objective 3 (1) Flashcards
what are the functions of the musculoskeletal system?
Protection of vital organs
* Mobility and movement
* Facilitate return of blood to the heart
* Production of blood cells (hematopoiesis)
* Reservoir for immature blood cells
* Reservoir for vital minerals
what is the structure of the musculoskeletal system?
- 206 bones in the body
- Joints
- Muscles
- Attached to bones and other structures by tendons
- Encased in a fibrous tissue called fascia
- Contraction of muscle causes movement
muscles
process of bone formation
osteogensis
the process of formation of the bone matrix and deposition of minerals
ossification
what are the regulating factors of bones?
- Stress and weight-bearing
- Vitamin Parathyroid hormone and calcitonin
- Blood supply
what are the age-related changes?
- Effects of musculo-skeletal changes range from mild discomfort and
decreased ability to perform activities of daily living (ADL) to severe,
chronic pain and immobility. - Decreased muscle cells; loss of elasticity in ligaments, cartilage; joint
problems; decreased bone density - Osteoarthritis and osteoporosis
what do we include in the assessment?
data related to function ability
health history
assessment of pain and altered sensations
physical assessment
Overall impression of the patient’s health status
health history
determine bone density, texture, erosion and changes in
bone
x-ray studies
performed with or without contrast, shows in
detail a specific plane of involved bone and reveal tumors or soft tissue
injuries
computed tomography
uses magnetic fields, radiowaves, and
computers to show alterations of soft tissue with or without contrast
magnetic resonance imaging
contrast or air is injected, then x-rayed to identify acute or
chronic tears of the joint capsule
arthrography
used to estimate bone density, measures of the hip
and spine are accurate for estimating osteoporosis
bone densitometry
detects primary and metastatic tumors, radioisotope is
injected and scan is performed 2-3 hours later
bone scan
direct visualization of a joint under general anesthesia
arthroscopy
obtains synovial fluid for examination or
relief of pain
arthrocentesis
provides information about the electrical potential of
the muscles and the nerves supplying them
electromyography
performed to determine structure and composition of bone
marrow, bone, muscle or synovium
biopsy
what are the lab studies?
mineral metabolism
serological studies
muscle enzymes
A rigid, external immobilizing device
*immobilize a reduced fracture
*Correct a deformity
*Apply uniform pressure to soft tissues
*Provide support to stabilize a joint
Materials - nonplaster (fibreglass), plaster
casts
what do we do for cast care?
- support cast during drying – handle with palms of hands, support
on a firm surface - Leave cast uncovered and exposed to air
- NEVER use a hairdryer to dry cast- may use fan
- Assess circulation q 4 hours
- Used for conditions in which rigid immobilization is not
required, when swelling may be anticipated or special
skin care required - Immobilizes and supports the body, well padded
splints
- Used to provide support, control movement, and
prevent additional injury - Custom fitted (plastic, cloth, leather, metal)
braces
- Vascular insufficiency and nerve compression due to
unrelieved swelling - Increased tissue pressure within a limited space
- Cast must be cut to relieve pressure
- Elevate affected area, no higher than heart level
compartment syndrome
- Pressure from a cast or inappropriately applied brace lower
extremities most susceptible - Pain and tightness in the area
- Drainage, odor may be present
pressure ulcers`
- Muscle atrophy, loss of strength
- Tense muscles to prevent
disuse syndrome
Pins, plates, rods, screws
internal fixation
- Use to manage open fractures with soft tissue damage
- Metal pins are inserted into the bone and attached to
external rods
external fixator
- Application of a pulling force to part of the body
- Minimizes/reduces pain and muscle spasms
- Immobilizes a joint or part of the body
- Reduces fractures
- Treat a pathological joint condition (tumour or infection)
traction
what are the principles of traction?
- Must be continuous, never interrupted
- Weights not removed
- Patient must be in good body alignment
- Ropes unobstructed, weight hang freely
applied to the skin, pulling force in a straight line
with the body part resting on the bed (Buck’s)
skin traction
directly to the bone
skeletal traction
applied with the hands
manual traction
Nurse must know weight bearing status and correct
technique if using an assistive device
ambulation
NWB
non weight bearing
TTWB
toe touch weight bearing
WBAT
weight bearing as tolerated
- Cane, crutches, transfer belt
- Type depends on stability needed and safety
assistive devices
fracture of the proximal third of the femur
fractured hip
Used to treat severe joint pain &
disability and for repair & management
of joint #’s or joint necrosis
Frequently replaced joints include hip,
knee, & fingers
Joints including shoulder, elbow, wrist,
& ankle may also be replaced
joint replacement
Infection of the bone, marrow and surrounding tissue that
results in inflammation, necrosis, and formation of new
bone
osteomyelitis
bone surgery, open fracture or traumatic
injury
direct entry
ascular insufficiency (diabetes, PVD)
commonly pelvis and vertebrae
indirect entry
- soft tissue injury produced by blunt force
- Hematoma develops
- Pain, swelling and discoloration of area
contusion
Caused by excessive stretching of a muscle or tendon
strain
mild stretching, minor edema, tenderness,
mild muscle spasm, no noticeable loss of function
first-degree strain
partial tearing of the muscle or tendon,
loss of load-bearing strength, edema, tenderness, spasm and
ecchymosis
second-degree strain
rupture and tearing of involved tissue, pain,
spasm, ecchymosis, edema, and loss of function
third-degree strain
