Muskuloskeletal System and Dermatology Flashcards
Bone Densitometry
“Dual-energy Xray Absorptiometry” (DEXA)
Non-invasive
For: Osteoporosis
Pre: Ask for LMP
Discontinue Calcium Supplements
(48 hours prior to procedure)
Insertion of an electronically charged needle to check for muscle activity
Electromyography
Pre-procedure for electromyography
Get consent
Inform: uncomfortable procedure
Hold stimulants for 2-3 hours prior to procedure
(True of False): Expect bruising in electromyography
True
(Provide cold and warm compress post procedure)
Bone-bone
Joints
In between bones
Ligaments
Bone to Muscle
Tendons
Increase risk to fracture?
Steroid use (⬇️ Ca Absorption)
Alcohol intake
Endocrine problem (Cushing’s)
Calcium intake
Family history
Overstretching of tendons
Strain
Overstretching of ligaments
Sprain
Break in continuity of bone
Fracture
S/Sx of Fracture
(SPACED)
Soft tissue edema
Pain: sharp and continuous
Abnormal movement
Crepitus: grating sound
Ecchymosis: hematoma/discoloration
Deformity: obvious
(True or False): In fracture management, immobilizers are worn at all times and must be well-fitted, not snug.
True
Management of Sprain and Strain
(RICE)
Rest/immobilize
Ice first 24hours (10-20mins)
Compression
Elevate and extend
Broken pieces of bones are attached
Fixation
Realignment of bone
Reduction
Types:
A) open reduction - surgery
B) closed reduction - manual
Build up of pressure that can’t expand
Compartment Syndrome
Surgical opening of limb to release pressure
Fasciotomy
Neurovascular Compromise (NVC)
(5Ps and 2Cs) REPORT!
Pain (upon extension, unrelieved by
analgesics, “deep,throbbing,
unrelenting”)
Paresthesia (INITIAL SIGN of NVC)
“Numbness, tingling, pins and
needles, prickling, crawling”)
Pallor
Pulselessness
Paralysis
Phantom (can feel sensation in area
not touched)
Cool to touch
Cyanosis
Gypsum crystal
Plaster of paris
Heavy, cheap
Plaster of paris
Polyurethane (color varies)
Fiberglass or Synthetic
Light and expensive
Fiberglass or Synthetic
20-30mins
Fiberglass
24-72 hours
Plaster of Paris
Exercise for people with cast
Isometric exercise
(contraction of a group of muscles)
Can lead to muscle atrophy
Disuse syndrome
(Isometric exercise)
Compression of duodenum
Cast Syndrome
S/sx of Cast Syndrome
(3As)
Abdominal pain
Absent bowel sounds
Abdominal distention
Maintain a straight line of pull
Traction
Early S/sx of Fat embolism
REPORT!
Altered LOC
Restlessness
Due to thrombus embolism
Pulmonary Embolism
S/Sx of Pulmonary Embolism
Respiratory S/Sx
Cough,
Tachypnea,
tachycardia,
Pain in chest, unilateral
Hallmark sign:
PULMONARY EMBOLISM
Petechial rash
> 6 months fusion
Delayed fusion
Didn’t fuse
Non-union
Fused to another
Mal-union
Decreased supply of blood - low 02, low perfusion, = necrosis
Management?
Avascular necrosis
Mgt: AMPUTATION
Infection of bones? Management?
Osteomyelitis
Mgt: ANTIBIOTICS
Skin traction (indication, anchored, weight)
Children, short-term
Soft tissue (intact skin)
5-7 lbs
Skeletal traction (indication, anchored, weight)
Adult, long-term
Hard tissue (non-intact skin)
25-40 lbs
Higher risk for infection (traction)
Skeletal traction
Priority: Skin traction
Skin care q shift
Priority: Skeletal traction
Pin site care q shift
Bryant’s traction, Russel’s traction
Skin traction
Halo fixation device, crutchfield tong, BST, 90-90 degree traction
Skeletal traction
Priority: Buck’s extension and Russel’s traction
1) NVC
2) Foot drop (foot plate/board)
Pin site care
Clean inner to outer
Report sign of infection (redness,
swelling, pus formation, fever)
CHLORHEXIDINE
HALF STRENGTH HYDROGEN
PEROXIDE