orthopedic nursing Flashcards
what is the most common manifestation of the muscoloskeletal system
include pain, weakness, deformity, limitation of movement, stiffness, and joint crepitation (crackling sound).
what is the muscle strength scale of 0/5
No detection of muscular contraction
what is the muscle strength scale of 1/5
A barely detectable flicker or trace of contraction with observation or palpation
what is the muscle strength scale of 2/5
Active movement of body part with elimination of gravity
what is the muscle strength scale of 3/5
Active movement against gravity only and not against resistance
what is the muscle strength scale of 4/5
Active movement against gravity and some resistance
what is the muscle strength scale of 5/5
Active movement against full resistance without evident fatigue (normal muscle strength)
what are soft tissue injuries
sprain
strain
dislocations
subluxation
what is a sprain
is an injury to the ligaments surrounding a joint, usually caused by a wrenching or twisting motion.
how are sprain catergorized
first degree
second degree
third degree
what is a first degree sprain
involves tears in only a few fibers, resulting in mild tenderness and minimal swelling.
what is second degree sprain
is partial disruption of the involved tissue with more swelling and tenderness.
what is a third degree sprain
is complete tearing of the ligament in association with moderate to severe swelling.
what is a strain
is an excessive stretching of a muscle, its fascial sheath, or a tendon.
what is a first degree strain
mild or slightly pulled muscle
what is a second degree strain
(moderate or moderately torn muscle
what is a third degree strain
severely torn or ruptured muscle
a severe sprain can lead to
avulsion fracture, in which the ligament pulls loose a fragment of bone.
what is a dislocation
is the complete displacement or separation of the articular surfaces of the joint. It results from severe injury of the ligaments surrounding the joint.
what is a subluxation
is a partial or incomplete displacement of the joint surface. The clinical manifestations of a subluxation are similar to those of a dislocation but are less severe.
what is bursitis
(inflammation of the bursa) results from repeated or excessive trauma or friction, gout, rheumatoid arthritis, or infection.
what is a fraction
is a disruption or break in the continuity of bone.
what are some fraction secondary to
to a disease process such as cancer or osteoporosis (pathologic fracture)
what is a open fracture
the skin is broken and bone exposed, causing soft tissue injury.
what is a closed fracture
the skin remains intact.
what do a majority of fractures come from
traumatic injuries
what do we do if we suspect a fracture
immobilize
what are clinical manifestation of fractures
localized pain decreased function inability to bear weight or use guard against movement may or may not have deformity
what is a complete fracture
if the break goes completely through the bone.
what is an incomplete fracture
ccurs partly across a bone shaft but the bone is still intact. An incomplete fracture is often the result of bending or crushing forces applied to a bone.
what are the stages of fracture healing
fracture hematoma granulation tissue callus formation ossification consolidation remodeling
what are complications of fracture healing
delayed union nonunion malunion angulation pseudoarthrosis refracture myositis ossificans
what is delayed union
Fracture healing progresses more slowly than expected. Healing eventually occurs.
what is nonunion
Fracture fails to heal despite treatment. No x-ray evidence of callus formation.
what is malunion
Fracture heals in expected time but in unsatisfactory position, possibly resulting in deformity or dysfunction.
angulation
Fracture heals in abnormal position in relation to midline of structure (type of malunion).
pseduoarthrosis
Type of nonunion occurring at fracture site in which a false joint is formed with abnormal movement at site.
refracture
New fracture occurs at original fracture site.
what is myositis ossificans
Deposition of calcium in muscle tissue at site of significant blunt muscle trauma or repeated muscle injury.
what is the overall goal of fracture treatment
anatomic realignment
immobilization
restoration of normal or near normal function
what is a closed reduction
nonsurgical, manual realignment of bone fragments
action and counetrtraction applied
under local or general anesthesia
immobilization afterwards
what is open reduction
surgical incision internal fixation risk for infection early ROM of joint to prevent adhesions facilities early ambulation
what is traction
is the application of a pulling force to an injured or diseased body part or extremity.
what is the purpose of traction
prevent or decrease pain and muscle spasm
immobilize joint or part of body
reduce fracture or dislocation
treat a pathological joint condiiton
what are the two most common types of traction
skin traction- short term
skeletal traction- long term
what is skin traction
short term 48-72 hours
tape, boots or splint applied directly to skin
traction weights 5-10 lbs
skin assessment for breakdown
what is a bucks traction boot
is a type of skin traction used preoperatively for the patient with a hip fracture to reduce muscle spasms
what is a skeletal traction
long term pull to maintain alignment pin or wire inserted into bone weighs 5-45 lbs risk for infection complications of immobility
what is a balanced suspension traction
maintain countertraction, typically the patients own body weight, elevate end of bed
maintain continuous traction
keep weights off the floor
what is an external fixator
is a device composed of metal pins that are inserted into the bone and attached to external rods to stabilize the fracture while it heals.
what is an electric bone growth stimulation
increase calcium uptake
actiate intracellular calicum stores
increase bone growth factor production
non invasive, semi invasive and invasive methods
what are some central and peripheral muscle relaxant drugs
carisoprodol
cyclobenzaprine
methocabamol
what should we increase with fractures
protein vitam K,C,D calcium, phosphorus and mg fluid fiber
what is compartment syndrome
swelling and increased pressure within a confined space
compromises neurovascular function of tissues within that space
usually involves the leg
what are the clinical manifestations of compartment syndrome
pain pressure paresthesia (numbness/tingly) pallor(pale) paralysis pulselessness
what is an early sign of compartment syndrom
paresthesia
what do we not do with compartment syndrome
DO NOT ELEVATE
NO ICE
what is an fasciotomy
The fasciotomy site is left open for several days to ensure adequate soft tissue decompression.
what is a fat embolism
is characterized by systemic fat globules from fractures that are distributed into tissues, lungs, and other organs after a traumatic skeletal injury.
what are some anticoagulants
enoxaparin (lovenox)
warfarin (coumadin)
apixaban( eliquis)
rivaroxaban (xarelto)
what should we always know
if someone is on an anticoagulant
when is a fat embolism most common
with fractures of long bones, ribs, tibia, and pelvis
what are the 2 types of theory for fat emoblism
mechanical and biological
what is a mechanical theory
fat released from marrow and enters circulation where it can obstruct
what is biological theory
hormonal changes caused by trauma simulate release of fatty acids to from fat emboli
when do symptoms usually occur for a FES
24-48 hours after injury
what is an important clinical manifestation of FES
petechiae which is red little dots
usually on neck, chest wall
what could happen in a short time with FES
skin color could change from pallor to cynosis
what is osteoarthritis
slowly progressive noninflammatory disorder of the diarthroidal joints
27 million americans effected
who is more likely to have osteoarthtis after age 50
women
what is a collies fracture
is a fracture of the distal radius and is one of the most common fractures in adults
