Musculoskeletal system Flashcards
Risk factors accosicated with Musculoskeletal disorders
- Autoimmune disorders
- Calcium deficiency
- Falls
- Hyperuricemia
- Infection
- Medications
- Metabolic disorders
- Obesity
- Postmenopausal status
- Trauma & injury
Athrocentesis
Used to diagnose joint inflammation and infection. Done by aspirating synovial fluid, blood or pus via a needle inserted into the joint cavity.
Arthrography
Radiographic examination of the soft tissue of the joint structures. Used to diagnose trauma to the joint capsule or ligaments. Contrast dye is injected into joint followed by an x-ray.
Arthroscopy
Endoscopic joint exam used to diagnose and treat acute disorders of the joint.
Dual X-Ray Absorptiometry
Measures bone mass of the spine, wrist, hip and total body. Used to diagnose metabolic some disease and monitor bone density changes.
Bone Scan
Used to identify, evaluate and stage bone cancer and used to detect fractures. Radioisotope is injected and collects in areas of abnormal bone metabolism and fractures.
Electromyography (EMG)
Measures electrical potential of skeletal muscle contractions by inserting needles into muscle and activity is recorded on an oscilloscope. Used to evaluate muscle weakness.
Sprains are treated with…
R - Rest
I - Ice
C - Compression
E - Elevation
Closed/Simple fracture
Skin over the fracture is in intact
Comminuted fracture
Bone is splintered or crushed
Complete fracture
Bone broken into two parts
Depressed fracture
Bone fragments are driven inward
Greenstick fracture
One side of the bone is broken the other is bent
Impacted fracture
Part of the fractured bone is driven into another bone.
Incomplete fracture
Fracture does not go all the way through the bone
Oblique fracture
Fracture runs at an angle across the bone
Open/compound fracture
Bone exposed to the air increasing the risk of infection and soft tissue injury.
Pathological fracture
Fracture caused by weakening of the bone structure by a pathological process such as neoplasia.
Neoplasia
Abnormal growth of new tissue
Transverse fracture
Bone fractured straight across
Closed reduction
Manual manipulation of a bone fracture to restore bone alignment
Open reduction
Surgical intervention to realign bone fracture.
Fixation
Insertion of screws, pins or plates to repair damaged bone. May include removal of parts of bone and immediate stabilization.
Skeletal traction
Applied mechanically to the bone with pins, wires or tongs. Typical weight is 25-40 lbs.
Skin traction
Applied using elastic bandages or adhesive, foam boot or a sling.
Dunlop’s traction
Horizontal traction used to align fractures of the humerus. Vertical traction maintains proper alignment.
Isometric exercises
Prevent muscle atrophy
Monitor a casted extremity for…
- Pain
- Swelling
- Discoloration
- Tingling
- Numbness
- Coolness
- Diminished pulses
Fat embolism
Complication of fracture. Originates in the bone marrow and occurs after a fracture when a fat globule is released into the bloodstream. Usually occurs in a long bone.
Symptoms of a fat embolism
- Restlessness
- Hypoxemia
- Mental status changes
- Hypotension
- Dyspnea
- Tachypnea
- Petechial rash upper chest
Petechiae
Pinpoint, round spots that appear on the skin as a result of bleeding. The bleeding causes the petechiae to appear red, brown or purple. Commonly appear in clusters and may look like a rash.
Compartment syndrome
Pressure increase in on or more compartments leading to decreased blood flow, tissue ischemia, and neurovascular impairment. Neurovascular impairment becomes permanent if not treated within 4-6 hours of onset.
Paraesthesia
Loss of sensation
Signs and symptoms of compartment syndroms
- Increased pain in dumb
- Distal tissue is pale, dusky or edematous
- Paint with passive moment
- Paresthesia
- Pulselessness (late sign)
Intervention for compartment syndrome
Notify HCP and prepare to assist with fasciotomy to relieve pressure and restore perfusion. Losses tight dressings or bivalve a restrictive cast.
Osteomyelitis
Inflammatory response of the bone tissue which can be caused by microorganisms invading the bone causing localized infection.
