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U of R SCHOOL OF NURSING > NUR 370 MUSCULOSKELETAL > Flashcards

NUR 370 MUSCULOSKELETAL Flashcards

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1
Q

Bone

A
  • living metabolically active tissue
  • specialized form of connective tissue
  • blocks oxygen and food diffusion - must contain blood vessels
  • crystals of calcium phosphate salt make bone rigid
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2
Q

Types of Bone

A
  • long bones
  • short bones
  • flat bones
  • irregular bones
  • sesamoid bones
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3
Q

Long Bones

A
  • bodies that are longer than they are wide
  • growth plates at each end (epiphyses)
  • compact bone outside
  • spongy bone inside (contains marrow)
  • ex: femur, tibia
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4
Q

Short bones

A
  • wide as they are long
  • provide support and stability
  • large amounts of bone marrow
  • ex: carpals and tarsals
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5
Q

Flat bones

A
  • strong, level plates of bone protecting vital organs
  • anterior and posterior formed from compact bone
  • center has spongy bone
  • most RBC formed in flat bone
  • ex: scapula, sternum, skull
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6
Q

Irregular bones

A
  • non-uniform shape
  • spongy bone with thin layer of compact
  • ex: vertebrae, mandible
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7
Q

Sesamoid bones

A
  • short or irregular bones in a tendon

- ex: patella

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8
Q

Bone growth from long bones

A
  • epiphyseal growth plate
  • cartilage multiply and enlarge
  • epiphysis and metaphysics fuse
  • growth cells stop diving at puberty
  • cartilage changes into hardened bone at puberty
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9
Q

Osteoblasts

A
  • contained in outer surface of periosteum
  • aid in remodeling and repair
  • building of bone through collagen
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10
Q

Osteoclasts

A
  • break down spongy bone to regulate blood calcium level
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11
Q

Osteocytes

A
  • mature cells that help maintain bone matrix

- form when osteoblasts are calcified

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12
Q

Red bone marrow

A
  • blood-cell factory

- as we age, red bone marrow decreases

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13
Q

Yellow bone marrow

A
  • forms during adolescence

- appears more as we age

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14
Q

Cartilage

A
  • shiny connective tissue that is tough and flexible

- avascular tissue consisting of chondrocytes

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15
Q

Types of cartilage

A
  • hyaline cartilage
  • fibrocartilage
  • elastic cartilage
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16
Q

Hyaline cartilage

A
  • most abundant type

- ex: found in joints

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17
Q

Fibrocartilage

A
  • shock absorber

- ex: intervertebral disk

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18
Q

Elastic cartilage

A
  • flexibility

- ex: ears

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19
Q

Types of muscle

A
  • skeletal
  • cardiac
  • smooth
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20
Q

Skeletal muscles

A
  • connect to bone

- most frequently occurring muscle type

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21
Q

Smooth muscles

A
  • line walls of hollow organs and tubes

- involuntary

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22
Q

Cardiac muscle

A
  • makes up the heart

- under involuntary control

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23
Q

Kyphosis

A
  • increased curvature of thoracic spine outward
  • causes hunchback
  • occurs during puberty (poor posture) or when older
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24
Q

Lordosis

A
  • exaggerated concave of lumbar spine
  • occurs during puberty (poor posture), when older, extra abdominal fat, frequent pregnancies
  • commonly associated with dwarfism
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25
Q

Scoliosis

A
  • lateral deviation of spine
  • imbalance in osteoclast activity
  • before puberty as growing quickly, trauma or posture can develop older as well
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26
Q

How to monitor congenital MS disorders?

A
  • can be monitored with physical therapy
  • if dramatic surgery may be involved
  • compressing/putting stress on certain vital organs (GI tract, lungs, etc.)
  • pain from how spine has grown and deviated
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27
Q

Fractures

A
  • break in the bone
  • main diagnostic tool is x-ray
  • most common type of traumatic musculoskeletal disorders
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28
Q

Simple fracture

A
  • fracture with a single break in the bone and which bone ends maintain their alignment and position
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29
Q

Simple fracture types

A
  • transverse
  • oblique
  • spiral
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30
Q

Transverse fracture

A
  • fracture straight across the bone shaft
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31
Q

