TLO 2.8 Musculoskeletal - Adult Flashcards

Question

What is a Total Hip Arthroplasty?

Answer 1

Replacement of BOTH femoral head and acetabulum with a prosthesis

Answer 2

``` Maintain skin integrity Pain relief Assess circulation to extremity Assess for DVT Monitor incision Hip precautions Prevent hip flexion >90 degree and adduction (for total hip replacement) ```

Answer 3

Exercises are started next day with quadriceps exercises, progressing to straight leg raises CPM (continuous passive) machine is sometimes used, goal 90 degrees ``` Premedication prior to therapy May have wound suctions drainage Assess weight bearing status Dorsiflexion of foot to prevent DVT Post op SCD, pharm, DVT prophylaxis ```

Answer 4

Large amount of force (MVA, falls,) Trauma Pathologic fractures Common in adult Edematous painful thigh Inability to move hip/knee Pedal pulses, cap comparing to unaffected extremity

Answer 5

Treatment: skeletal traction surgical Assessment: full weight bearing restricted until bone growth, partial weight bearing to promote bone growth CMTS (circulation, movement, tingling, sensation)/5P's, incision/dressing complications: hypovolemia r/t blood loss, fat embolism, muscle atrophy, ligament damage gluteal/quad isometric exercises

Answer 6

Slow progressive loss of joint cartilage ``` Increasing age genetics excessive weight inactivity repetitive joint use occupation that required frequent kneeling or stopping ```

Answer 7

``` Pain/stiffness Deep ache Pain associated with movement/resolved with rest May have paresthesia's Joint enlargement r/t bony overgrowth Decreased ROM ```

Answer 8

``` Nutritional/weight management Rest/joint protection Heat/cold Drug therapy Surgery ```

Answer 9

When the canal through which the flexor tendons pass becomes narrowed: irritation of the medial nerve occurs Common work related injury thought to be a result of the number of people using computers causing repetitive use

Answer 10

Patient c/o Numb/tingling thumb, index finger, lateral ventral surface of middle finger Affected hand may become weak Pain interferes with sleep Pain may be alleviated by shaking or massaging hand

Answer 11

Patient history (may reveal occupation that involves repetitive movement) Phalen's test: hold the wrist in acute flexion for 60 seconds should have no pain or numbness/tingling MRI EMG

Answer 12

``` Immobilize/splint Reset joint Ice first 24-48 hours May use ice following by heat q4h Steroid injection Surgery: resection of carpal ligament to enlarge the tunnel ```

Answer 13

AKA: ruptured disc herniated nucleus pulposus slipped disc Discs made of inner nucleus pulposus and outer collar called annulus fibrosus Herniated occurs when nucleus pulposus protrudes thru weak or torn annulus fibrosus

Answer 14

``` More common in men Most between 30-50 Most occur in lumbar L4, L5, S1 Cervical usually involves C6, C7 May be r/t trauma or spontaneous ```

Answer 15

``` pain in lower back pain radiates down posterior leg pain increases with sneezing or coughing pain while lifting leg while dorsiflexing the foot weakness, sexual/urinary function keen/ankle reflexes weak/absent ```

Answer 16

``` Cause: degeneration and trauma (whiplash) pain in shoulders/neck arm paresthesia muscle spasms stiff neck decreased or absent arm reflexes ```

Answer 17

pain in neck, shoulder anterior arm paresthesia of forearm, thumb, forefinger, lateral arm triceps reflex normal to hyperactive

Answer 18

pain in mid-gluteal region, posterior thigh, calf to heel paresthesia posterior calf, lateral heel, foot/toes difficulty walking on toes

Answer 19

pain in hip, lower back muscle spasms paresthesia over lateral leg web of treat toe foot drop with complete root compression, bowel/bladder incontinence

Answer 20

Conservative: done for approx. 2-6 wks., PT, meds, injections Surgery: Laminectomy Discectomy Spinal fusion

Answer 21

Most frequently performed Removal of part of the vertebral lamina Done to relieve pressure on nerves Often protruding nucleus pulposus is removed

Answer 22

Removal of the nucleus pulposus of an intervertebral disc | Can be performed alone or with laminectomy

Answer 23

Insertion of wedge shaped bone or bone ship between vertebrae to stabilize them Spinal implant sometimes used made of titanium that has a hollow cylinder with holes. It is packed with grafted bone and placed in space where disc was removed

Answer 24

Log roll to avoid twisting of spine promoting body alignment Assess for urinary retention, should void w/in 8 hrs Assess pain, leaking of CSF Increase mobility as prescribed Assess CMTS, grips, push/pulls, neuro status

Answer 25

Circulation Movement Tingling Sensation

Answer 26

Rest Ice Compression Elevation