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NURS 319: MS
Chapters 37, 38 and 39: Musculoskeletal System
| Question | Answer |
|---|---|
| 5 functions of bones | structural support, storage of minerals, production of blood cells, protect body organs, provides leverage and movement |
| osteogenesis | bone growth |
| trabecular bone (and example) | spongy and cancellous bone wrist, hip, vertebrae |
| cortical bone (and example) | rigid and calcified bone femur |
| osteoblasts | bone forming cells |
| osteoclasts | mature osteoblasts that maintain bone matrix |
| osteoclasts' function | bone resorption and keep bone tissue from overgrowing |
| bone remodeling is organized by two opposing activities: | bone formation by osteoblasts which produces organic bone tissue AND bone resorption by osteoclasts which dissolves bone |
| bone maintenance is affected by: | calcium/ vitamin D, physical activity, tobacco and alcohol use, sex, size, age, race/ family history, hormone levels, eating disorders, medications |
| ligaments connect | movable bones of joints |
| tendons connect | muscles to bones |
| synovial fluid is | fluid that lubricates and facilitates movement |
| tonus | state of muscle readiness |
| flaccid | muscle that is limp and without tone |
| spastic | muscle with greater than normal tone |
| atonic muscle | denervated muscle |
| hypertrophy | increase in muscle size |
| atrophy | decrease is muscle size |
| what are MS diagnostic tools? | x-ray, ultrasound, computed tomography, MRI, bone scan, electromyography, dual energy X-ray, absorptiometry scan, biopsy, lab studies, spinal stenosis |
| concerning MS symptoms | cool extremities, pallor/cyanosis, cap refill greater than 3 seconds, weak/absent pulses distally, decreased motor strength, active/passive ROM, decreased sensation, decreased/ absent DTRs, paresthesia, wounds, joint instability, DVT/PE |
| difference between a sprain and a strain | sprain: overstretched ligament strain: overstretch of a muscle or tendon |
| muscle contusion | bruise of a muscle |
| closed (complete) fracture | bone fragments separate completely |
| open (compound) fracture | fracture of bone that protrudes to the outside of the body |
| incomplete fracture | bone fragments are still partially joined |
| compression fracture | consists of the crushing of cancellous bone |
| transverse fracture | parts of bone are separated but close to each other |
| comminuted fracture | fracture with more than one fracture line and more than two bone fragments (may be shattered or crushed) |
| stress fracture | a failure of one cortical surface of the bone, often caused by repetitive activity |
| avulsion fracutre | separation of a small fragment of bone at the site of attachment of a ligament or tendon |
| greenstick fracture | incomplete break in the bone with the intact side of the cortex flexed (one side broken and one side bent); seen in children usually |
| impacted fracture | one part of the fracture is compressed into an adjacent part of the fracture |
| spiral fracture | twisting force causes a fracture line that encircles the shaft of the bone |
| stage 1 of bone healing | fracture and inflammatory phase: bleeding between edges of fractured bone |
| stage 2 of bone healing | granula tissue formation: fibroblasts are attracted to the area of injury, growth of vascular tissue |
| stage 3 of bone healing | callus formation: consisting of osteoblasts and chondroblasts, synthesis of extracellular organic matrix of woven bone and cartilage |
| stage 4 of bone healing | lamellar bone disposition: strengthening phase, ossification occurring |
| stage 5 of bone healing | remodeling: involves remodeling of the bone at the site of the fracture, adequate strength (commonly occurs at 3-6 months) |
| fat embolism | disruption of blood supply from fat globules in blood vessels |
| delayed union | fracture healing taking longer than expected |
| nonunion | fracture with no chance of healing |
| malunion | healing of bone in an unacceptable position |
| avascular necrosis | fracture + inefficient blood supply |
| following a fracture of an extremity, what would you assess? | check pulses, sensation, blood flow |
| if there is poor perfusion and neurovascular changes, what would we see? | pain, pulselessness, pallor, paresthesia, paralysis |
| compartment syndrome- why is it an emergency? how do you identify it? | tissue pressure exceeds perfusion pressure; ischemia, necrosis, functional impairment; severe pain that does not make sense and weak/ lack of distal pulses |
| rhabdomyolysis | muscle breakdown |
