musculoskeletal part 3 (2) Flashcards
what is osteomyelitis
infection of the long bones (lower extremity)
is osteomyelitis acute or chronic
could be either
what ages is osteomyelitis seen in?
1-12 y.o.
what gender is osteomyelitis usually seen in?
boys more than girls (more trauma)
causes of osteomyelitis?
trauma/surgery
infections (bacterial, respiratory, UTI)
can osteomyelitis spread?
yes, if not caught early enough
case study
-9 y.o. with hx of football injury, pain in upper shin, swelling, limited mobility, fever
what is diagnosis?
osteomyelitis
how is a sports injury ruled out when considering osteomyelitis
labs, xray, MRI, bone scan
describe treatment of osteomyelitis
antibiotics first, then prep for PICC if unsuccessful after a week or so
how long will a patient have to be on IV antibiotics for osteomyelitis
3-6 weeks, oral if improvement
complications from osteeomyelitis
disruption of growth plate, joint damage, recurrent infection
what is the term for brittle bone syndrome
osteogenesis imperfecta
what is a connective tissue disorder that primarily affects the bones, bones more likely to fracture
osteogenesis imperfecta
pathophys behind osteogenesis imperfecta
biochemical defect in collagen production
is osteogenesis imperfecta genetically transmitted?
yes
how would you change a diaper in a baby with osteogenesis imperfecta
be extra careful, slow and support body
which of the following are clinical manifestations of osteogenesis imperfecta?
1. blue sclera
2. multiple/frequent fractures
3. increased flexibility
4. large anterior fontanel
5. short stature
all
what are the 2 drugs used for osteogenesis imperfecta
pamidronate!!!
zolidronic acid
what is the action of pamidronate?
osteogenesis imperfecta
bisphosphonates slow normal bone breakdown, allow mass to increase
action of zolidronic acid?
osteogenesis imperfecta
decreases fractures and pain
diet of osteogenesis imperfecta patients
high vitamins D & C, high calcium
what should be screened in a osteogenesis imperfecta case
potential abuse
what should be avoided in a diet with osteogenesis imperfecta
too many calories to stay ligher (easier on bones) (may resemble abuse)
which 2 things make up muscular dystrophy?
muscle fiber degeneration and muscle wasting
what is the age of onset of muscular dystrophy
birth or gradual
what is the most common type of muscular dystrophy, only seen in males
duchenne
which of the following are symptoms of duchenne muscular dystrophy?
1. muscle weakness of lower extremities
2. small, underdeveloped calf muscles
3. occurs in early childhood
4. child trips or toe walks
5. disease progresses up body
1,3,4,5
are the upper or lower extremities affected by duchenne muscular dystrophy?
lower
what do calves of someone with duchenne muscular dystrophy look like?
enlarged (connective tissue)
what are other conditions that can occur with duchenne muscular dystrophy?
scoliosis, cardiomyopathy, resp distress
what is the common cause of death for those with duchenne muscular dystrophy?
resp infection or cardiac failure
which of the following tests are used to confirm a diagnosis of duchenne muscular dystrophy?
1. serum enzyme assay
2. muscle biopsy
3. electromyography
4. CBC
1,2,3
treatment of duchenne muscular dystrophy?
steroids ti preserve function, no others
researching gene therapy
what is the most common way a fracture is reduced?
closed reduction (cast)
what is a condition in the soft tissue of an extremity with increased pressure in a limited space (cast)
comaprtment syndrome
how long after tissue ischemia does compartment syndrome start?
30 minutes after tissue ischemia
what is treamtment of campartment syndrome
removal of cast immediately
what is a cast cutter like
loud, tickles, can cut to the skin, produces heat
what is the purpose of traction
immobilization
which of the following are included in nursing care of fractures?
1. circ/neuro assessment
2. pain assessment
3. maintain alignment
4. pin care
5. decreased fiber
1,2,3,4
