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CSON Module 5 Exam 4 > Musculoskeletal Dysfunction > Flashcards

Musculoskeletal Dysfunction Flashcards

1
Q

What will occur when resistance between a bone and an applied stress yields to the applied stress, resulting in a disruption to the integrity of the bone?

A

Fracture

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2
Q

What is the most common site of a fracture?

A

distal forearm (radius, ulna, or both)

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3
Q

What tends to happen faster in children rather than adults?

A

healing/remodeling of the bone

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4
Q

What factors affect remodeling?

A

age, location, degree of deformity

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5
Q

What are the six types of fractures?

A
  • plastic deformation (bend)
  • buckle (torus)
  • greenstick
  • complete
  • spiral
  • growth plate
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6
Q

What will you see in a new fracture?

A
  • generalized swelling
  • pain or tenderness
  • deformity
  • diminished functional use
  • ecchymosis
  • muscular rigidity
  • crepitus
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7
Q

What are the priority actions that you must do with a fracture?

A
  • calm and reassure
  • determine the mechanism of injury
  • assess the 6 P’s
  • move the injured part as little as possible
  • cover open wounds with sterile or clean dressing
  • immobilize the limb
  • reassess neurovascular status
  • apply traction if circulatory compromise is present
  • elevate the limb if possible
  • apply cold to the injured area
  • call EMS or transport t to medical facility
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8
Q

What are a few advantages of plaster casts?

A
  • molds close to the body (used better for areas such as pelvis)
  • less expensive
  • smooth finish (easier to write on)
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9
Q

What are a few disadvantages of plaster casts?

A
  • very heavy
  • dry from the inside out
  • can take up to 72 hours to dry
  • not water resistant
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10
Q

What are a few advantages of synthetic casts?

A
  • lighter weight
  • dry quickly
  • can be made to be water resistant
  • comes in multiple colorsc
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11
Q

What are a few disadvantages of synthetic casts?

A
  • rough texture (harder to write on)
  • cannot be molded as close to the body
  • more expensive
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12
Q

What is the gold standard to diagnose a fracture?

A

X-ray

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13
Q

What should you consider when applying a cast to a patient?

A
  • developmental considerations
  • cotton liner prior to casting
  • pad boney prominences
  • mold cast material to limb
  • ensure smooth cast edge
  • inspect skin integrity
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14
Q

What are a few cast considerations?

A
  • dry from inside out
  • no heat lamps or warm hair dryers
  • reposition wet cast with palms
  • elevate cast/extremity
  • apply ice
  • assess for s/s of infection
  • petal if needed
  • assess 6 P’s
  • windows
  • bivalve
  • objects
  • moisture
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15
Q

What do you use to remove a cast?

A

cast cutter/saw

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16
Q

What should you educate regarding cast removal?

A
  • appearance
  • skin care
  • return to activity
  • joint mobility
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17
Q

What is the purpose of traction?

A
  • realign bone
  • immobilize
  • fatigue muscle to reduce spasms
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18
Q

What are the two different types of traction?

A
  • skin

- skeletal

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19
Q

What is the type of traction ordered dependent on?

A
  • fracture
  • child’s age
  • associated injuries
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20
Q

What is skin traction applied to?

A

directly to the skin surface and indirectly to the skeletal sutures

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21
Q

How does skin traction work?

A

pulling force is applied by weights using tape and straps, weights are attached by a rope to the extremity

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22
Q

What is buck extension useful for?

A

short term immbolization for issues such as dislocated hips and Legg-Calve-Perthes

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23
Q

How does buck extension work?

A
  • leg is placed in an extended position

- boot appliance is attached to the traction

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24
Q

What is bryant traction useful for?

A

immobilizes both lower extremities

  • fractured femurs
  • developmental dysplasia of the hip
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25
Q

How does bryant traction work?

A

traction applied to the legs, legs flexed at a 90 degree angle at the hips, buttocks raised slightly off bed

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26
Q

What is skeletal traction useful for?

A

allows for longer traction time and heavier weights

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27
Q

How does skeletal traction work?

A

applied direclty to the skeletal structure, pin, wire, or tongs inserted into or through the diameter of the bone distal to the fracture

28
Q

What is 90-90 traction useful for ?

A

bone realignment, lower portion of leg is supported in cast boot or sling

29
Q

How does 90-90 traction work?

A

Steinmann pin or Kirschner wire in distal fragment of femur, results in 90 degree angle at both the hip and knee

30
Q

What is halo traction useful for?

A

allows for greater mobility of the body while avoiding cervical spinal motion in displaced or fractured vertebrae

31
Q

How does halo traction work?

A

steel halo is attached by four screws inserted into outer skull, rigid bars connect halo to a vest
*scheduled neuro assessments

32
Q

What should you assess for with all forms of traction?

