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Musculoskeletal 3of4
| Question | Answer |
|---|---|
| chronic inflammatory process and multi-system disease that results from tick bite | Lyme disease |
| Lyme disease is most common in what area? | northeast, mid-Atlantic states and other northern areas where deer ticks are more prevalent |
| S/S of Stage I of Lyme disease: | red macule or papule at the site (may not appear for 20-30 days); characteristic bulls-eye rash; headache; neck stiffness; fever, chills, malaise; some may have nausea, vomiting, and sore throat; pain |
| S/S of Midstage Lyme disease | Cardiac - involves dysrhythmias and heartblock (electrical impulses in heartbeat are blocked); neurologic - involves facial palsy, meningitis, encephalitis, may also have pain and parasthesia |
| S/S of later stage of Lyme disease (4 weeks after bite) | arthritis and other musculoskeletal problem; joints (particularly the knee) become warm, swollen and painful; joint erosion may result from inflammatory process |
| Antibodies detected 6 weeks after bite (in Lyme disease) | IgG antibodies |
| Medical treatment of Lyme disease: | antiboitics, supportive measures |
| If Lyme disease is treated early, prognosis is: | favorable |
| If Lyme disease treatment is delayed, what may occur? | permanent multisystem problems |
| Infection of the bone. Limited blood supply, inflammation of and pressure on the tissue and formation of new bone around devitalized bone tissue make this difficult to treat. | osteomyelitis |
| Staphylococcus aureus causes what percentage of osteomyelitis cases? | 70-80% |
| Other bacteria that cause osteomyelitis are: | proteus vulgaris, Pseudomonas aeruginosa, Escherichia coli |
| Acute osteomyelitis results from: | bacteria reaching the bone through the blood stream |
| Acute localized osteomyelitis occurs when: | bone is contaminated directly by trauma, such as penetrating wounds and compound fractures |
| In osteomyelitis, microorganisms appear to migrate to the area just below the _______ | epiphysis of a long bone (where the blood supply is more generous). |
| As microorganisms multiply on the epiphysis of the bone, they spread ____________. | down the bone shaft. |
| In osteomyelitis, pressure from the collecting exudate in the bone elevates the __________. | periostium (membrane covering the bone). |
| In osteomyelitis, new bone cells are deposited on the periostum while the underlying bone becomes _________. | necrotic. |
| In it's weakened condition, bone is prone to: | pathological fracture |
| Other complications of osteomyelitis include: | septicemia, thrombophlebitis, muscle contractures, and non-union fractures. |
| S/S of osteomyelitis: | high fever, chills, rapid pulse; tenderness and pain over affected area; redness and swelling; drainage from wounds; exposed bone |
| Diagnostic testing for osteomyelitis show: | elevated WBCs and ESR; positive blood culture; x-rays show irregular bone decalcification, bone necrosis, elevation of the periousteum and new bone formation; bone scans and MRI are useful |
| Medical management of osteomyelitis includes: | immobilization with a cast or immobilizer (to decrease pain and prevent fracture); application of warm saline soaks (to promote circulation);IV antibiotics (after causative organism is identified); surgical debridement of the necrotic tissue; bone grafts |
| Nursing management of osteomyelitis includes: | education about diagnosis and care (especially antibiotics - watch for superinfections); protect skin from breakdown; administer meds and antibiotics; meticulous diabetic care of extremities |
| Diffuse connective tissue disease that affects multiple body systems such as the skin, joints, kidney, serous membranes of the heart and lungs, lymph nodes and GI tract | Lupus Erythematosus |
| LE is beleived to be: | autoimmune |
| LE may have a strong _________ tendency. | familial |
| LE is more common in __________. | women |
| LE is more common at age: | 30-40, but may be seen in children and older adults. |
| In Lupus Erythematosus, antibodies destroy ______________. | connective tissues |
| LE has periods of ____________. | remission |
| In LE, affected structures undergo: | inflammation, fibrosis, scarring dysfunction |
| S/S of lupus erythematosus: | fever; weight loss; pain in the joints; malaise; muscle pain; extreme fatigue; may have patchy loss of hair; may have behavioral disturbances like confusion, hallucinations and irritability; chest pain; fluid retention, proteinuria, hematuria, weight loss |
| More S/S of LE: | n/v, irregular or heavy menses; EKG changes; pericardial friction rub; enlargement of the spleen and lymph nodes; Raynaud's phenomenon; musculoskeletal problems |
| Diagnosis of lupus erythematosus is made by: | symptoms, blood tests (to evaluate multisystem dysfunction) |
| Medical management of LE: | no specific treatment; aim at producing remission and preventing or treating acute exacerbations of disorder; high doses of corticosteroids are used initially; cytotoxic drums (a type of chemo); renal failure treated with dialysis or transplant |
| People with LE should stay away from: | people who are sick because of depressed immunity. |
| Chronic bone disorder characterized by abnormal bone remodeling. | Paget's Disease |
| Paget's Disease affects adults older than: | 60 |
| Paget's Disease most commonly affects the: | long bones, spine, pelvis and skull |
| Excessive osteoclastic activity causes the bones to become: | soft and bowed (initially). |
| Resorption is greater than ___________ of bone in Paget's Disease. | formation |
| bones destroy themselves and then rebuild | osteoclastic activity |
| Bones thicken when osteoblast activity: | resumes |
| __________ has high mineral content but is not well formed and is prone to fracture. | New bone |
| Complications of Paget's disease include: | pathological fractures; paralysis from spinal cord compression; cranial nerve damage such as deafness from compression of th skull; kidney stones |
| S/S of Paget's disease: | Some have marked skeletal deformities that may include enlargement of the skull, bowing of the long bones and kyphosis. Some are asymptomatic with only some mild skeletal deformity. |
| Diagnostic findings of Paget's disease: | bone changes observed; pathological fractures |
| Medical management of Paget's disease: | analgesics, NSAIDs, Calcitonin drug therapy, Fosamax, EDHP (in advanced cases) |
| Calcitonin and Fosamax are used in Paget's disease to: | block resorption of bone |
| EHDP is used in advance cases of Paget's disease to: | reduce normal and abnormal bone resorption and reduce bone formation that is coupled to bone resorption |
| Surgical treatment is used in Paget's disease to: | relieve neurological complications and to repair pathological fractures |
| Deformity of the great toe at its metatarsal-phalangeal joint | hallux valgus (or bunions) |
| Flexion deformity of the interphalangeal joint and may involve several toes. | Hammer toe |
| Treatment for hallux vagus and hammer toe | rest, elevation of foot, analgesics, bunionectomy(bunion removed and deformity corrected); hammer toe joints redone (to fix malformation - called hammer toe release) |
| Difficulty with activities that stretch arms above the head. Usually worse at night. | rotator cuff tear |
| Treatment for rotator cuff tear: | corticosteroid injections |
| Surgical treatment for rotator cuff tear: | debridement of devitalized tissue; tendon repair |
| Inflammation of a tendon caused by overuse. | tendonitis |
| Types of tendonitis: | carpal tunnel syndrome; epicondylitis; ganglion |
| Group of symptoms located in the wrist where the carpal bones, carpal tendons and median nerve pass through a narrow, in-elastic canal | Carpal Tunnel Syndrome |
| Results from repetitive wrist motion that traumatizes the tenon sheath or ligament in the carpal canal | carpal tunnel syndrome |
| S/S of carpal tunnel syndrome | pain and burning in the hand that radiates to the forearm and shoulder in severe cases. Tends to be worse at night and early in the morning. Sensation may be lost in thumb, index, middle, and a portion of the ring finger. |
| S/S of epicondylitis: | pain that radiates down the dorsal surface of the forearm; weak grasp |
| Treatment for epicondylitis: | RICE (Rest, Ice, Compression, Elevation) |
| Cystic mass that develops near tendon sheaths and joints in the wrist. | Ganglion |
| S/S of ganglion | pain in affected area |
| Usually the result of misplaced or overgrown clusters of normal bone or cartilage cells that cause the structure to enlarge and impair function. | bone tumor |
| Bone tumors grow ________ and do not __________. | slowly; metastasize |
| Bone structure is __________ when a bone tumor is present. | weakened |
| S/S of bone tumor: | pain or discomfort that increases with weight bearing; deformed bone with swelling over the affected area |
| Treatment of bone tumor: | surgery if bone is deformed, growing tumor, or if pain interferes with ADLs and mobility. |
Created by:
akgalyean
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