Musculoskeletal Panopto Part 1 Flashcards
What are some Musculoskeletal considerations to remember for the Elderly?
Bone Density + CT & Cartilage + Joints + Muscle Mass
At what age does Bone Density and Muscle Mass start to change?
~Age 30
With Menopausal pt’s, what’s important to remember about their Bone Loss?
Bone Loss is Faster during Menopause (Due to Hormonal Changes / Not enough Calcium being Absorbed)
What does Menopause leave you at a higher risk of?
Osteoporosis
What happens to your Joints as you age?
They become more susceptible to damage + Be at a higher risk of Osteoarthritis
What is Synovial Fluid?
It basically acts as a sort of lubricant or cushion to allow for your joints to bend back and forth without any kind of friction occurring
What leaves you at a higher risk of Osteoarthritis as you age?
Loss of Synovial Fluid & Collagen
What are some of the conditions that lead to alterations in Mobility?
Synovitis + Arthritis + Muscle Atrophy + Osteoporosis + Osteoarthritis
What is Synovitis?
Inflammation of the Synovial Membrane
What can Synovitis be caused by?
Contusion / Sprain + Repetitive Motion + Rheumatologic Disease
How is Sinovitis treated?
Heat / Ice + Anti-Inflammatory Agents (Motrin).
May have to use Antibiotics depending on the cause.
What are the symptoms of Sinovitis?
Painful joints that worsen with movement + Edema at night + Full extension of the affect limb = Painful
How is Sinovitis diagnosed?
Ultra-Sound + MRI + Aspiration of the Synovial Fluid
Whenever you have your Synovial Fluid Aspirated, what is it being sent to the lab for to figure out?
To test for what type of Inflammation / Infection is in the Synovial Fluid
What is Arthritis?
Inflammation of the Joint
What are the symptoms of Arthritis?
Joint Pain + Stiffness + Edema + Decreased Mobility
Can Arthritis affect any joint or only specific ones?
Any of them
How is Arthritis treated?
Immobilization + Anti-Inflammatory Meds
What are some of the main causes of Arthritis?
Aging + Autoimmune Disorders + Viral / Bacterial Infections
How is Arthritis diagnosed?
X-Ray of the Affected Joint + Ultrasound (If they need to remove Synovial Fluid from the Joint)
What is Osteoporosis?
Softening of the Bone
What does Osteoporosis leave you at an increased risk for?
Fractures
How is Osteoporosis diagnosed?
Dual-Energy Absorptiometry (DXA).
X-Rays may be needed but it’s not considered to be diagnostic for Osteoporosis.
In Post-Menopausal pt’s what condition are they at a high risk for?
Osteoporosis
In what bones can bone loss occur?
Cortical and Calcaneus Bones
What are Primary Causes for Osteoporosis?
Aging + Gonadal Insufficiency + Decreased Calcium Intake + Low Vitamin D
What are Secondary Causes for Osteoporosis?
Chronic Kidney Disease + COPD + Multiple Myeloma + Malabsorption Syndromes + Endocrine Disorders + Rheumatoid Arthritis
What are the symptoms of Osteoporosis?
Generally Asymptomatic until Fractures occur.
When it causes Fractures of the Vertebral Bones:
Acute Pain + Residual Pain for Several Months.
When it causes a Thoracic Compression Fracture:
Can lead to Kyphosis + SOB + Suppression of the Abdominal Cavity.
How does Kyphosis lead to Respiratory Issues?
Their lungs become compressed by their humped back + Leaning forward won’t help the pt breathe anymore
What does a DXA measure?
Bone Density
What labs need assessed if the pt has Osteoporosis? Why?
Calcium + Magnesium + Liver Enzymes (ALT + AST) + Parathyroid (PTH) Levels.
These need assessed in order to rule out any possible Cancers that may be occurring, that could have led to the Osteoporosis.
How can Cancer lead to Osteoporosis?
Most of them steal Calcium from the body
What is the most common disease of the joints?
Osteoarthritis
What is Osteoarthritis?
Chronic Degeneration of the Joints
In what joints is Osteoarthritis the most common?
Weight Bearing Joints (Hands + Hips + Knees + Vertebrae)
What symptoms does Osteoarthritis have if it’s affecting the Cervical/Lumbar Vertebrae?
