Musculoskeletal System pt.1 Flashcards
1
Q
majority of occupational injuries in the hospital are
A
registered nurses
2
Q
functions of the musculoskeletal system
A
- first line of defence against external forces
- enable mobility, protection of internal organs
- damage to our skeletal or muscle systems makes movement difficult and painful
3
Q
what population has the highest incidence of fracture
A
males age 15-24 and adults over 65
4
Q
trauma injury
A
bone is subjected to stress, greater than it can absorb
5
Q
Pathological injury
A
caused by weakness within bones
- osteoporosis, tumors, infection
6
Q
stress injury
A
bone not able to adapt to repetitive pressure, bone weakne over time
7
Q
what are the most common fractures from accidental trauma in young people
A
clavicle, tibia, humerus
8
Q
what are th emost common fracture sin the workplace
A
hands and feet
9
Q
what are the most common fractures linked with osteoporosis in older adults
A
upper humerus, upper femur, vertebrae, and pelvis
10
Q
transverse fracture
A
runs through the bone
11
Q
linear fracture
A
runs parallel to the bone
12
Q
oblique/displaced fracture
A
breaks on a an angle
13
Q
spiril fracture
A
encircles the bone
14
Q
what are shin splints
A
- stress on the the tibia by overworking your muscles
- not allowing your muscle to grow
15
Q
greenstick fractures are often seen in
A
children
16
Q
waht is a greenstick fracture
A
more of a bend, not a complete fracture
17
Q
what is an comminuted fracture
A
fractured into more than 2 fregments
18
Q
signs and symptoms of fracture
A
- swelling a the site of injury (soft tissue edema)
- hemorrhage into muscles and joints
- pain (muscle spasms; continues until bone fragments are mobilized)
- loss of fucntion
- deformity
- crepitus
- brusing
- hypotension
- pulselessness
19
Q
what symptoms are diffrent for pathological trauma
A
- can potentially have asymptomatic deformity and swelling, or more generalized bone pain
20
Q
what symptoms are diffrent for stress trauma
A
- pain can occur during repetitive injury, resolved with rest
21
Q
what is dislocation
A
a complete disruption of the joint
- joint surfaces lose contact with each other
22
Q
what is subluxation
A
a partial dislocation followed by relocation
- partial contact between opposing joint can damage the ligaments, nerves, joint surfaces (cartilage), as well as bones that make up the joint
23
Q
causes of dislocation and subluxation
A
- developing joint (ligaments may have developed looser)
- trauma
- muscular imbalance (unbalanced exercise program, bad posture, inactivity)
- incogruities in surfaces (rheumatoid arthritis)
- joint stability (repetive dislocations, stretching of the ligaments in previous injury)
24
Q
direct healing
A
bone cortices are in contact with eachother
25
indirect healing
development of callus and eventual remodeling a solid bone
26
stages of bone healing
1. Hematoma
2. Soft callus
3. Hard callus
4. remodelling
27
how long does it take for most fractures to heal
4-8 weeks
28
what factors can prolong fracture healing
osteporosis, general health of the individual, can prolong healing
29
soft tissue injury
sprians/strains
30
strain
tearing or stretching of a muscle or tendon
31
what are the most common strains
hands, feet, knees, upper arm, thigh, ankle, and heal
32
sprain
ligament tears
33
what are the most common sprains
wrist, ankle, elbow, and knee
34
1 degree soft tissue injury
fibres are stretched
- muscle and joint remain stable
35
2nd degree soft tissue injury
more tearing of tendon or ligament muscle weakness, joint instability
36
3rd degree soft tissue injury
inability to contact the muscle and significant joint instability
37
signs and symptoms of sprains and strains
pain (sharp, localized), swelling, changes in the contour of ligaments or tendon
38
3rd degree sprains and strains requires
surgery to suture ends together
39
what is rhabdomyolysis
rapid breakdown of muscle causes release of intercellular contents including myoglobin, enzymes, and potassium into the extracellular space and bloodstream
40
rhabdomyolysis causes
- trauma (crush injuries)
- medications and rugs
- excessice muscle contraction
- infectous afents
- toxins (carbon monoxide)
41
complications of rhabdomyolysis
- hyperkalmia
- cardiac dysrhythmias
- kidney failure
42
rhabdomyolysis symptoms
muscle pain, weakness, and dark urine
- elevated creatine kinase (most reliable indicator)
43
