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Med Surg Test #3


Periosteum composed of fibrous connective tissue that covers the bone
Crepitus crackling sound or grating sensation as a result of friction or broken bone or cartilage bits in joint
Dislocation severe injury of the ligamentous structures that surround a joint resulting in complete displacement or speration of the articular surfaces of the joint
Sublaxation partial or incomplete displacement of the joint surface. Clinical manifestations are similar to dislocation but less severe
Dislocation Clinical Manifestations overwhelming force to the joint disrupting surrouding tissue w/asymmetry of the musculoskelatal contour
Carpal tunnel syndrome caused by compression of the median nerve beneath the transverse carpal ligament within the narrow confines of the carpal tunnel located in the wrist. Postive Phalen's sign and postive Tinel's sign
CTS Occupational considersation Syndrome is associated w/occupations that require contiuous wrist movement (e.g. butchers, dentists, seamstress, machine operator, musician, hair stlist, secretaries, painters, carpenters, computer operator, bowlers, knitters, guitarist
RSI (Repettitive Strain Injury) cumlative trauma disorder resulting from prolonged, forceful, or awkward movement. Repeated movements strain tendons, ligaments, and muscles, causing tears than inflame. w/o tx affected areas can deteriorate, hypersensitive, painful
RTI Treatment Identifying precipitating activity, modification of equipment or activity, pain management including heat/cold application, NSAIDs, rest, PT for strengthening exersices, and lifestyle changes.
Rotator cuff injury The ratator cuff is a complex of four muscles in the shoulder that act to stabilize the humeral head in the glenoid fossa while assisting w/ROM of the shoulder joint and rotation of the humerous.
Rotator cuff injury Treatment Tx emphasizes maintaining passive ROM and the return of abduction strength. The pt. may tx w/rest, ice, heat, NSAISs, periodic corticosteroid inj. into joint, and PT. Nonresponsive to tx may require surgical repair (Arthroscope - acromioplasty
Bursitis Inflammation of the bursa (sacs in synovial membrane b/t tendons/bones) result from repeated/excessive traums or friction, gout, RA, or infection.
Bursitis Signs and Symptoms warmth, pain, swelling, and limited ROM in the affected part. Sites as which bursitis occur include hand, knee, greater trchanter of hip, shoulder, and elbow. Rest is the only Tx needed.
Ambulatory AIds (blank)
Compartment Syndrome condition in which elevated intracompartmental pressure within a confined myofascial compartment compromises the neurovascular function of the tissues with that space.
Compartment Syndrome Manifestations Ischemia can occur w/4-12 hours. Regular neruovascular checks...Six P's (paraesthesia, pain, pressure, pallor, paralysis, and pulselessness.) Urine output (myoglobin), dark reddish/brown urine
Compartment Syndrome Nsg-NI DO NOT-elevate or ice- remove or loosen the bandage and bivalve the cast.
Venous Thrombosis The veins of the lower extremites and pelvis are highly susceptible to thrombus formation after fracture. Venous stasis is aggravated by inactivity.
Fat embolism (FES) presence of fat globules in tissues and organs after a traumatic skeletal injury. Most common fracture sites : long bones, ribs, tibia, and pelvis. Large fat globules lodge in the lungs.
Fat embolism Symptoms occur 24-48 hours after injury. ARDS-chest pain, tachypnea, cyanosis,dyspnea, apprehention, tachycardia, and dereased partial pressure of arterial oxygen (PaCO2) All these s/s cause poor oxygen exchange. Change in LOC, and petechiae
Compound fracture (Open fracture) involves communication of the fracture through the skin with the external environment
Greenstick fracture incomplete fracture with one side splintered and the other side bent
Fragmented fracture (blank)
Displaced fracture (overriding) involves a displaced fracutre fragment that is overriding the other bone fragment. The periosteum is disrupted on both sides.
