Musculoskeletal System Flashcards
Functions of musculo-skeletal system
Protection of vital organs (heart, brain, lungs)
Provides framework to support body structure
Makes mobility possible
Production of blood cells (hematopoiesis)
Reservoir for immature blood cells/vital minerals
Facilitate return of blood to the heart
What is atrophy?
Shrinkage like decrease in the size of the muscle
RICE
Rest
Ice
Compress
Elevate
Ligaments
bone to bone
Tendons
muscle to bone
Assessment of the MS system includes
ADL’s, ability to perform, any problems related to mobility
Physical assessment of the musculoskeletal system includes
Posture Gait Bone integrity Joint function Muscle size and strength
CT scans determine
used to visualize tumors, soft tissue, severe trauma to the chest, and or pelvis
MRI’s help assess
bone and soft tissues, muscle ligaments and cartilage, herniated disks
What is a cast?
Immobilizing device used to specifically immobilize a reduced fracture, correct/prevent deformities, support or stabilize weak joints
What should you teach the pt when a cast is being placed?
Explain condition needing of cast. Keep dry, do not cover with plastic. With fiberglass explain that heat is given off while cast is applied.
Splints
More commonly used in outpt settings. Often used for simple/stable fractures, sprains, tendon injuries
Splints do not compromise
Circulation
Braces are used to
Provide support, control movement, and prevent additional injury
Assessments for casts, splints, and braces are performed
every hour the first 24 hours and then every 1-4 hours thereafter
When assessing for peripheral circulation of a pt with a cast, splint or brace you check
Peripheral pulses
Capillary refill
Edema
Color and temp of skin
What are indications of neurovascular compromise (5-P’s)
Pain Pallor Pulselessness Paresthesia Paralysis
What is compartment syndrome?
Occurs when increased pressure within a confined space compromises blood flow
External fixation devices
Used for complicated fractures of humerus, forearm, femur,tibia, and pelvis.
For external fixation device, monitor neurovascular status
every 2-4hrs, assess each pin site at least every 8-12hrs
What is traction?
A pulling force to promote and maintain alignment of injured body part. Goal is to reduce muscle spasms and pain.
Bucks extension traction is used for
to immobilize fractures of the proximal femur and hip before surgical fixation (skin traction)
Nursing management for Bucks traction
Auscultate lungs every 4-8hrs
Reduced GI motility results in contstipation, needs a diet high in fiber and fluids. Monitor fluid I&O. Educate pt on how to perform foot and ankle exercises ever 1-2 hrs to prevent DVT
Low back pain patho
Disk degeneration is a common cause
Obesity
Postural problems
Overstretching of spinal support
Medication for low back pain
Tylenol (acetaminophen) NSAIDS Flexeril (muscle relaxant) Cymbalta Neurontin (radiculapathy pain)
Non pharmacologic interventions for low back pain
Hot/cold therapy Spinal manipulation Physical therapy Massage Acupuncture Exercise and yoga
Pt with low back pain should avoid
Twisting Lifting Bending Reaching Sitting for more than 20-50min
Treatment for tendonitis
Hot/cold therapy
NSAIDS
Corticosteroid injections (most effective)
Carpal tunnel syndrome is caused by
Repetitive hand-wrist movements
Treatment for carpal tunnel includes
Open nerve release
Endoscopic laser surgery
Corticoisteroid injections
Wrist splints
Osteoporosis patho
Calcitonin and estrogen decrease. Bones become brittle and pourous. Bone resorption is greater than bone formation
Risk factors for osteoporosis
Small framed Asian/Caucasian women.
Obesity, imobility
Patients that underwent bariatric surgery
Why is a patient with a hx of bariatric surgery at risk for osteoporosis?
The duodenum is bypassed. The duodenum is the site of calcium absorption
Medical management of osteoporosis
Calcium and vitamin D rich diet
20-30 min of aerobic exercise
Calcium and vitamin D supplements
Biophosphates
What is osteomalcia?
Metabolic bone disease characterized by inadequate mineralization of bone. Softening of the bones
Patho of osteomalacia
Deficiency of activated vitamin D, may result from failed Ca+ absorption or excessive Ca+ loss.
Severe renal insufficiency results in acidosis,
prolonged use of antiseizure meds
malnutrition
GI disorders where fats are inadequately absorbed
What is osteomyelitis
Infection of the bone
What pt’s are at risk for osteomyelitis
Older adults Poorly nourished Obese Pt's w/ diabetes Rheumatoid arthritis IV drug users
Patho of osteomyelitis
MRSA
Gram + organisms
Soft tissue infection
S/S of osteomyelitis
Fever/chills
Rapid pulse, mailase
Infected area becomes painful, swollen, and extremely tender
Bone necrosis
Medical management of osteomyelitis
Hydration Diet high in vitamins/proteins Correction of anemia Antibiotics Surgical debridement (if infection is chronic and does not respond to antibiotics)
Contusion
Soft tissue injury produced by blunt force (kicking, falling etc) causing small blood vessels to rupture and bleed into soft tissues
Sx of contusion
Pain, swelling, and discoloration
How to treat a contusion
Applying cold packs, and elevation of extremity
Strain
Injury to a muscle or tendon from overuse, overstretching or excessive stretch
Sprain
Injury to the ligaments and tendons that surround a joint
What causes a sprain
Twisting motion or hyperextension of a joint
RICE
R stands for
What is the reason for it?
Rest, prevents additional injury
RICE
I stands for?
What is the reason for it?
Ice, applying cold packs during the first 72 hrs produces vasoconstriction (decreases bleeding/edema)
RICE
C stands for?
What is the reason for it?
Compress, elastic compression bandage controls bleeding and reduces edema
RICE
E stands for?
What is the reason for it?
Elevate. Elevation at or above heart level controls the swelling
Types of fractures
Complete Incomplete (greenstick) Comminuted Closed (simple) Open
What is a complete fracture?
Break across entire cross section of bone, frequently displaced
What is a incomplete fracture?
Break thru only part of the cross section of bone. Commonly occurs in children
What is a comminuted fracture?
Produces several bone fragments
What is a closed fracture?
A fracture where there is no break in the skin
What is a open fracture?
Compound or complex.
Skin or mucous membrane wound extend to the bone
What is a grade 1 open fracture?
Clean wound, less than 1cm long
What is a grade 2 open fracture?
Larger wound w/o soft tissue damage
What is a grade 3 open fracture?
Highly contaminated, extensive soft tissue damage
Manifestations of fractures
Pain Loss of function Deformity Shortening Crepitus
What is crepitus?
A crumbling sensation that may be felt or heard
Emergency management of a fracture
Immediately immobilize before pt is moved. Adequate splinting is essential
Patients with open fractures are at risk for
Osteomyelitis
Tetanus
Gas gangrene
Complications of fractures
Shock
Fat embolism
On assessment, a patient with osteomalacia may have
Kyphosis and bowed legs
Treatment for osteomalacia is mainly
Dietary. Supplementation
increase vitamin D, treat underlying cause.
