Musculoskeletal Dysfunction Flashcards
what is the assessment for musculoskeletal problems
hx
6p’s
skin
what are the 6 p’s
pain, pallor, pulselessness, paresthesia, paralysis, pressure
damage to the soft tissue, subcutaneous structures, and muscle
contusion
what is a sprain
partial tear of ligament
what is a strain
partial tear of a tendon/muscle
what is the tx for sprains and strains
RICE
compression of nerves, blood vessels, and muscle inside a confined place
compartment syndrome
what are the causes of compartment syndrome
tight dressing, cast, hemorrhage, burns, surgery, massive IV infiltration
compartment syndrome is a neurovascular _____ and can possibly _____ a limb
emergency; lose
what are CM of fractures
generalized swelling pain or tenderness deformity or muscle splinting diminished functional use exxhymosis muscle regidity crepitus
bone is bent but not broken *may bend up to 45 degrees
plastic deformations (bend)
once side of the bone buckles (compresses upon itself *appears as raised or bulging projection at site of fracture
buckle (torus)
bone cracks but does not break all the way through *incomplete fracture not all the way through
greenstick
occurs from twisting motion *physically associated with physical abuse
spiral fracture
what are the areas of developing cartilage tissue near the ends of long bones and the weakest points of bones
growth plate (physics)
can lead to deformities and limb length discrepancies
growth plate fracture
what types of traction are there
skin
skeletal
halo
what is the purpose of traction
fatigue muscle to reduce spasms
realign bone
immobilize
prevent or improve deformity
infection within the bone
osteomyelitis
what is the most common cause in osteomyelitis
staphylococcus aureus
what are CM of osteomyelitis
irritability fever tachycardia edema pain constant but increased with movement decreased movement of area warmth
aseptic necrosis of the femoral head (no blood flow to the area)
legg- calve- perthes disease
what is the definitive dx of legg-calve-perthes disease
MRI
what are the symptoms of egg-calve-perthes
limp is more pronounced after activity
hip, thigh, knee pain
what is the non-surgical containment of egg-calve-perthes
abduction brace, cast, harness sling
complex deformity of the spine that also affects the ribs. characterized by lateral curvature of the spine and spinal rotation that causes rib asymmetry
scoliosis
what would the back of a pt who has scoliosis look like
uneven shoulders and pelvic tilt
what is the adams forward bend test
assess asymmetry of ribs and flanks in scoliosis
what is the scoliometer
measures the angle of rotation in scoliosis
what is the definitive dx of scoliosis
x-ray while child is standing
what is the tx of scoliosis
curve less than 10 degrees= not worry about it just inform parents
curve of 25-45 degrees= bracing
curve more than 45 degrees= surgery
what is the goal of bracing a scoliosis pt
to keep curve from progressing (won’t undo curvature of spine)
what is important to inform pt and family post op of scoliosis surgery
log roll pt
spectrum disorder r/t abnormal development of the hip that may occur at any time during fetal life, infancy, or childhood
development dysplasia of the hip
what are CM of DDH in infants
positive galeazze sign
asymmetry of gluteal folds
positive Barlow test
positive Ortolani test
what are CM of DDH in children
affected leg appears shorter
trendelenburg sigh
waddling gait
limp
what is the tx for newborn to 6months for pt with DDH
pavlik harness
bryant traction
hip spica cast
what is the tx for 6-24mos for pt with DDH
surgical closed reduction
spica cast or abduction brace
complex deformity of the ankle and foot
clubfoot
what is the tx for clubfoot
ponseti method
- serial casting for 6-10 wks and weekly gentle manipulation and stretching of the foot
- percutaneous heel cord tenotomy at end of casting
- long leg casting for 3 wks
- orthotic device
characterized by excessive fractures and bone deformity
osteogenesis imperfecta
what are CM of OI
bone fragility bone deformity fractures blue sclera hearing loss discolored teeth
what is important to do when caring for OI pt
careful handling to prevent fx
lift by butt or support with pillows for diaper changes
what is one lab finding that will differentiate OI from non accidental trauma
elevated serum alkaline phosphatase
chronic inflammation of the synovium with joint effusion and eventual erosion, destruction and fibrosis of the articulate cartilage
juvenile idiopathic arthritis
what is the dx of JIA
arthritis in one or more joints for 6 weeks or longer
*no definitive test, worse in the morning
