Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Adult Health > Musculoskeletal Disorders > Flashcards

Musculoskeletal Disorders Flashcards

1
Q

Joints

A

Areas where two bones join together
- Surfaces are lined with articular cartilage
- Bursae are fluid filled sacs of connective tissue that protect and relieve friction around joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Three Main Types of Joints

A
  1. Fixed - skull bones
  2. Slightly moveable - ribs/sternum
  3. Freely moveable - ankle, shoulder, elbow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Ligaments

A

Cross over the joint capsule and attach one bone to another

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Skeletal Muscle

A
  • Attached to the bones by bands of connective tissue called tendons
  • Occasionally, skeletal muscles are attached to other muscles by a broad, flat sheet of tendon called an aponeurosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Vital Functions of the Musculoskeletal System

A
  1. Protection
  2. Support
  3. Movement
  4. Heat production
  5. Calcium storage
  6. Production of blood cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Musculoskeletal System: Health History

A

Pain or altered sensation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Musculoskeletal System: Physical Assessment

A
  1. Inspection
  2. Gait - leg length equality
  3. Posture - spinal curvature
  4. Joint function - ROM
  5. Muscle strength and size
  6. Neurovascular status
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Muscle Strength Scale

A

0 - no detection of muscular contraction
1 - trace contraction with observation
2 - active movement with elimination of gravity
3 - active movement against gravity only
4 - active movement against some resistance
5 - active movement against full resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Musculoskeletal System: Imaging

A
  1. Radiographs or xrays - most common study
  2. CT
  3. MRI - shows hydrogen density of tissues; ideal for soft tissue (cartilage, ligament, disc); no metal objects allowed in room
  4. Arthrogram - injection of contrast material into joint; permits visualization of joint structure on xray, CT, or MRI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Laboratory Studies for Musculoskeletal System

A
  1. Calcium and phosphorus: primary minerals of bone
  2. Alkaline Phosphatase: enzyme elevated during bone formation
  3. Rheumatoid Factor: autoantibody seen in RA and other conditions
  4. Erythrocyte Sedimentation Rate (ESR): non-specific marker of inflammation
  5. C-Reactive Protein (CRP): used to diagnose inflammatory diseases; peaks at 18-24 hours after damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Musculoskeletal System: Diagnostic Procedures

A
  1. Arthrocentesis
  2. Electromyogram (EMG)
  3. Arthroscopy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Arthrocentesis

A

Puncture of joint capsule to obtain sample of synovial fluid
- Normally clear viscous fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Electromyogram (EMG)

A

Evaluates skeletal muscle contraction using small needle probes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Arthroscopy

A
  • Diagnostic or therapeutic
  • Insertion of scope into joint to visualize structure and content
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Contusion

A

Soft tissue injury (bruise)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Sprain

A

Ligament injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Strain

A

Excessive stretching of a muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Diagnosing Contusions, Strains, and Sprains

A

Diagnosed primarily by H&P
** X-rays to rule out fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Musculoskeletal Injuries: Heat and Cold Applications

A
  1. Used to reduce or prevent tissue swelling, promote healing, ease pain, and promote comfort
  2. Risk factors for injury from heat and cold applications
    • Very old or very young age
    • Chronic illness
    • Very fair skin
    • Impaired sensation
    • Disorientation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Cold Applications

A
  • Used for people who have musculoskeletal injuries resulting from trauma, such as sprains and fractures
  • Applications of cold reduces pain and swelling and decreases bleeding
  • Cold applications can be either moist or dry
  • Cold applications should not be left in place for longer than 20 minutes, and skin should be checked every 10 minutes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Heat Applications

A
  • Relaxes the muscles, relieves pain, and promotes blood flow to the area
  • Can be either moist or dry
  • Should not be left in place for longer than 20 minutes, and the skin should be checked every 5 minutes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Dislocations

A

Complete displacement of articular surfaces
- Severe injury of ligamentous structures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Subluxation

