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Health Assessment > Quiz #4 Musculoskeletal > Flashcards

Quiz #4 Musculoskeletal Flashcards

1
Q

By what gestation has fetus formed cartilage scale model of the skeleton?

A

3 months

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2
Q

When is bone growth most rapid?

A

infancy and adolescence

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3
Q

epiphyses

A

growth plates. Transverse disks at the ends of the long bones where lengthening of the long bones occurs.

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4
Q

curve of the spine at birth

A

single C shape

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5
Q

change in the spine at 3-4 months

A

raising the baby’s head from prone develops the anterior curve in the cervical neck region

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6
Q

change in the spine from 1 year-18 months

A

standing erect develops the anterior curve in the lumbar region

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7
Q

Diets rich in what and low in what in prevent obesity and promote bone mass accrual in children?

A

Dark green and deep yellow vegetables (greens, carrots, sweet potatoes)

Low in fried foods

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8
Q

What causes increased mobility in the joints of the pregnant woman?

A

Estrogen, relaxin, corticosteroids

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9
Q

Spine in the pregnant woman

A

lordosis increased, which compensates for enlarging fetus to shift weight back to lower extremities.

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10
Q

What postural changes in the pregnant woman compensate for lordosis?

A

Anterior flexion of the neck and slumping of the shoulder girdle. May put pressure on nerves and cause aching, numbness, and weakness in upper extremities.

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11
Q

bone remodeling

A

cyclic process of bone resorption and deposition.

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12
Q

Remodeling favors deposition until

A

skeletal maturity at 25-35 years- peak bone mass

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13
Q

After what age does loss of bone matrix occur more rapidly than new bone formation?

A

Age 40

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14
Q

Why do women have more osteoporosis than men?

A

For 5 years after menopause, women lack estrogen, leading to accelerated bone loss.

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15
Q

What causes decreased height with age?

A
  1. Shortening of the vertebral column due to loss of water content and thinning of the intervertebral disks
  2. Decrease in the height of individual vertebrae due to osteoporosis.
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16
Q

When does decrease in height begin/become signficant?

A

Begins in the 40s, becomes significant at age 60. Increaes in the 70s and 80s due osteoporitic collapse of the vertebrae

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17
Q

Postural changes with aging

A

kyphosis
backward head tilt to compensate for kyphosis
slight flexion of the hips and knees

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18
Q

In the 40s and 50s, weight….

A

begins to increase. Fat lost in the face and deposited in the abdomen and hips

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19
Q

In the 80s and 90s, fat

A

decreases in the periphery—especially apparent in the forearms.

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20
Q

Best preventative exercise for osteoporosis

A

Fast walking- faster decreases chance of a bone fracture.

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21
Q

Benefits of physical activity in the older adult

A
  1. Improves muscle strength
  2. Prevents falls
  3. Increases balance and posture control
  4. Decreases back pain
  5. Improves quality of life
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22
Q

Older adults with a physical activity training program with resistance, balance, and functional training showed

A

significant increases in strength, flexibility, HR after exercise, and balance.

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23
Q

BMD values in Af Am women

A

Much higher- lower risk of hip fracture

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24
Q

BMD in white women

A

In femoral neck at the hip joint, BMD peaks earlier in whites than other race groups. Weight bearing exercise is imperative.

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25
Q

Subjective data for musculoskeletal system

A
  1. Joint pain or problems
  2. Knee joint
  3. Muscles
  4. Bones
  5. Functional ADL
  6. Patient-centered care
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26
Q

Pain in bilateral joints may indicate

A

Rheumatoid arthritis

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27
Q

rheumatoid arthritis S+S

A

Bilateral joint pain, very tender

Worse in the morning and after rest

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28
Q

Joint pain that is worse later in the day

A

osteoarhritis

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29
Q

Joint pain that improves during the day

A

Tendonitis

30
Q

Joint pain 10-14 days after untreated strep throat suggests…

A

rheumatic fever

31
Q

Decreased ROM may be caused by

A

Joint injury to cartilage or capsule or muscle contracture

32
Q

Myalgia felt as

A

cramping or aching, viral illness when associated with fever/chills

33
Q

Fracture pain

A

sharp, increases with movement

34
Q

Categories for functional ADL in subjective interview

A
  1. Bathing
  2. Toileting
  3. Dressing
  4. Grooming
  5. Eating
  6. Mobility
  7. Communicating
35
Q

Cigarettes and alcohol affect on bones

A

Cigarettes cause increased bone loss and risk of fracture in older women
Moderate-heavy drinking increases falls risk