Leg / Back Pain that’s aggravated by walking
What symptoms does Osteoarthritis have if it’s affecting the Hip?
Loss of ROM + Pain aggravated by Weight Bearing Activities
What symptoms does Osteoarthritis have if it’s affecting the Knee?
Knee Instability
What symptoms does Osteoarthritis have if it’s affecting the Hand?
Mostly affects the Phalanges (Knuckles, Fingers)
What is a Fracture?
A Break in the Bone (May be Open or Closed + May be Complete or Partial)
What is a Fracture caused by?
Direct Injury + Pathological Processes (Cancer)
What’s the difference between a Closed and Open Fracture?
Closed = Skin stays intact
Open = Skin’s not intact
What is a Pathological Fracture?
Fracture that occurs from Minimal Force due to an Underlying Disease
What is Osteogenesis Imperfecta?
The Bones are too Brittle
What is a Stress Fracture?
Fractures that are a result of Repetitive Force that’s applied to an area
Where are Stress Fractures especially common? What type of person is especially at risk for a Stress Fracture?
The Feet (Runners are especially at risk)
What meds might the elderly be taking that will increase their fall risk?
Anti-Hypertensives + Anti-Anxiety Meds + Opioids
Once the pt is over the age of 65 and they experience a Hip Fracture, statistically, how long do they have left to live?
10 Years
In what age group do Hip Fractures most often occur in?
Older Adults
What are the symptoms of a Hip Fracture?
Inability to Bear Weight + Hip / Groin Pain on the affected leg when Outwardly Extended + Affected leg is Shorter than the Unaffected Leg.
What are the symptoms of a Fracture?
Pain at Fracture Site + Bruising + Edema + Tenderness + Shortness of a Limb + Deformity + Displacement
What is Displacement?
The Bone is out of alignment with the other Bone
How is a Fracture diagnosed?
X-Ray 1st, then an MRI 2nd if necessary
What are the Integumentary complications of Fractures?
Higher risk of Infection (If an Open Fracture)
Higher risk of Pressure Ulcers
What are the Respiratory complications of Fractures?
High risk of Atelectasis + Pneumonia
What does a fracture do to your sleep?
Can give you Insomnia due to the pain
What are the top complications to be aware of that occur after Fractures? (Act Quickly if Suspected)
Infection + Bleeding + Neurovascular Compromise + Compartment Syndrome + Embolism
The risk of the pt becoming Unstable due to Severe Bleeding is greater in what kinds of Fractures?
(Hypovolemic Shock Risk)
Pelvic + Femoral + Open Fractures
How might a Fracture cause Neurovascular Compromise?
Damage to the Blood Vessels or Nerves
What types of Fractures are the most often cause of a Disruption of Blood Supply?
Closed Fractures that are Displaced
Generally, how long will it take for a pt to regain function of a Fractured Limb?
~2 Months
When assessing a Joint for issues, what is important that we do?
Keep the Joint Immobile (To Prevent Further Complications)
What are the 5 main things to assess during a Neurovascular Assessment?
Color
Edema / Deformities
Movement
Temperature
Sensation / Pain
When performing a Neurovascular Assessment, what major complications are you checking for?
Compartment Syndrome + Bleeding + Fat Embolism
What should always be done prior to Immobilizing a pt’s fracture?
Stabilizing Them
What are some Orthopedic things that can’t be done by us because it is out of our scope of practice?
Reduction of a Fracture (Putting a Joint back in place)
What do pt’s wearing a cast need to avoid?
Putting stuff in the cast + Getting it wet + Trimming rough edges
Are Splints and Immobilizers aloud to be removed for bathing?
Yes
What needs to be avoided before reapplying a Walking Boot? Why?
Wet Skin (Because of Skin Breakdown)
For a pt with a Fracture, where should their affected limb be?
Elevated above the level of the Heart
What is a Fasciotomy?
Reduces Pressure by cutting an opening into the limb
When might you do a Fasciotomy?
Compartment Syndrome, etc.
What is a Spiral Fracture a huge indicator of?
Abuse
What are the 6 P’s for Compartment Syndrome?
Pallor + Pulse + Paresthesia + Pain
Could be Paralysis, Peripheral Edema, or Poikilothermia? I dunno I’ve heard lot’s of different things
