Musculoskeletal Disorders and Care Flashcards
What types of objective data do you need to obtain from a musculoskeletal history?
- Pain, tenderness, altered sensation
- Posture and gait
- Bone integrity
- Joint Function
- Muscle strength and size
- Skin
- Neurovasular status
Changes in the musculoskeletal system in the older adult
- Alterations in bone remodeling
- Loss of bone density
- Loss of strength, size
- Deterioration of muscle fibers and cell membranes
- Degenerated joint cartilage.
Bursitis
When the bursae (fluid-filled sacs that prevent friction
between joint structures during joint activity) become inflamed
Shoulder
Tendonitis
Muscle tendon sheaths also become inflamed with repetitive stretching
Shoulder
Carpal tunnel syndrome
Is an entrapment neuropathy that occurs
when the median nerve at the wrist is compressed, caused by repetitive hand and wrist movements. (+ Tinel sign)
Hallux Valgus (bunion)
Is a deformity in which the great toe deviates laterally
Onychocryptosis (ingrown toenail)
Is a condition in which the free edge of a nail plate
penetrates the surrounding skin.
Plantar fasciitis
An inflammation of the foot- supporting fascia, presents as an acute onset of heel pain experienced with the first steps in the morning.
Osteomyelitis
Infection of the bone
Contusion
Soft tissue injury produced by blunt force
Strain
Pulled muscle injury to the musculotendinous unit
Sprain
Injury to ligaments and supporting muscle fiber around a joint
Dislocation
Articular surfaces of the joint are not in
contact
Fracture signs and symptoms
Acute pain, loss of function, deformity, shortening of the extremity, crepitus, and localized edema and ecchymosis
How to Manage Fractures
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
The “6 Ps” indicative of symptoms of Neurovascular Compromise
- Pain
- Polikilothermia
- Pallor
- Pulselessness
- Parethesia
- Paralysis
Main interventions for people with a fractured hip
- 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
Casts
Are used to immobilize (most common
form of treatment for fractures)
What are the priority problems or concerns with casts, splints, and braces?
- Acute Pain
- Impaired Physical Mobility
- Fear
- Risk for ineffective peripheral tissue perfusion
- Risk for Impaired Skin Integrity
What are short term goals for patients with casts, splints, and braces?
- Knowledge
- Safety
- Relief of Pain
- Adequate Neurovascular Function
What are long term goals for patients with casts, splints, and braces?
- Absence of Complications:
- Prevent disuse syndrome/Prevent pressure injury
Compartment Syndrome
Occurs when increased pressure within a confined space
(e.g., cast, muscle compartment) compromises
blood flow and tissue perfusion.
Pressure Injury
Pressure on soft tissues “hot spot”, particularly if they are inappropriately applied, causing tissue anoxia and pressure ulcers.
Disuse syndrome
Deterioration of body systems as a result of prescribed or unavoidable musculoskeletal inactivity
How do we evaluate patients in splints, casts, or braces?
- Reports decreased level of pain
- Exhibits normal peripheral tissue perfusion
- Maximizes mobility within the therapeutic limits
- Exhibits absence of complications
Priority problems of a patient with an amputation
- Acute pain
- Impaired skin integrity
- Disturbed body image
- Grieving
- Self-care deficit
- Impaired physical mobility
Achieving Physical Mobility for Patients with Amputations
- Proper positioning of limb; avoid abduction, external rotation and flexion
- Turn frequently; prone positioning if possible
- Use of assistive devices
- ROM exercises
- Muscle strengthening exercises
- “Preprosthetic care”