36
Q

Patient centered care for musculoskeletal system

A 
Occupational hazards
Exercise program— type, frequency, warm up
Pain during exercise
Weight gain, diet
Medications- NSAIDS, muscle relaxant, pain relievers, hormones
Calcium, vitamin D, dairy
Effect of chronic disability or illness
Cigarettes & Alcohol
37
Q

Objective data for musculoskeletal system

A
  1. Inspection
  2. Palpation
  3. ROM
  4. Hip
  5. Spine
38
Q

Swelling in the joints may be caused by

A
  1. Excessive joint fluid (effusion)
  2. Thickening of the synovial lining
  3. Inflammation of the surrounding soft tissue (bursae/tendons)
  4. Bony enlargement
39
Q

Dislocation

A

Complete loss of contact between two bones in a joint

40
Q

Subluxation

A

Two bones in a joint still in contact, but misaligned

41
Q

Contracture

A

Shortening of a muscle causing decreased ROM in a joint

42
Q

Ankylosis

A

Stiffening or fixation of a joint

43
Q

Is the synovial membrane normally palpable?

A

No

44
Q

When thickened, synovial membrane feels

A

Doughy or boggy. If pushed, fluid will move and bulge out on another side.

45
Q

When is a musculoskeletal exam appropriate?

A

Problems with ADLs

Musculoskeletal symptoms

46
Q

If you see a limitation in active ROM

A

gently attempt passive motion with the person’s muscles relaxed while you move the body part.

47
Q

What is the most sensitive sign of joint disease?

A

Limitation in ROM

48
Q

Articular disease

A

Inside the joint capsule. Produces all around swelling and tenderness around the whole joint, limits all planes of ROM in both active and passive motion.

49
Q

Extra-articular disease

A

Injury to a tendon, ligament, or nerve. Produces only partial limitations to ROM, especially during active movement.

50
Q

Crepitation

A

Audible and palpable crunching when joints move. Caused by roughening of the articular surfaces of the joints, eg RA

51
Q

Hip inspection

A

Look for symmetric iliac crests, gluteal folds, and buttocks. Check for smooth and even gait

52
Q

Positive thomas test

A

Flexion reveals a flexion deformity in the opposite hip

53
Q

Limited internal rotation of hip

A

early and reliable sign of hip disease

54
Q

Most common motion dysfunction in hip disease

A

Limitation of abduction of the hip while supine

55
Q

A difference in shoulder elevation and level of scapulae and iliac crests, gluteal folds indicates

A

scoliosis

56
Q

Kyphosis

A

pronounced curve

57
Q

Lateral tilting and forward bending occur with

A

herniated nucleus pulposus

58
Q

Chronic axial skeletal pain occurs with

A

fibromyalgia

59
Q

Lasegue test

A

Straight leg raise while supine. If sciatic pain produced, confirms the presence of herniated nucleus puplosus

60
Q

True leg lengths equal but apparent leg lengths unequal occurs with

A

Pelvic obliquity or adduction or flexion deformity in the hip

61
Q

Kyphosis is common in adolescents due to

A

chronic poor posture

62
Q

Screen for scoliosis with

A

Foward bend test- stand with feet shoulder widith apart and bend forward and touch toes. Spine should be straight and vertical. Posterior ribs should be symmetric, equal elevation of shoulders, scapulae, and iliac crests

63
Q

Scoliosis most apparent when?

A

During the adolescent growth spurt

64
Q

Lengthening of the arm trunk axis in the aging adult refers to

A

Shortening of the trunk with comparatively long extremities

65
Q

Get up and Go test

A

Identifies older adults at increased risk of falling. Health adult can rise, walk 10 feet, turn, walk back, and sit down in under 10 seconds.
>10 seconds and hx of falls and mobility problems indicates increased risk of future falls

66
Q

Perform a functional assessment for ADLs in

A

Those with advanced aging changes, arthritic changes, or musculoskeletal disability

67
Q

IADL assesssment tests (6)

A
  1. Walk with shoes on
  2. Climb up stairs
  3. Walk down stairs
  4. Pick up an object from the floor
  5. Rise from sitting in a chair
  6. Rise up from lying on the bed.
68
Q

What bones are most commonly affected by osteoporosis?

A

Wrist, hip, and spine

69
Q

Among what group is osteoporosis highest?

A

Mexican Americans, white women

70
Q

How much calcium do women need?

A

1000mg age <50

1200mg age 51+

71
Q

Spinal change common in obese people

A

pronounced lumbar curve

72
Q

Prevent osteoporosis through

A
  1. Well-balanced Diet
  2. Exercise
  3. Avoid Smoking
  4. Limit alcohol intake
  5. Enough vitamin D and calcium

Health Assessment (20 decks)

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