what is compartment syndrome
occurs when there is damage to a compartment but the fascia encicleing the compartment is intact
44
result of compartment syndrome
increased pressure within the compartment restricting blood flow
45
compartment syndrome is caused by
- bleeding within the compartment or increased pressure outside of the compartment or a combination of both
- severe bursn, bleeding, crush injuries, bites, tight casts or bandages
46
what leads to msucle infraction and neural injury
muscle ischemia, can cause edmea, increased compartment pressure, and tamponade
47
what are the 6 P's of compartment syndrome
Pain - beyond what is expected for the injury
Pressure - sweeling or tenderness felt over affected area
Pallor - decreased blood flow to extremity
paresthesia - numbness or tingling due to nerve impingement
Paresis - muscle weakness
Pulselessness - inadequate blood perfusion
48
compartment syndrome diagnosis
measurement of intercompartmental pressure
manometer
49
what is osteoporosis
- decreased bone density and increased risk of fractures
- chronic disease
- old bone is being absorbed faster than new bone is being made
50
where is osteoporosis commonly seen
spine vertebrae, femoral neck, and wrist
51
postmenopausal osteoporosis is caused b
estrogen deficency
52
secondary osteoporosis can be caused by
dysfunction of the endocrine system
- parathyroid hormone, cortisol, thyroid hormone and growth hormone (most commonly associated with osteoporosis)
- medications, lack of physical activity, abnormal BMI
53
what age is peak bone mass
30
54
most common complication of osteoporosis
fractures
- vertebral fractures
55
signs and symptoms of osteoporosis
- bone deformity and pain due to fractures
- vertebral fractures can cause kyphosis (hump back)
- fractured hip
- fractured femur (falls)
56
osteoporosis diagnosis
x ray
- loss of 25-30% bone tissue
57
osteomyelitis
- infection of the bone
- most often caused by bacteria (staph aureus)
58
hematogenous osteomyelitis
- caused by a pathogen carried in the bloodstream
- more common in children
59
continous osteomyelitis
caused by infection, spread from adjacent bone
60
continous osteomyelitis is cuased by
- caused by open fractures, penetrating wounds, or surgical procedures
- metabolic or vascular disease (diabetes, PVD)
- lifestyle risks (smoking, alcohol, drug abuse and age)
61
who is at risk for osteomyelitis
chronically ill, diabetics, alcoholics, individuals on high dose of steroids or immunosuppressive medications
62
osteomyelitis process
intitial infection- inflammatory response - forms biofilms that adhere to surfaces - increase antibiotic resistance - small terminal vessels thrombose and exudate seals the bone canaliculi - exudate extends into the marrow cavity - blood flow is disrupted which leads to necrosis and death producing sequestrum - osteoblasts lay down new bone over affected bone - openings in the incoluccrum allow exudate to escape to surrounding tissues through skin by sinus tracts
63
signs and symptoms of hematogenous osteomyelitis
vague: fever, malaise, anorexia, weight loss, and pain in or around infected area
64
continous osteomyelitis signs and symtoms
inflammatory exudate in soft tissues
- abscesses form, low grade fever, lymphadenopathy, local pain, and swelling of puncture wound
65
osteomyelitis treatment
- antimicrobial agents
- debridement of infected bone
- would irrigation and antibiotics
66
what is osteoarthritis
loss of protective cartilage
67
osteoarthrisis is cuased by
physical use (wear and tear of joint)
68
what is the most common form of arthritis
osteoarthritis
69
osteoarthristis most commonly affects
hands, knees, and hips
70
what components of the joint are affected in osteoarthritis
all components of the joint
- cartilage, bone and synovial fluid
71
osteoarthrisitis process
- articular cartillage breaks down, can flake off and develop longitudinal fissures, underlying unprotected bone becomes sclerotic, as the articular bone breaks down, ostophytes will try to build new bone forming bone spurs - into the synovial cavity, these spurs can break off increasing the irritation and volume of the joint - contributes to immobility
72
osteoarthrisis sings and symptoms
- intially asymptomatic
- pain, stiffness, swelling, decreased ROM< muscle wasting, partial dislocation, and deformity
joint stiffness
joint effusion (swelling of joint)
73
risk factors for osteoarthritis
