 28

Immobility increases risk for

Answer 28

fat embolism, atelectasis, and pulmonary emboli.

Question 29

KNOW the SIX Ps: Cast Assessment

Answer 29

Pain
Pallor
Paresthesia
Pulselessness
Paralysis
Polar

Question 30

Watch out for ____________ after skeletal or muscular injury/surgery!

Answer 30

Deep Vein Thrombosis

Question 31

10% volume loss =

Answer 31

tachycardia

Question 32

memorize stages of blood loss

Answer 32

Stage I up to 15% (up to 750 ml)
Stage II 15-30% (up to 1500 ml) -subtle signs
Stage III 30-40% (1500-2000 ml) –obvious shock
Stage IV over 40% (over 2000 ml)

Question 33

Muscle Spasms Interventions

Answer 33

Heat

Question 34

Intervention: DVT/PE/FES

Answer 34

Client wears elastic stockings.
Teach leg exercises.
Observe for changes in mental status, chest pain and SOB.
Observe for swelling, redness and pain in legs (DO NOT MESSAGE).

Question 35

Is accomplished by surgically inserting metal wires or pins thru distal bones to the # site or by anchoring metal tongs in the skull

Answer 35

Skeletal Traction

Question 36

Check the four P’s of traction maintenance

Answer 36

Pounds
Pull
Pulleys
Pressure

Question 37

Anterior cruciate ligament injuries

Answer 37

Tear of ACL

Question 38

Mostly preformed on knee and shoulder by use of a fibroptic arthoscope

Answer 38

Arthroscopy

Question 39

Complications of Arthroscopy

Answer 39

Infection
Blood in joint (hemarthrosis
Swelling
Synovial rupture