Musculoskeletal System Flashcards by Kelsey Grunwaldt

X-Ray

Determines bone density, texture, and erosions

Shows changes in bone relationships

Can see fluid, spurs, narrowing

Screen for pregnancy and use protective shielding

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Computed Tomography

Shows slices of the body and body sections from different angles

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

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Magnetic Resonance Imaging

Detects minute problems

Expensive

Do not go in with any kind of metal

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Bone Scan

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

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Bone Densiometry and Dual Energy X-Ray Absorptiometry)

Detects osteoporosis

Looks at the mass of the bone

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Myelogram

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

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Arthroscopy

Scope into the joint space to assess for injuries

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Arthrocentesis

Removal of fluid from the joint cavity

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Electromyogram

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

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Open Fracture

Compound fracture

Bone comes through the skin

Involves more soft tissue injury

More prone to infection

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Closed Fracture

Simple fracture

Can be realigned through external manipulation

Can usually see a bruise or hematoma

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Greenstick Fracture

Incomplete fracture

Kids are most likely to get these

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Complete Fracture

Fracture line is completely through the bone

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Comminuted Fracture

Bone is splintered into three or more fragments

More than one fracture line

May require surgery

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Impacted Fracture

One bone fragment is forcibly wedged into another bone fragment

Can shorted the extremity if a long bone is involved

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Transverse Fracture

Break is across the bone at a 90 degree angle

Oblique Fracture

Break is across the bone at a 45 degree angle

Spiral Fracture

Breaks in a coil around the bone

Commonly seen in abuse victims

Colle’s Fracture

Distal portion of the radius breaks

Pott’s Fracture

Foot is displaced outward

Displaced Fracture

Ends of the bone are not aligned

Signs and Symptoms of Fractures

Pain

Loss of function, obvious deformity

Change in curvature/length of bone

Crepitus

Edema, warmth, ecchymosis

Loss of sensation distal to injury

Assessment of Fractures

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

Pulselessness, Paresthesia, Paralysis, Pallor, Pain

Treatment of Closed Fractures

Closed reduction, traction, ORIF, external fixators, immobilization

Fiberglass Casts

Common for arm fractures, waterproof, more durable than plaster, dries quickly More difficult to contour and mold, used for simple fractures only

Plaster Casts

Less costly, better mold Not water resistant, heavier, take 48-72 hours to dry Used for body casts

Assessment of Casts

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

Synovectomy

Excision of the synovial membrane

Osteotomy

Cutting into the bone to correct a bone or joint deformity Performed to improve function

Arthrodesis

Surgical fusion of a joint whenever there is severe joint destruction

Arthroplasty

Repair or refashioning of a specific tissue in a joint Can do half or whole Done to restore or increase mobility

Treatment of Open Fractures

Surgical debridement Culture of wound Tetanus toxoid Observe for signs of infection Close the wound Reduce and immobilize the fracture

Compartment Syndrome

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

Signs and Symptoms of Compartment Syndrome

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

Treatment of Compartment Syndrome

Remove the cast Fasciotomy

Pressure Ulcers Caused by Splints/Casts

S/S include hot spots, localized pain, drainage, foul odor Treat by bivalving, creating a window to inspect the area

Disuse Syndrome

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

Shock Caused by Fractures

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

Fat Embolism

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