Treatment for osteomyelitis
- Long term IV antibiotic therapy
- Hyperbaric oxygen
- Surgery and bone grafts
Avascular necrosis
Fracture which interrupt the blood supply to the bone causing bone death. Necrotic tissue must be removed.
Intracapsular Fractured Hip
Femoral head is broken with the joint capsule. Slow to heal as less blood supply to the head, skin traction post-op. Treated with THR or open internal fixation with head replacement.
Extracapsular Fractured Hip
Fracture outside the joint capsule. Repaired with open reduction with internal fixation. Post-op lie flat with head of bed elevated 30-45 degrees for meals only. Weight bearing is restricted. Leg kept elevated, extended and supported.
Dislocation
Ligament injury which leads to separation of the articular surfaces of the joint.
Subluxation
Incomplete displacement of joint surfaces when forces disrupt the tissue surrounding the joints.
Cervical disk herniation, pain radiates to
- Shoulder
- Arms
- Hands
- Scapulae
- Pectoral muscles
Motor and sensory deficits of cervical disk herniation
- Paresthesia
- Numbness
- Weakness of upper extremities
Diskectomy
Removal of herniated disk tissue and related matter
Discectomy with fusion
Fusion of vertebrae with bone graft
Laminectomy
Excision of part of the vertebrae (lamina) to remove disk.
Laminotomy
Division of the lamina of the vertebrae
Neuroma
Growth of tumor or nerve tissue
Amputation of lower extremity - positioning the patient
- First 24 hours - elevate foot of bed, then keep bed flat to prevent hip flexion
- 24-48 hours position patient prone to stretch the muscles.
Rheumatoid arthritis
Chronic, systemic inflammatory disease that leads to destruction of connective tissue and synovial membrane within the joints.
Signs and symptoms of rheumatoid arthritis
- Inflammation, pain and tenderness at the joint
- Low grade temperature
- Fatigue
- Weakness
- Anorexia and weight loss
- Anemia
- Elevated ESR
Rheumatoid arthritis diagnosed…
Via a blood test.
Non-reactive - 0-39
Weak reactive - 40-79
Reactive 80+
Synovectomy
Treatment for rheumatoid arthritis, surgical removal of the synovial to help maintain joint function.
Arthrodesis
Bony fusion of joint used to treat rheumatoid arthritis.
Arthroplasty
Joint replacement
Osteoarthritis
Bone buildup and loss of articular cartilage with progressive deterioration of the joints.
Crepitus
Grating or crackling sounds or sensation under the skin at the joints.
Osteotomy
Bone resected to correct joint deformity and promote realignment and reduce stress in osteoarthritis.
Osteoporosis
Bone demineralization, loss of calcium and phosphorus salts leading to fragile bones.
Primary osteoporosis
Occurs in postmenopausal women and low testosterone men.
Secondary osteoporosis
Caused by prolonged use of corticosteroids, thyroid reducing medications, aluminum containing antacids and anticonvulsants. Also associated with alcoholism, immobility and malnutrition.
Treatment for osteoporosis
- Assess risk and prevent injury
- Provide a diet high in protein, calcium, vitamins C and D, and iron
- Avoid alcohol and coffee
Gout
Systemic disease in which urate crystals deposit in joints and other body tissues.
Asymptomatic gout
No symptoms but an increase in uric acid levels.
Acute gout
Excruciating pain and inflammation
Intermittent gout
Intermittent periods with no symptoms between attacks
Chronic gout
Repeated episodes of acute gout resulting in crystal deposits under the skin and in organs.
Treatment for gout
- Low purine diet (no organ meats, wine or aged cheeses),
- 2000mL intake per day to reduce stone formation
- Increase urine pH
- Bed rest
- Heat/cold compress
- Analgesics, anti-inflammatories, uricosuric agents.
How should a casted extremely be elevated after cast applied?
Elevate for first 24-48 hours to minimize swelling and promote venous return.
What is normal arterial oxygen level?
80-100 mmHg
What is an early sign of fat embolus?
Altered mental state
What is the main concern with limb amputation?
Excessive edema. Compression bandages are essential.
Risk factors for osteoporosis
- Asian
- White
- Smoker
- Long term corticosteroid use
- Small boned
- Fair skinned
- Long term anticonvulsant use
- Early menopause
- Family history
- Sedentary lifestyle.