Oblique fracture

A
  • fracture at an angle to the bone shaft
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32
Q

Spiral fracture

A
  • fracture that twists around the bone shaft
33
Q

Comminuted fracture

A
  • fracture characterized by multiple fracture lines and bone pieces
34
Q

Greenstick fracture

A
  • incomplete fracture in which the bone is bent and only the outer curve of the bend is broken
35
Q

Compression fracture

A
  • fracture in which the bone is crushed or collapses into small pieces
36
Q

Complete fracture

A
  • bone is broken into two or more pieces
37
Q

Incomplete fracture

A
  • bone is partially broken
38
Q

Closed fracture

A
  • skin is intact
39
Q

Open fracture

A
  • skin is open
40
Q

Fracture assessment

A
  • loss of function distal to fracture
  • compromised blood flow distal to fracture
  • loss of nerve function
  • muscle spasms around affected bone
41
Q

Compartment syndrome definition

A
  • swelling within the muscle compartment
  • trauma begins inflammatory response to increase swelling, capillary permeability
  • fascia not able to expand
  • causes pressure within compartments, blood vessels, and nerves
42
Q

Signs/symptoms of compartment syndrome

A
  • can happen within a few hours of trauma
  • decreased pulses distal to trauma
  • excruciating pain
  • dusky fingers or toes
  • area looks swollen
43
Q

Treatment of compartment syndrome

A
  • IV narcotics
  • elevation
  • diuretics
  • fasciotomy (cutting fascia to decrease pressure)
44
Q

Fat embolism syndrome definition

A
  • some yellow bone marrow leaks out of fracture into the bloodstream
  • causes inflammatory/immune response
  • deadly if embolism gets into vital organs
45
Q

Signs/symptoms of fat embolism syndrome

A
  • 5-12 hours
  • pain
  • acute respiratory stress (decreased RR)
  • changes in consciousness
  • petechiae rash starting on chest (can spread to other areas)
46
Q

Treatment of fat embolism syndrome

A
  • emergency help
  • ventilate to give oxygen
  • corticosteroids to decrease inflammation
  • prevention of fracture is reduced in timely manner
47
Q

Dislocation

A
  • abnormal displacement of articulating surfaces of a joint

- subluxation (partial) or total

48
Q

Causes of dislocations

A
  • congenital (hip dysplasia)
  • traumatic (anterior shoulder dislocation most common)
  • pathologic (arthritis, paralysis)
49
Q

Treatment for dislocation

A
  • x-ray main diagnostic tool
  • reduction
  • sometimes surgery
50
Q

Assessment for dislocation

A
  • distal for nerve function

- distal for muscle function

51
Q

Causes of hip dislocation

A
  • bone cancers
  • osteoporosis
  • most common: after car accidents
  • ALWAYS A MEDICAL EMERGENCY
52
Q

Tendons

A
  • connect muscles to bone
53
Q

Ligaments

A
  • connect bones to bones
54
Q

True or False

Tendons and ligaments tear with fast, strong movements

A
  • True
55
Q

Sprain

A
  • stretch or tear of ligament
56
Q

Sprain grade I

A
  • minimal damage or disruption
  • tender without swelling
  • no bruising
  • active/passive ROM painful
  • no expectation of instability or functional loss
57
Q

Sprain grade II

A
  • moderate damage
  • moderate swelling/bruising
  • very tender
  • ROM painful and restricted
  • joint unstable, functional loss as result
58
Q

Sprain grade III

A
  • complete disruption of the ligament
  • prognosis variable (may require surgery)
  • prolonged healing/rehab period
59
Q

Strain

A
  • muscle and tendon tearing
  • due to sudden stretch
  • causes inflammatory response with tissue injury
60
Q

Treatment of strain

A
  • NSAID to decrease inflammation
  • skeletal muscle relaxants (Lidocaine)
  • RICE
61
Q

Herniated intervertebral disk

A
  • nucleus pulposus (gelatinous component) protrudes through the annulus fibrosis (tough covering) and starts pressing on the nerve
62
Q

Causes of herniated disk

A
  • improper body mechanics
  • lifting heavy objects
  • trauma
  • obesity
  • aging
63
Q