A

Partial displacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Dislocation and Subluxation: Orthopedic Emergency

A

Must maintain blood supply to joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Musculoskeletal Injuries: Management

A
  1. Immobilization
  2. Provide comfort
  3. Ice packs
  4. Neurovascular status
  5. Protect joint
  6. Take steps to prevent infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Fractures

A
  • Broken bone caused by trauma
  • Older people at increased risk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Types of Fractures

A
  1. Closed
  2. Open
  3. Greenstick
  4. Impacted
  5. Comminuted
  6. Spiral
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Fractures: Non-Pharmacologic Management

A

Immobilization should precede:
- xray
- application of ice for 48-72 hours
- elevation of extremity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Fractures: Pharmacologic Treatment

A
  1. Analgesia: NSAIDs, acetaminophen, narcotics,
  2. Antibiotics for infections
  3. Tetanus toxoid for open wounds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Fractures: Reduction and Fixation

A
  1. Reduction may be closed or open
  2. Fixation may be external (cast) or internal (metal plates, screws, pin, wires, or rods)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Traction

A

Used to keep the ends of the bone in alignment until the fracture can be permanently repaired by casting or surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Musculoskeletal System: Age-Related Changes

A
  1. Leading cause of disability in older adults
  2. Age-related changes include
    - loss of bone tissues
    - loss of muscle mass
    - wear and tear on joints (articular cartilage)
    - intervertebral disc degeneration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Musculoskeletal System: Age-Related Changes Physical Findings

A
  1. Joints
    - stiffness
    - pain
    - crepitation
  2. Back pain
  3. Disc compression
    - loss of height
  4. Increased kyphosis (Dowager’s hump)
  5. Muscle
    - decreased strength and bulk
34
Q

Osteoporosis: What is it?

A

Disease characterized by low bone mass and micro-architectural deterioration of bone tissue leading to enhanced bone fragility and a consequent increase in fracture risk.
- Osteoporotic fractures can lead to significant morbidity and mortality
- Declining estrogen levels in post-menopause increase bone resorption, thus increasing the risk of fractures in some women
- BMI influences risk; estrogen is produced peripherally by fat cells, leading to greater risk in women with lower BMI
** Increased osteoclast activity

35
Q

Osteoporosis: Etiology

A
  • Genetics, family history of osteoporosis
  • Estrogen deficiency
  • Calcium of vitamin D deficiency
  • Use of alcohol and nicotine
  • Immobilization
36
Q

Osteoporosis: Which bones are most commonly affected?

A

Commonly affects the bones of the spine and pelvis and the long bones in the arms and legs

37
Q

Osteoporosis: Risk Factors

A
  1. Family history
  2. Smoking
  3. Inactivity or immobility
  4. Diet lacking in calcium, vitamin D
  5. Certain drugs, such as steroids
  6. Diseases of the thyroid and adrenal glands
  7. White race
  8. Small bones
  9. Anorexia
38
Q

Osteoporosis: Diagnostic Studies

A
  • Diagnosis is difficult to establish by normal xray
  • Labs are often normal
  • DEXA scans (Dual Energy Xray Absorptiometry): measures bone mineral density
39
Q

Osteoporosis: Prevention

A

Can be prevented by exercising regularly and eating a diet rich in calcium, protein, and vitamin D, starting early in life

40
Q

Osteoporosis: Treatment

A
  1. Bisphosphonates (1st line treatment)
  2. Calcium and vitamin D supplementation
  3. Calcitonin
  4. Hormone replacement therapy (controversial due to risks for breast cancer and cardiovascular disease)
41
Q

Four Types of Arthritis

A

Inflammation of the joints
1. Osteoarthritis
2. Rheumatoid arthritis
3. Gout
4. Infectious or Septic

42
Q

Gout: What is it?

