Musculoskeletal System

Question 1

X-Ray

Answer 1

Determines bone density, texture, and erosions

Shows changes in bone relationships

Can see fluid, spurs, narrowing

Screen for pregnancy and use protective shielding

Question 2

Computed Tomography

Answer 2

Shows slices of the body and body sections from different angles

Make sure they do not have seafood allergies if using contrast dye

Question 3

Magnetic Resonance Imaging

Answer 3

Detects minute problems

Expensive

Do not go in with any kind of metal

Question 4

Bone Scan

Answer 4

Nuclear medicine test

Good for detection of bone cancer and osteomyelitis

Should drink plenty of fluids afterwards

Empty the bladder before the test

Screen for pregnancy and breastfeeding

Question 5

Bone Densiometry and Dual Energy X-Ray Absorptiometry)

Answer 5

Detects osteoporosis

Looks at the mass of the bone

Question 6

Myelogram

Answer 6

Injection of radiopaque dye into the subarachnoid space to look at the spinal cord and/or vertebral column

Looking for herniated disks, spinal tumors

Common side effect is a headache

Patient should lie flat for 8 hours and avoid strenuous activity for 1-2 days

Major problems include severe headache, stiff neck, leg weakness, problems going to the bathroom

Question 7

Arthroscopy

Answer 7

Scope into the joint space to assess for injuries

Question 8

Arthrocentesis

Answer 8

Removal of fluid from the joint cavity

Question 9

Electromyogram

Answer 9

Looking at the electricity to assess for muscle or nerve conduction problems

Question 10

Open Fracture

Answer 10

Compound fracture

Bone comes through the skin

Involves more soft tissue injury

More prone to infection

Question 11

Closed Fracture

Answer 11

Simple fracture

Can be realigned through external manipulation

Can usually see a bruise or hematoma

Question 12

Greenstick Fracture

Answer 12

Incomplete fracture

Kids are most likely to get these

Question 13

Complete Fracture

Answer 13

Fracture line is completely through the bone

Question 14

Comminuted Fracture

Answer 14

Bone is splintered into three or more fragments

More than one fracture line

May require surgery

Question 15

Impacted Fracture

Answer 15

One bone fragment is forcibly wedged into another bone fragment

Can shorted the extremity if a long bone is involved

Question 16

Transverse Fracture

Answer 16

Break is across the bone at a 90 degree angle

Question 17

Oblique Fracture

Answer 17

Break is across the bone at a 45 degree angle

Question 18

Spiral Fracture

Answer 18

Breaks in a coil around the bone

Commonly seen in abuse victims

Question 19

Colle’s Fracture

Answer 19

Distal portion of the radius breaks

Question 20

Pott’s Fracture

Answer 20

Foot is displaced outward

Question 21

Displaced Fracture

Answer 21

Ends of the bone are not aligned

Question 22

Signs and Symptoms of Fractures

Answer 22

Pain

Loss of function, obvious deformity

Change in curvature/length of bone

Crepitus

Edema, warmth, ecchymosis

Loss of sensation distal to injury

Question 23

Assessment of Fractures

Answer 23

Assess for signs of shock (cold and clammy hands, pale, decreased BP, tachycardia, tachypnea, confusion, restlessness)

Pulselessness, Paresthesia, Paralysis, Pallor, Pain

Question 24

Treatment of Closed Fractures

Answer 24

Closed reduction, traction, ORIF, external fixators, immobilization

Question 25

Fiberglass Casts

Answer 25

Common for arm fractures, waterproof, more durable than plaster, dries quickly

More difficult to contour and mold, used for simple fractures only

Question 26

Plaster Casts

Answer 26

Less costly, better mold

Not water resistant, heavier, take 48-72 hours to dry

Used for body casts

Question 27

Assessment of Casts

Answer 27

CSM, skin, burning, drainage spots, hot spots, odors

Question 28

Synovectomy

Answer 28

Excision of the synovial membrane

Question 29

Osteotomy

Answer 29

Cutting into the bone to correct a bone or joint deformity

Performed to improve function

Question 30

Arthrodesis

Answer 30

Surgical fusion of a joint whenever there is severe joint destruction

Question 31

Arthroplasty

Answer 31

Repair or refashioning of a specific tissue in a joint

Can do half or whole

Done to restore or increase mobility

Question 32

Treatment of Open Fractures

Answer 32

Surgical debridement

Culture of wound

Tetanus toxoid

Observe for signs of infection

Close the wound

Reduce and immobilize the fracture

Question 33

Compartment Syndrome

Answer 33

Caused by swelling of the muscles around a fracture that leads to progressive arterial vessel compression

Reduces blood supply to the extremity

Question 34

Signs and Symptoms of Compartment Syndrome

Answer 34

Swelling, burns around the extremity, pain that is unrelieved, numbness/tingling, cyanosis, slow capillary refill, inability to flex fingers/toes, absence of pulses

Question 35

Treatment of Compartment Syndrome

Answer 35

Remove the cast

Fasciotomy

Question 36

Pressure Ulcers Caused by Splints/Casts

Answer 36

S/S include hot spots, localized pain, drainage, foul odor

Treat by bivalving, creating a window to inspect the area

Question 37

Disuse Syndrome

Answer 37

Muscle atrophy and loss of strength related to inactivity of muscle group while in a cast

Perform isometric exercises every hour while the patient is awake

Question 38

Shock Caused by Fractures

Answer 38

Caused by inadequate blood supply, pain, fear, blood loss

Altered LOC, decreased BP tachycardia, tachypnea, pallor

Restore the blood volume, give oxygen, take vital signs constantly, keep patient flat in bed, keep patient warm

Question 39

Fat Embolism

Answer 39

Fat breaks loose out of the long bone and starts to circulate in the capillaries; usually seen within 4 hours

S/S include irritability, restlessness, disorientation, stupor, coma, chest pain on inspiration, difficulty breathing, hypoxemia, adventitious lung sounds (crackles, wheezes), petechial rash

Treatment is to immobilize long bones, give IV fluids, steroids, digoxin, oxygen, incentive spirometry