Signs/symptoms of herniated disk

A
  • sciatica
  • pain or weakness in lower back and one leg, or neck, shoulder, chest, arm, etc.
  • severe pain with flexion and radiating to back leg
  • bowel or bladder changes (EMERGENCY SITUATION!)
64
Q

Treatment of herniated disk

A
  • wait pain out
  • NSAIDs
  • keep moving
65
Q

Osteoporosis

A
  • progressive loss of bone calcium that leaves the bones brittle
  • decrease in bone density based on person’s age or gender
66
Q
  • Risks of osteoporosis
A
  • women at the time of menopause
  • thin, small framed people
  • deficient intake of protein, Vitamin C/D
  • excessive intake of phosphorus
  • caucasians/Asians
  • smoking
  • excessive alcohol/nicotine
  • prolonged use of reflux medication (antacids, PPI, histamine-2 blockers)
67
Q

Scurvy

A
  • decrease in vitamin C intake

- slows growth at epiphyseal plate and diaphysial growth

68
Q

Rickets

A
  • softening and weakening of bones in children
  • prolonged vitamin D, calcium, or phosphate deficiency
  • softening with weight bearing changes shape
  • called osteomalacia in adults
69
Q

Paget’s disease

A
  • progressive condition characterized by abnormal bone destruction and remodeling, resulting in bone deformities
  • bone remodeling happening 20x the rate than normal
  • creating new larger bones and blood vessels, but bones are weak
  • fragile, misshapen, thick bones
  • thickened structure can push on soft tissues (headaches, GI distress, difficulty breathing)
70
Q

Medications for bone disorders

A
  • calcium supplements
  • selective estrogen receptor modulator
  • bisphosphonates
  • calcitonin
71
Q

Selective estrogen receptor modulator

A
  • Raloxifene (Evista)
  • agonist estrogen for blood clotting and decreasing bone resorptions but selective antagonist to estrogen on breast tissue
  • decreasing bone break down but do not enhance risk for cancers
  • increased risk for blood clotting when taken with oral contraceptives (decrease other risks of blood clots)
72
Q

Bisphosphonates

A
  • decrease number and action of osteoclasts, inhibit bone resorption
  • Fosamax
  • need to drink with glass of water
  • stand/sit upright to make sure it is in stomach
  • if it does go back into the esophagus, can erode esophagus and cause perforation
    Slow down rate of osteoporosis
73
Q

Osteoarthritis

A
  • degenerative, destruction of articular cartilage “wear-and-tear”
  • involves weight bearing and finger joints
  • normal synovial aspirate (no immune response involved)
  • better in the morning
  • older population
  • unilateral
  • pain worsens as day goes on
  • injection of corticosteroids 2-3 times/year
  • joint replacement
74
Q

Rheumatoid arthritis

A
  • systemic autoimmune disease causing inflammation of connective tissue
  • hands and wrists (non-weight-bearing places)
  • worse in morning
  • WBC in synovial fluid
  • pain management w/ corticosteroids, DMARDs
  • bilateral joints
  • pain worse in the morning but when moving gets better
75
Q

Signs of late stages of uncontrolled rheumatoid arthritis

A
  • ulnar deviation of MCP joints
  • boutonniere deformity of thumb (flaring outward)
  • swan-neck deformity of DIP joints
  • systemic symptoms: fatigue, muscle spasms, low-grade fever
  • blood work for rheumatoid factor: factor present = worse type of rheumatoid arthritis
76
Q

Gout

A
  • inflammatory disease resulting from deposits of uric acid crystals in tissues and fluids within the body
  • enzyme defects that result in overproduction of uric acid and/or inadequate elimination of uric acid by the kidney
77
Q

Gout treatment/prevention

A
  • decrease joint inflammation (ibuprofen)
  • Colchicine (analgesic effective for reducing gout pain)
  • Allopurinol (lowers serum acid)
  • reduce weight, decrease alcohol consumption, increase fluids, avoid purine-rich foods, avoid meals that inhibit renal excretion of uric acid
78
Q

Ankylosing spondylitis

A
  • progressive inflammatory disorders affecting sacroiliac joints, intervertebral spaces, and costovertebral joints
  • vertebrae appear square and vertebral column becomes rigid and loses curvature

U of R SCHOOL OF NURSING (12 decks)

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