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109 ch. 66
Assessment of Musculoskeletal Fx
Question | Answer |
---|---|
What fx does the musculoskeletal system provide | protection, framework(support), mobility, produce heat, hematopoiesis, mineral bank (ca/P0), energy storage(adipose) |
What do tendons attach? What do ligaments attach? | Tendons: muscles to bones, limited blood supply(slow healing),Achilles Ligaments: bone to bone, elastic,easily torn |
what types of bones are in the body and how many? | 206, long(femur)- wt bearing/mvmt short(metacarpalsm sliding)- cancellous covered by compact flat(sternum, pelvis, cranium)- hematopoiesis, protect vital organs irregular(vertebrae, scapula, mandible) |
what is cancellous bone? | trabecular, lattice-like, less strength ends on long bones- epiphyses filled with bone marrow in irregular bones |
what is cortical bone? | compact, organized, shafts of long bones- diaphysis |
what is the epiphysis | separated by epiphyseal plate, growth plate. Calcified in adults |
Structure of the bone | epiphysis, diaphysis, medullary cavity(bone marrow), articular cartilage(cover ends of long bones), periosteum, endosteum, epiphyseal plate |
What is periosteum | nourishes/ facilitates growth and is flooded with blood cells, dense, fibrous membrane. Provides attachment of tendons and ligaments. |
what is endosteum | covers bone marrow cavity of long bones and spaces in cancellous bone. Osteoclasts are near endosteum |
what is bone marrow | vascular tissue in medullary of long and flat bones |
What are the two types of bone marrow | red- hematopoiesis in sternum, ilium, vertebrae, ribs yellow - has fat in adult located in femur, humerus, ulna, radius, tibia, fibia(long bones) |
what is hematopoiesis? | produce RBC, WBC, platelets |
how is blood carried to compact bone? | thru Volkmann's canals and periostal vessels |
During osteogenesis, what term is used in bone growth for adults and children | adults- remodeling- maintains bone structure and fx thru reabsorption child- modeling |
what are three types of bone cells | osteoblasts- secret bone matrix, form bone from mainly CA and P osteocytes- mature bone cells in lacunae(bone matrix units) osteoclasts- dissolve and resorb bone |
what keeps balance of bone formation and resorbtion | physical activity, nutrients(Ca & P), hormones(calcitriol/Vit D, PTH calcitonin, thyroid hormone, cortisol, GH, sex), |
How much Ca is essentially needed | 1000-1200 mg |
what does calcitriol do | absorbs Ca from gastro tract |
What does PTH do with Ca | regulates concentrations of Ca in blood, promote mvmt of Ca from bone |
what does calcitonin do | secreted by thyroid gland in response to elevated Ca, inhibits bone resorbtion, incr bone deposits in bone |
GH and sex hormones do what in relation to Ca | stimulate growth and remodeling and bone formation |
where does bone fracture healing take place | in the bone marrow in three phases |
what are the three phases of healing for bone | phase 1- reactive phase: hematoma 72 hrs from bleeding and granulation forms in clot 3-14 days Phase II: Reparative: callus(procallus)from 3wk to 6mos. Consolidation determined by Xray Phase III: Remodeling: years, bone removed and streamlined |
what are three kinds of joints | synarthorsis: immovable(skull) amphiarthrosis: limited motion(vertebral, symphysis pubis) and joined by cartilage Diarthrosis: freely moveable |
what is the junction of two or more bones | a joint (articulation) |
what are five kinds of diarthrosis joints? | synovial joints: ball/socket, hinge, saddle(thumb), pivot(radium/ulna), gliding(wrist) |
how does the medial meniscus help the knee joint | cartilage that provides shock absorption and lied between joint surfaces in synovial cavity |
what are three types of cartilage | elastin- ear lobes, stretch hyalin- end of nose, ends of articulating bones fibrocartilage- disks b/n vertebrae |
what is the fx of a bursa | sac filled wtih synovial fluid, cushions mvmt of tendons, ligaments, bones; elbow, shoulder, hip, knee |
what is fascia | encase muscle fibers, nerves and blood in compartments, limited stretch, allows sliding of adjacent structures |
what is difference in isometric and isotonic contractions | isometric: length of muscle remains same, force incr(push against a wall) isotonic: muscle shortens, no incr in tension (flex forearm) |
flaccid vs spastic vs atonic hypertrophy/atrophy | flaccid: limp muscle w/o tone spastic: > than normal tone atonic: soft/flabby hypertrophy: enlargment of muscle atrophy: decr size of muscle |
effects of aging on musculoskeletal system | osteopenia leads to osteoporosis loss of bone mass, incr collagen, atrophy, thinning cartilage, week ligaments |
what is difference in bone pain, muscle pain, fracture pain, osteomyelitis(bone infection) pain | bone pain: dull, deep ache, "boring" muscle pain: soreness, cramps fracture pain: sharp/piercing osteomyelitis: incr, sharp, |
paresthesia | burning, tingling, numbness |
kyphosis, lordosis, scoliosis | curvature of spine kyphosis: incr forward of thoracic spine (huncback), elderly w/ osteoporosis lordosis: swayback, in pregnancy scoliosis: lateral curve of spine, idiopathic |
some abnormal gaits | spastic hemiparesis gait (stroke), step-page gait (lower motor neuron disease), shuffling gait (Parkinson's disease) |
the joint system is evaluated by noting | ROM, deformity, stability, nodular formation ( from RA, gout, OA |
what is joint effusion? | swollen with fluid in capsule, incr temp. (knee) |
Assessment of neurovascular status is to asses what? | CMS: circulation, motion, sensation Five P's: pain, pallor, pulselessness, paresthesia, paralysis |
Imaging of bone density is done mainly by what? Imaging of soft tissue is done best with? Arthrography id's what? Electromyography? | DEXA MRI arthrography: tears of joint capsule or ligaments w/ contrast Electromyography: test muscle weakness, pain, disability and nerve problems |
What should the nurse look for before any imaging? | Nurse look for allergies to contrast and special considerations |
Blood lab studies for alkaline phosphatase | alkaline phosphatase: elevated in early fracture healing and bone tumors Ca & P: inverse relationship, |