A
  • Metabolic disease
  • Increased uric acid levels
  • Deposition of sodium urate crystals in joints and subcutaneous tissues (tophi)
43
Q

Gout: Risk Factors

A
  • More males than females affected
  • Middle aged
44
Q

Gout: Most Common Initial Manifestation

A

Inflammation of the great toe (podagra)

45
Q

Gout: Drug Therapy

A
  1. NSAIDs
  2. Corticosteroids
  3. Allopurinol, colchicine (chronic)
46
Q

Infectious (Septic) Arthritis: Route of Infection

A
  • Hematogenous seeding of joint with bacterial microorganisms
  • Trauma or surgical incision
47
Q

Infectious (Septic) Arthritis: Organisms

A
  1. Staphylococcus aureus: most common overall
  2. Neisseria gonorrhea: most common among sexually active young adults
48
Q

Infectious (Septic) Arthritis: Symptoms

A
  1. Pain and swelling
  2. Systemic signs of infection: fever, chills
49
Q

Infectious (Septic) Arthritis: Diagnosis

A

Aspiration of joint fluid (arthrocentesis)
- Elevated WBC
- Culture and Gram stain

50
Q

Infectious (Septic) Arthritis: Treatment

A
  1. Antibiotics
  2. Drainage sometimes required
51
Q

Osteoarthritis: What is it?

A

Degenerative disease of the cartilage of joints
** No known cause

52
Q

Osteoarthritis: Contributing Factors

A
  1. Decreased estrogen at menopause
  2. Genetics
53
Q

Osteoarthritis: Risk Factors

A
  1. Obesity
  2. Extreme activities (overuse)
  3. Lack of exercise
  4. Family history
  5. Trauma
54
Q

Osteoarthritis: Most Commonly Affected Joints

A
  1. DIP and PIP of fingers
    - Heberden’s nodes (DIP)
    - Bouchard’s nodes (PIP)
  2. CMC of the thumbs
  3. Weight bearing joints (hips, knees)
  4. MTP of the foot
  5. Cervical and lower lumbar vertebrae
    ** Non-symmtetric
55
Q

Osteoarthritis: Diagnostic Studies

A
  1. History and PE
  2. Xrays
    • Include weight bearing films
    • Confirmation and monitoring
  3. CT
  4. MRI
    • May be useful in early OA
56
Q

Osteoarthritis: Radiographic Changes

A
  1. Joint space narrowing
  2. Osteophyte formation
  3. Bony sclerosis
  4. Subchondral cysts
    ** No laboratory changes - Normal ESR
57
Q

Osteoarthritis: Conservative Treatment

A
  1. Rest
  2. Exercise
  3. Drug therapy (tylenol, NSAIDs, glucosamine, chondroitin, COX-2 inhibitors)
    4 Intraarticular injections (cortisone, hyaluronic acid)
58
Q

Osteoarthritis: Operative Treatment

A
  1. Arthroscopy
  2. Arthroplasty (total, hemi, unicondylar)
59
Q

Rheumatoid Arthritis (RA): What is it?

A
  • Chronic systemic disease
  • Inflammation of connective tissue
  • Periods of remission and exacerbation
60
Q

Rheumatoid Arthritis (RA): Risk Factors

A
  • Female
  • Native American
  • Smoking
61
Q

Rheumatoid Arthritis (RA): Cause

A

Cause unknown:
- Autoimmune etiology likely
- Genetic: HLA-DR4 in white RA patients

62
Q

Rheumatoid Arthritis (RA): Manifestations

A
  1. Insidious onset
  2. Fatigue, anorexia, generalized stiffness in morning lasts 30-60 minutes or longer
  3. Articular changes
    - pain and stiffness
    - symmetric involvement (small joints)
  4. Extraarticular
    - rheumatoid nodules
    - tenosynovitis
    - Sjogren syndrome
63
Q

Rheumatoid Arthritis (RA): Diagnostic Studies

A
  1. History and PE
  2. Laboratory Studies
  3. Synovial fluid analysis: straw-colored, elevated WBC
  4. Xrays: not specifically diagnostic; narrowing of joint space, erosion, subluxation
64
Q