trauma, mechanical stress, inflammation in the joint, joint instability due to damage to supporting structures, neurological blood or endocrine disorders, cogenital deformities, medications
74
stae 1 OA
patients will develope very minor wear and tear and bone spurs at the end of the knee joints
75
stage 1 OA treatments
supplements such as glucosamine and chondotin may be recommended
76
stage 2 OA
more bone spur growth, space between the bones appears normal, symtoms of joint pain
- area around the knee may feel stiff and uncomfortable
77
stage 2 OA treatments
- relieve the pain and discomfort
- strict regime of exercise and strength training for increased joint stability
- braces, knee support, or shoe inserts (protect knee from stress)
78
stage 3 OA
obvious erosion to the cartilage surface between bones and fibrilation narrows the gap between the bones
- bones develop spurs at the joints as it becomes rougher
- frequent pain when walking, running, squating, extending kneeling
- joint stiffness after sitting for a long time or when waking in the morning
- may be popping or snapping sound when walking
79
stage 3 OA treaments
- over the counter NSAIDS
- may require intra-articular injections of hyaluronic acid
80
stage 4 OA
joint space between the bones are considerably reduced, causing the cartilage ot wear off, leaving the joint stiff
chronic inflammatory response, with decreased synovial fluid causes friction, greater pain and discomfort when walking or moving the joint
development of more spurs causeing excrutiation pain, which makes everyday chores, including walking, difficult
81
stage 4 OA treatments
- osteotomy or bone realignment surgery
- total knee replacement or arthroplasty
82
what is Rheumatoid arthritis
chronic autoimmune disease
83
what is typically seen in rheumatoid arthritis
- joint swelling and tenderness
- destruction of synovial joints
- disability and in some cases premature death
84
hwo is RA diffrent than OA
Ra: synovial membrane is the first tissue affected
85
what are the msot common site for rheumatoid arthritis
- fingers, feet, wrist, elbows, and knees
86
signs and symptoms of rheumatoid arthritis
- joint degration is symmetrical
stiffness (more prounced in the morning, last longer than 1 hour)
symmetrical involvment of hands
3 or more affected joints
low grade fever
fixed flexion of smaller had joints "swan neck (thumbs) and boutomiere"
other organ involvement: lymphadenopathy, spenomegaly, nephronpathy, eyes
87
rheumatoid arthritis risk factors
enviorments, diet, socialeconomic status, smoking
88
grout is caused by
overproduction of uric acid or under excretion (90%) of uric acid by the kidneys
89
with grout inflammation and pain of the joints is most common in
feet and legs
90
gout pathophysiology
concentration of urice acide increases to the point it cristalizes
- insolvable precipiates deposited in connective tissue
- crystalization in synovial fluid results in painful inflammation of the joint
91
risk factors for gout
male gender, increasing afe, high intake of alcohol, read meat and fructose, increasing BMI
92
gout can lead to
chronic disbaility, HTN, and renal disease
93
gout signs and symtoms
pain, inflammation of the joints, kidney stones, joint enlargements (crystals harden, eroding bone and cartilage), back pain (pain in kidenys)
94
fibromyalgia
Syndrome of chronic pain (not inflammation)
- abnormally low levels of serotonin, typically reduces pain signals
- sleep pattern is affected
95
fibromyalgia sings and symtoms
- chronic generalized pain and fatigue
- cognitive dysfunction, changes in mood
96
Disuse atrophy
muscle wasting
- reduction in normal size of muscle fibres after prolonged inactivity from bed rest, trauma, or local nerve damage
97
muscular deconditioning
can occur within days of inactivity
98
noral individuals will lose muscle mass at a rate of
3% per day
99
disue atrophy treatment
frequent forceful contractions
passive lengthening exercises
get up walking and moving quickly
100
Contractures
loss of passive ROM
- secondary to joint, muscle or soft tissue limitation
- trauma, arthritis, CNS disease
101
most common contractures
joint immobilaization
102
dupuytrens contracture
- caused by connective tissue in palm thickens and becomes scare like
- not painful but restricts movement
103
risk factors for Dupuytrens contracture
genetic factors, alcohol, tobacco use, and diabetes
