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Musculoskeletal Cond
| Question | Answer |
|---|---|
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| What is term of pain radiating down leg | radiculopathy or sciatica |
| What is bursitis/tendinitis | inflammatory condition of bursae sacs |
| what is impingement syndrome | lesions that involve the rotator cuff of shoulder |
| what is carpal tunnel syndrome | median nerve at wrist is compressed by thickened tendon sheath, skeletal encroachment, edema or soft tissue mass |
| What sign is used for carpal tunnel syndrome | Tinel's sign |
| what is treatment of carpal tunnel | open nerve release or endoscopic laser surgery |
| what are ganglion | collection of gelatinous material near tendon sheaths adn joints on wrist. TX: aspiration, corticosteroid injection, surgical excision |
| what is Dupuytren's Disease | inherited, slowly progression contracture of palmar fascia, flexes 4th/5th fingers and middle finger. |
| when is ice best | 24-48 hours after surgery |
| what is a corn | area of hyperkeratosis(overgrowth of horny layer of epidermis), usually 5th toe |
| what is callus | thickened area of skin exposed to friction. |
| what is onychocryptosis | ingrown toe nail, clip straight across |
| Deformities of the foot: Hammer toe Hallux Valgus(bunion, and assoc with OA) Pes Cavus Morton's Neuroma Flatfoot | Hammer toe: flexion of interphalangeal joint Bunion: great toe deviates laterally Pes Cavus: abnormally high arch (clawfoot) Morton's Neuroma: swelling 3rd toe |
| When is peak adult mass achieved? | B/n 18-25 yrs |
| What are some interventions for osteoporosis | incr Ca, weight bearing exercise, decr caffeine, cig, carbonated drinks, alcohol |
| what is osteoporosis | reduced bone mass, deterioration of bone matrix, diminished bone strength. Osteoclast bone resorption out weighs bone formation Leads to kyphosis |
| What hormones related to Ca incr and decr in aged | estrogen and Calcitonin- decr PTH- incr bone turnover |
| Who is at greatest risk for osteoporosis | small framed, nonobese, Caucasian women |
| Recommended Ca intake? Vit. D? | Ca: 1000-1200 Vit D: 800-1000 |
| where is Ca best absorbed | Duodenum in sm intestine |
| When can osteoporosis be detectable | When 25%- 40% demineralization so BMD testing is recommended for 65 yrs and older |
| what is good mgmt against osteoporosis | Usually a lack of Vit. D metabolic bone disease, softening/weakening of skeleton, many fractures |
| what is osteomalacia | Usually a lack of Vit. D metabolic bone disease, softening/weakening of skeleton, many fractures |
| how does the liver/kidney aid in Ca absorption | liver/kidney convert Vit. D to active form to absorb Ca |
| What leads to osteomalacia? hyperthyroidism, hypo, hyperpara, hypopara | hyperparathyroidism |
| What is Paget's Disease | localized rapid bone turnover in skull, femur, tibia, pelvic bones, vertebrae. Enlarged skull |
| What retards bone resorption | Calcitonin |
| what is osteomyelitis | infection of the bone that results in inflammation, necrosis, formation of new bone |
| Who is most at risk for osteomyelitis | elderly, malnourished, obese |
| what is process of a bone abscess if not treated | the sequestrum forms- dead bone tissue in abscess cavity then covered by new bone growth, involucrum, surrounds sequestrum. Tx: remove dead bone tissue |
| What kind of benign bone tumors did we learn | "droma" osteochondroma, enchondroma, bone cyst, osteoid osteoma, rhabdomyoma, fibroma |
| what is the most common | osteochondroma, usually at ends of long bones |
| what kind of malignant bone tumors did we learn | "sarcoma" osteosarcoma(most common and most fatal), chondrosarcoma, Ewing's sarcoma, fibrosarcoma |
| which is more common, metastatic bone disease or primary bone tumors | metastatic bone disease(secondary bone tumor) |
| what is autograft? allograft? | autograft: bone tissue from pt allograft: cadaver donor |
| what are classifications of fractures | complete, incomplete comminuted by location |
| what is compartment syndrome | incr tissue pressure in limited space(cast) that compromised circulation, cast must be bivalved |
| What causes footdrop? | injury to peroneal nerve due to pressure,Especially in traction.. |
| What should the nurse do to monitor for cast syndrome | cast syndrome has psychological and physiological effects. Nurse should note bowel sounds Q 4 to 8 hrs. Check for distention, nausea, vomiting - TREATMENT: nasogastric intubation with suction and IV fluid til motility restored |
| Home care with a cast | control swelling- elevate to heart level |
| What are immobiliztion techniques for fractures | cast/splint, traction, external, internal fixators |
| what do external fixators do? | manage open fractures and provide stable support for comminuted |
| types of traction: manual, skin and skeletal | manual skin: Bucks(lower leg), cervical, pelvic. No more than 4.5 to 8lbs, 10-20 on pelvic. Asses circ. Q15m then Q1-2hrs Skeletal: thomas splint, halo. 15-25lbs. Balanced, must maintain alignment |
| Complications of traction | pin site infection, CMS/peroneal nerve damage, joint stiffness, |
| what is ORIF | open reduction with internal fixation, |
| Prophylactic antibiotics before surgery is best when given how soon before? | 60 min. prior to incision |
| what are some complications of total hip replacement surgery | dislocation, wound drainage, thromboembolism, infecftion, heel |
| what should the nurse do to prevent dislocation of hip | positoin leg in abduction with wedge pillow, never flex over 90 degrees, head of bed 60 or less, avoid internal/ext rotation, hyperextension |
| with post surgery, what are some major risks? | with post surgery, what are some major risks? |
| Temp elevations within 48 hours after surgery can indicate waht? | atelectasis/resp problems |
| Temp changes in next few days indicates what? In 4-6 days? | urinary tract infections Superficial wound infection |
| A contusion is the same thing as | ecchymosis, bruising |
| Tx of strain, sprain, contusion | Rest ice- first 24-48 hrs, then heat compression elevation |
| what is a dislocation | articular surfaces of distal/proximal bones not aligned |
| Subluxation | partial dislocation |
| what can happen if dislocation or subluxation not reduced immediately | avascular necrosis |
| what is epicondylitis also known as | tennis elbow, excessive repetitive extension, flexion, pronation, supination |
| what do menisci do and how to best diagnose it | act as shock absorbers in knee, MRI |
| What is injured if you cannot plantar flex foot | achilles tendon |
| what is a fracture | complete, incomplete disruption in continuity of bone structure. |
| what are types of fractures | complete- break across entire bone incomplete-thru part(greenstick) comminuted- several bone fragments closed- simple, not break skin open- break skin, compound |
| what are signs of a fracture | acute pain, loss of fx, deformity, shorteningo fextremity, crepitus, edema, ecchymosis |
| More types of fractures | avulsion- muscle pull bone off compression depressed- fragments driven in epiphyseal greenstick- one side broke, other bent impacted- bone driven into bone oblique- angle pathologic- diseased bone spiral, stress, transverse |
| what does it mean to have fracture reduction | restoration of fracture fragments to anatomic alignment and positioning. |
| Two types of reduction | closed- thru manipulation/manual traction open- int/external fixation |
| what is always used to determine proper reduction | xrays |
| how long does a fracture typically take | 6 - 8 weeks |
| what is goal with open fractures | prevent infection. Primary wound closure is usually delayed |
| which fracture heal more quickly, the shaft area of long bones or the ends of long bones | The ends becuase more vascular adn cancellous. Weight bearing stimulates healing |
| what is a fat emboli | can develop after fracture of long bone or pelvic bones. Usually in males over 40. Sx: petechiae, hypoxia, tachypnea, tachycardia, pyrexia, confusion, irritability. TX: maintain fluid/electrolyte balance, O2 |
| what is compartment syndrome | perfusion pressure falls below tissue pressure in compartment. Decr of blood to distal area of injury. Pain w/ passive ROM Tx: elevate at heart level, bivalve |
| what are sensory deficits when assessing neurovascular fx after a fracture | deep, throbbing, escalating pain, paresthesia, hypothesia(diminished sensation) |
| Peripheral circulation is assesed by looking for | cool skin, pale color, slow capillary refill time, edema, slow pulse(tested with Wick catheter) |
| After a fracture neurovascular assessment consists of the "5 P's" | pain, paralysis, paresthesia, pallor, pulselessness |
| Pts with fractures of lower extremeties are at high risk for | venous thromboemboli DIC- disseminated intravascular coagulation- hemorrhaging systemically and signs are unexpected bleeding after surgery, puncture sites, gastro/intest tract |
| what is delayed/mal/nonunion | delayed: healing doesn't occur in expected time for fracture mal: ends of fractured bone don't unite in normal alignment non: ends of bone don't unite |
| when repairing nonunions, what kind of bone will doctors use | cortical bone for structural strength cancellous bone for osteogenesis corticocancellous for strength and rapid incorporation |
| what three things can a doctor do to treat nonunion | bone graft, internal fixation, electrical bone stimulation |
| what is CRPS- complex regional pain syndrome | painful sympathetic nervous system problem in upper extremities in women. Sx: burning pain, edema, stiffness, discoloration, glossy skin, incr hair/ |
| what is heterotopic ossification | abnormal formation of bone, near bones or in muscle due to trauma |
| what fracture is seen more in older women | fractures of proximal humerous through neck of humerous and impacted fractures of neck Tx: pendulum excercises |
| With an elbow fracture, what is most common complication | Volkmann's contracture usually displaced fractures treated wtih ORIF open reduction internal fixation |
| With radial and ulnar shafts what is particularly important for nondisplaced fractures | immobiliztion including pronation/supination. Long arm cast. |
| what is a fracture of the wrist called | Colles fracture |
| what does the pelvis consist of | sacrum, ilium, pubis, ischium |
| what is possible complication with the bowels in pelvic fractures | paralytic ileus |
| what are two types of hip fracture | intracapsular fractrues- neck of femur Extracapsular - trochanteric region(b/n neck and lesser) |
| With hip fractures, what is nurses key job in positioning pt | keep pillow b/n legs to maintain abduction and alignment. Turn by "log roll" |
| What are techniques to avoid DVT's | fluids, ankle/foot exercises, anti-embolism stockings(remove 20 min 2xday), pneumatic compression devices, anticoagulant therapy, assess legs Q 2-4 hrs(calf tenderness, redness, warmth, swelling) |
| What are preventions for pulmonary complications(atelectasis, pneumonia) | coughing, deep breathing, change position Q2h, incentive spirometer, assess breath sounds Q2-4h |
| Elevated temperature in early postoperative period can indicate what | atelectasis or pneumonia |
| Where is amputation usually performed | at most distal point that will heal successfully. Determined by circulation in part and functionality |
| What is a Syme amputation | at most distal point that will heal successfully. Determined by circulation in part and functionality |
| What is BKA, AKA | Below Knee Amputation, Above Knee Amputation |
| what is a staged amputation | used when gangrene and infection exist |
| what should nurse do if cast or elastic dressing comes off limb | immediately wrap limb with elastic compression bandage to prevent excessive edema |
Created by:
lgultom1
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