Rheumatoid Arthritis (RA): Laboratory Studies

A
  1. Rheumatoid factor: positive in about 75-80% of patients
  2. ESR: elevated
  3. CRP: elevated
  4. Anti-nuclear antibody (ANA): elevated in some
  5. Serum uric acid
65
Q

Anatomic Stages of Rheumatoid Arthritis: Stage 1

A

No destructive changes on xray

66
Q

Anatomic Stages of Rheumatoid Arthritis: Stage 2

A
  • Xray evidence of osteoporosis and slight cartilage destruction
  • No deformity
67
Q

Anatomic Stages of Rheumatoid Arthritis: Stage 3

A
  • Cartilage and bone destruction
  • Some joint deformity
68
Q

Anatomic Stages of Rheumatoid Arthritis: Stage 4

A

Fibrous or bony ankylosis

69
Q

Deformities of RA

A
  1. Ulnar drift
  2. Boutonniere deformity (PIP flexion, DIP extension)
  3. Hallux valgus
  4. Swan-Neck deformity (PIP extension, DIP flexion)
70
Q

Rheumatoid Arthritis: Treatment

A
  1. Similar to OA for pain management (ASA, NSAIDs)
  2. Addition of drugs specific to RA
    - DMARDs
    - Biologics
    - Gold therapy
    - Corticosteroids
  3. Arthroplasty for large joints
71
Q

DMARDs

A

** For Rheumatoid arthritis
1. Leflunomide
2. Sulfasalazine
3. Azathioprine
4. Methotrexate
5. Hydroxychloroquine

72
Q

Biologics (Tumor Necrosing Factor Alpha Inhibitors)

A

** For Rheumatoid arthritis
1. Adalimumab
2. Certolizumab
3. Etanercept
4. Golimumab
5. Infliximab

73
Q

Comparison of OA and RA

A

OA:
1. > 40 yo
2. Obese
3. Localized
4. Weight-bearing joints (hip, knee)
5. Morning stiffness, improves during the day

RA:
1. Occurs between ages 40 and 60
2. Thin
3. Systemic
4. Small joints first (PIP, MCP, MTP)
5. Progressive stiffness, worsens during the day

74
Q

Low Back Pain

A
  • Remains the number one cause of disability globally and is the second most common cause for primary care visits
  • Low back pain is considered to be the most costly work related disability
    ** Cause is often unclear
75
Q

Low Back Pain: Risk Factors

A
  1. Obesity
  2. Sedentary lifestyle
  3. Cigarette smoking
  4. Chronic occupational strain
  5. Leg length discrepancy
  6. Poor posture
  7. Age greater than 65 years
76
Q

Low Back Pain: Assessment Findings

A

Pain
- back, buttocks, thighs
- muscle spasm in the lumbosacral area may also be present
- motor, sensory, reflex exams are essential, not and asymmetrical findings

77
Q

Low Back Pain: Cauda equine syndrome

A

Is a surgical emergency that presents with back pain and urinary retention or incontinence, saddle anesthesia, decreased anal sphincter tone or fecal incontinence, bilateral lower extremity weakness, and progressive neurologic deficits

78
Q

Low Back Pain: Diagnostic Studies

A
  • Routine imaging are not recommended for patients with acute back pain
  • In a patient older than 50 with new onset of back pain, most clinicians will obtain xrays (important to get an AP and Lateral view when doing so)
79
Q

Low Back Pain: Reg Flags

A
  1. Cauda equine syndrome symptoms
  2. Fracture
  3. Malignancy
  4. Infection
80
Q

Low Back Pain: Non-Pharmacologic Management

A

Conservative, non-pharmacological interventions are imperative here:
1. Provide patient education
2. PT, TENS unit, massage
3. Cold/heat application
4. Acupuncture

81
Q

Low Back Pain: Pharmacologic Management

A
  1. NSAIDs
  2. Acetaminophen
  3. Muscle relaxants
  4. Opioids
  5. Tramadol

Adult Health (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions