Musculoskeletal Disorders and Care

Question 1

What types of objective data do you need to obtain from a musculoskeletal history?

Answer 1

1. Pain, tenderness, altered sensation
2. Posture and gait
3. Bone integrity
4. Joint Function
5. Muscle strength and size
6. Skin
7. Neurovasular status

Question 2

Changes in the musculoskeletal system in the older adult

Answer 2

1. Alterations in bone remodeling
2. Loss of bone density
3. Loss of strength, size
4. Deterioration of muscle fibers and cell membranes
5. Degenerated joint cartilage.

Question 3

Bursitis

Answer 3

When the bursae (fluid-filled sacs that prevent friction
between joint structures during joint activity) become inflamed

Shoulder

Question 4

Tendonitis

Answer 4

Muscle tendon sheaths also become inflamed with repetitive stretching

Shoulder

Question 5

Carpal tunnel syndrome

Answer 5

Is an entrapment neuropathy that occurs
when the median nerve at the wrist is compressed, caused by repetitive hand and wrist movements. (+ Tinel sign)

Question 6

Hallux Valgus (bunion)

Answer 6

Is a deformity in which the great toe deviates laterally

Question 7

Onychocryptosis (ingrown toenail)

Answer 7

Is a condition in which the free edge of a nail plate
penetrates the surrounding skin.

Question 8

Plantar fasciitis

Answer 8

An inflammation of the foot- supporting fascia, presents as an acute onset of heel pain experienced with the first steps in the morning.

Question 9

Osteomyelitis

Answer 9

Infection of the bone

Question 10

Contusion

Answer 10

Soft tissue injury produced by blunt force

Question 11

Strain

Answer 11

Pulled muscle injury to the musculotendinous unit

Question 12

Sprain

Answer 12

Injury to ligaments and supporting muscle fiber around a joint

Question 13

Dislocation

Answer 13

Articular surfaces of the joint are not in
contact

Question 14

Fracture signs and symptoms

Answer 14

Acute pain, loss of function, deformity, shortening of the extremity, crepitus, and localized edema and ecchymosis

Question 15

How to Manage Fractures

Answer 15

Immobilization
Open fracture: cover with sterile dressing to prevent contamination
VS, respiratory status, LOC, and signs and symptoms of shock
Affected extremity=frequent neurovascular assessment
Anxiety and coping

Question 16

The “6 Ps” indicative of symptoms of Neurovascular Compromise

Answer 16

1. Pain
2. Polikilothermia
3. Pallor
4. Pulselessness
5. Parethesia
6. Paralysis

Question 17

Main interventions for people with a fractured hip

Answer 17

• Avoid or minimize the use of indwelling catheters
• Support healthy coping mechanisms
• Encourage coughing and deep breathing exercise
• Apply TED hose or SCDs as prescribed
• Encourage ankle exercises

Question 18

Casts

Answer 18

Are used to immobilize (most common
form of treatment for fractures)

Question 19

What are the priority problems or concerns with casts, splints, and braces?

Answer 19

• Acute Pain
• Impaired Physical Mobility
• Fear
• Risk for ineffective peripheral tissue perfusion
• Risk for Impaired Skin Integrity

Question 20

What are short term goals for patients with casts, splints, and braces?

Answer 20

• Knowledge
• Safety
• Relief of Pain
• Adequate Neurovascular Function

Question 21

What are long term goals for patients with casts, splints, and braces?

Answer 21

• Absence of Complications:
• Prevent disuse syndrome/Prevent pressure injury

Question 22

Compartment Syndrome

Answer 22

Occurs when increased pressure within a confined space
(e.g., cast, muscle compartment) compromises
blood flow and tissue perfusion.

Question 23

Pressure Injury

Answer 23

Pressure on soft tissues “hot spot”, particularly if they are inappropriately applied, causing tissue anoxia and pressure ulcers.

Question 24

Disuse syndrome

Answer 24

Deterioration of body systems as a result of prescribed or unavoidable musculoskeletal inactivity

Question 25

How do we evaluate patients in splints, casts, or braces?

Answer 25

1. Reports decreased level of pain
2. Exhibits normal peripheral tissue perfusion
3. Maximizes mobility within the therapeutic limits
4. Exhibits absence of complications

Question 26

Priority problems of a patient with an amputation

Answer 26

• Acute pain
• Impaired skin integrity
• Disturbed body image
• Grieving
• Self-care deficit
• Impaired physical mobility

Question 27

Achieving Physical Mobility for Patients with Amputations

Answer 27

1. Proper positioning of limb; avoid abduction, external rotation and flexion
2. Turn frequently; prone positioning if possible
3. Use of assistive devices
4. ROM exercises
5. Muscle strengthening exercises
6. “Preprosthetic care”