| rhabdomyolysis symptoms | myalgia, weakness, myoglobinuria; tea-colored urine |
| who is at risk for developing an infection after a MS injury? | diabetics and immunocompromised |
| why are patients with a MS injury at risk for a PE and DVT? | injury to vessel wall, not moving as much post-injury |
| joint dislocations | articular surfaces of bones are not aligned |
| pathological fracture | bone is weakened, fracture occurs without significant trauma, fragility fracture (elderly) |
| who is at highest risk for a hip fracture? | elderly |
| a patient presents to the ER with a hip fracture, what symptoms would you expect? | painful ROM with hip, unable to walk, weak pulses in leg |
| bursitis | bursae inflammation |
| bursitis symptoms | swelling, stiffness, pain |
| bursitis causes | repetitive movement, excessive pressure on joints, injury |
| tendonitis | tendon inflammation |
| tendonitis symptoms | pain, stiffness, swelling |
| tendonitis causes | repetitive movement, excessive pressure on joints, injury |
| carpal tunnel syndrome | hand/ finger numbness and pain |
| carpal tunnel syndrome symptoms | tingling, pain, numbness |
| carpal tunnel syndrome causes | median nerve at wrist is compressed |
| what is necessary to have in our diet for bone health? | calcium for healthy production of bone |
| how does PTH regulate calcium and where is it released? | released from parathyroid glands, stimulates calcium release |
| how does vitamin D regulate calcium and where is it released? | released from kidneys, increases calcium intake in intestines |
| how does calcitonin regulate calcium and where is it released? | released from thyroid gland, stimulates calcium deposition in bones |
| which sex hormones play a role in bone health and how? | testosterone and estrogen: estrogen inhibits bone breakdown and may stimulate bone formation; testosterone stimulates growth |
| anthropathy | joint disorder |
| monoarticular | arthritis of one joint |
| polyarticular | arthritis of more than one joint |
| chondrocytes | cartilage cells; make up cartilage |
| what is cartilage/ what does it do? | connective, flexible tissue on the surfaces of the ends of 2 opposing joints and provides cushioning |
| how does cartilage deteriorate and what does it lead to? | excessive force causes it to breakdown; leads to subchondral bone destruction |
| hallmark of osteoarthritis | osteophytes |
| osteoporosis risk factors | diet, medications, alcohol use |
| osteoporosis causes | breaks in trabecular matrix |
| osteoporosis symptoms | pain and weakness |
| osteoporosis diagnosis | DEXA |
| osteoarthritis risk factors | older than 40, trauma, obesity |
| osteoarthritis causes | osteophytes |
| osteoarthritis symptoms | pain, stiffness, crepitus |
| osteoarthritis diagnosis | serum markers, physical examination, x-rays |
| degenerative disc disease (DDD) risk factors | herniated disc, bulging disc, degenerated disc, slipped disc |
| degenerative disc disease (DDD) causes | spinal nerve impingement |
| degenerative disc disease (DDD) symptoms | pain, numbness, tingling, or weakness |
| degenerative disc disease (DDD) diagnosis | x-ray, MRI, EKG |
| how can bone get infected? | break in bone, bloodstream, or post-operative |
| osteomyelitis | infection of the bone |
| osteomyelitis is most likely caused by what bacteria? | s. aureus |
| hematogenous osteomyelitis | rapid onset of symptoms, most cases in children |
| contiguous osteomyelitis | caused by trauma, surgery, decubitus ulcers |
| chronic osteomyelitis | longer than 6-8 weeks |
| symptoms of osteomyelitis and who is at risk? | tenderness, swelling, redness; kids, immunocompromised, elderly |
| how is osteomyelitis diagnosed? | bloodwork, X-ray, CT scan, MRI, bone biopsy |
| what is gout and how is it triggered? | inflammation/ infection of the foot; triggered by hyperuricemia |
| primary gout | related to underexcretion or overproduction of uric acid |
| secondary gout | related to medications or conditions that cause hyperuricemia |
| what parts of the body can gout affect and what symptoms are there? | feet/ toes; swollen, red, painful |
| tophi | chunks of uric acid |
| podagra | great toe joint inflammation |
| gout risk factors | diet high in meat, high alcohol consumption, obesity, family history, chemotherapy, medications |
| gout complications | destruction of cartilage and bone, joint deformity, kidney stones, kidney disease |
| gold standard for diagnosing gout | aspiration of joint showing urate crystals |
Created by:
lcorlew1
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