A
  • 6 P’s
  • skin integrity
  • body alignment
  • pin sites
  • position of bandages, frames, splints, boots
  • ropes and pulleys
  • weights
  • bed position
  • administer analgesics/muscle relaxants
  • developmental and psychosocial needs
33
Q

Define osteomyelitis.

A

infection within the bone, usually casued by bacteria introduced by trauma or surgery, by direct extension from a nearby infection or via the bloodstream

34
Q

What is the most common organism that causes osteomyelitis?

A

staphylococcus aureus

35
Q

Where is osteomyelitis most commonly found?

A

long bones and in children less than 10 years old, and boys more commonly than girls

36
Q

What will you see in a child with osteomyelitis?

A
  • pain
  • fever
  • irritability
  • erythema
  • decreased movement
  • edema
  • warmth
37
Q

How is osteomyelitis diagnosed?

A
  • cultures
  • labs
  • x-ray
  • bone scan
  • CT scan
  • MRI
  • bone biopsy
38
Q

What nursing interventions should we apply to children with osteomyelitis?

A
  • assess 6 P’s
  • administer IV antibiotics
  • administer analgesics
  • promote rest/comfort
  • no weight bearing/immobilization
  • nutritional considerations
  • surgery possibly
  • developmental and psychosocial needs
39
Q

Define Legg-Calve-Perthes Disease.

A

A condition with unknown etiology that affects the hip where the femur and pelvis meet in the joint;

40
Q

Who is most susceptible to Legg-Calve-Perthes Disease?

A
  • children 2-12 years old

- boys 4-8 years old

41
Q

What are the four stages of Legg-Calve-Perthes Disease?

A
  1. Necrosis
  2. Fragmentation
  3. Reossification
  4. Remodeling
42
Q

What is the necrosis stage of Legg-Calve-Perthes Disease?

A
  1. Septic necrosis or infarction of the femoral capital epiphysis with degenerative changes which produces flattening of the upper surface of the femoral head
43
Q

What is the fragmentation stage of Legg-Calve-Perthes Disease?

A
  1. Capital bone resorption and revascularization with fragmentation (vascular resorption of the epiphysis
44
Q

What is the longest stage of Legg-Calve-Perthes Disease?

A

Stage 3-reossification

45
Q

What is the reossification stage of Legg-Calve-Perthes Disease?

A
  1. New bone formation, seen as calcification and ossification as increased density
46
Q

What is the remodeling stage of Legg-Calve-Perthes Disease?

A
  1. Gradual reformation of the femoral head, hopefully with a spherical form
47
Q

What clinical manifestations might you see in a patient with Legg-Calve-Perthes Disease?

A
  • slow onset
  • limp
  • joint stiffness with limited ROM
48
Q

How would you diagnose Legg-Calve-Perthes Disease?

A
  • H&P
  • physical assessment
  • x-rays
  • MRI
49
Q

What is the gold standard of diagnosing Legg-Calve-Perthes Disease?

A

X-ray (definitive diagnosis is made by MRI)

50
Q

What is Legg-Calve-Perthes Disease classified as?

A

osteonecrosis

51
Q

What are the initial nursing interventions for Legg-Calve-Perthes Disease?

A
  • rest/activity restrictions
  • reduce inflammation and irritability of the hip (NSAIDS)
  • limited or non-weight bearing (crutches, physical therapy, traction)
52
Q

What are the conservative containment nursing interventions for Legg-Calve-Perthes Disease?

A

abduction brace, cast, harness sling

53
Q

What is the key to treating Legg-Calve-Perthes Disease?

A

keep the ball of the hip in the socket (containment)

54
Q

Will Legg-Calve-Perthes Disease affect one leg or two?

A

majority of the time, one

55
Q

What are the two types of containment of Legg-Calve-Perthes Disease?

A
  • non-surgical (conservative), very slow process

- surgical reconstruction and containment (more serious cases)

56
Q

What is a benefit of surgical containment?

A

the child can return to normal activity in 3-4 months

57
Q

What is the goal of surgical reconstruction of Legg-Calve-Perthes Disease?

A

avoid prolonged immobility

58
Q

What is the outcome of Legg-Calve-Perthes Disease affected by?

A
  • early treatment

- child’s age

59
Q

Define scoliosis.

A

abnormal lateral curvature of the spine 10 degrees or more

60
Q

Is there a known cause for scoliosis?

A

no

61
Q

Which gender is scoliosis more common in?

A

females

62
Q

At what point of development is scoliosis diagnosed?

A

during the adolescent growth spurt

63
Q

What two types of curves are in scoliosis?

A

C-shaped and S-shaped

64
Q

What are a few clinicial manifestations of scoliosis

A

-a shoulder that sits higher than the other

65
Q

How can you screen for scoliosis?

A
  • forward bend test

- scoliometer

CSON Module 5 Exam 4 (5 decks)

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