Musculoskeletal System Flashcards
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
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
Magnetic Resonance Imaging
Detects minute problems
Expensive
Do not go in with any kind of metal
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
Bone Densiometry and Dual Energy X-Ray Absorptiometry)
Detects osteoporosis
Looks at the mass of the bone
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
Arthroscopy
Scope into the joint space to assess for injuries
Arthrocentesis
Removal of fluid from the joint cavity
Electromyogram
Looking at the electricity to assess for muscle or nerve conduction problems
Open Fracture
Compound fracture
Bone comes through the skin
Involves more soft tissue injury
More prone to infection
Closed Fracture
Simple fracture
Can be realigned through external manipulation
Can usually see a bruise or hematoma
Greenstick Fracture
Incomplete fracture
Kids are most likely to get these
Complete Fracture
Fracture line is completely through the bone
Comminuted Fracture
Bone is splintered into three or more fragments
More than one fracture line
May require surgery
Impacted Fracture
One bone fragment is forcibly wedged into another bone fragment
Can shorted the extremity if a long bone is involved
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