Communited fracture fracture with more than two fragments. The smaller fragmentss appear to be floating
Impacted fracture comminuted fracture in which two or more fragments are driven into each other
Stress fracture occurs in normal or abnormal bone that is subject to repeated stress, such as jogging or running
Pathologic fracture spontaeous fracture at the site of a bone disease
Avulsion fracture fracture of bone resulting from the strong pulling effect of tendons or ligaments at the bone attatchment
Crepitation signifance Crepitation may increase change for nonunin if bone ends are allowed to move excessively
Heperin This drug is given to patients as a preventive measure against deep vein thrombosus and Pulmary Embolism
olles' fracture fracture of the distal radious. Most often occurs with outstretched hand to break a fall. THe elbow must be immobilized to prevent wrist movement. Complications are vascular deficiency d/t edema
Femoral Shaft fracture common injury young adults. severe direct force is exerted and often damage to the adjacent soft tissue structures. Marked deformity and angulatgion, shortening of the extremity, inability to move either hip or knee and pain result. Concerns-fat embolism
ORIF Open reduction with internal fixation
Hip fracture referes to the proximal third of the femur,
Hip fracture (intracapsular-formal neck)) hip joint capsule and usually repaired with endoprsthesis to replace femoral head. Buck traction to affected extremity
Hip fracture ((extracapsular-outside hip joint) usually caused by severe direct trauma. repaired using fixed nail plates, intrmedullary devices, prothesis Bucks traction to afftect affected extremity
Pelvis fracture Often oversight in trauma injuries, Can cause serious intraabdominal injury. Pt. often survive injury to die from sepsis, FES, or DVT
Pelvis fracture (Nsg) Neurovascular of lower extremity. Care in handling or moving th ept. to prevent serious injury from a displaced fragment. Can damage other organs, assess bowel and urnary tract function and distal neurovascular function
Tibial fracture strong force is requried to produce fracture resulting in soft tissue damage, devascularization, and often open fracture. comp. campartment syndrome, FE, bony union and open fracture infection
Stable vertebral fracture vertebral column usualy automobile accident. not likely to cause spinal cord damage. Nsg goal assess spinal cord trauma, VS, B/B function, motor/sensory status of peripheral nerves. Tx support , heat, traction
Maxillofacial fracture truama/segmented motion of maxilla,-primary concern patent airway, ventilation, removal foreign objects/blood. Hemorrhage controlled pressure packing. Assess cranial nerves. treated as if they have a cervial injury
Intermaxillary fixation wiring the jaws, Immobiliztion from 4-6 wks.
Cast care tx following closed reduction, extremity elevation to reduce edema, ROM, development of cast syndrome. peripheral pulse, Keep clean and dry
Bucks Traction Used for condition affecting hip, femur, kee, or back, It is temporary immobilization/stabilization of fracture hips/femoral shaft.
Bryant's Traction Used for fractures of the femur, fractures in small children, and stabilization of hip joint in children 2 yr to 30 lbs.
Russell's Traction Used for fractures of femur or hip. same as Buck's traction
Pelvic belt or girdle used for sciatica, muscle spams (low back) and minor fractures of the lower spine
Pelvic sling traction used for pelbic fractures to provide compression for a seperated pelvic girdle.
Head halter used for soft tissue disorders and degenerative disk disease of the cervical spine. Common for unstable fractures of the spine
Skeletal Traction used for immoblization of fractures and dislocations of the upper arm and shoulder
Lateral Arm Traction used in immobilization of fractures and dislocation of the upper arm and shoulder
Balanced suspension traction used for injury or fracture of the fermoral shaft of the femur, acetablum, hip, tibia or any combination. Traction used half-ring Thomas splint and Pearson attachment
Internal Fixation devices (pins,plates, intramedullary rods and screws) are surgically inserted at the time of realighnment.
Traction pulling force to an injured part. prevent muscle spasm, reduce fracture/dislocation, immobilization, reduced a fracture or dislocation.
Skeletal Traction indicated when forces are expected to exceed 10lb or when used for a long time. Major concern bone infection
Osteolylitis severe infection of the bone, staphylococcus aureus. increased pressure leads to eschemia and vascular compromise of the periosteum. (sequestra) bony fragment breaks away becoming an infected island. WBC have difficulty reaching infection.
Osteomyelitis Manifestations initial infection less than 1 mth. asymptomatic, Acute s/s local and systematic-fever, night sweats, chills, reslessnesss, nausea, and malaise. Local-bone pain w/o releif, swelling, tenderness, and warmth. Later s/s drainage from sinus tract
Osteomylitis Treatment Vigorous and prolonged intravenous (IV) therapy-4-6 wks, Bone culture/bone biopsy, surgical debridement and decompression
Joint Replacement Surgery Infection-(gram+aerobic strep/staphyloccus) leads to pain and loosening of the prostheses. Also DVT.
Acute lower Back Pain cause often hyperflexion(last 4wks or less) gradual onset of pain. 80% of adults r/f low muscle tone, obesity, poor posture, smoking, and stress. Musculoskelatal problems-osteoarthritis,disk degeneration, herniated disk, mechanical strain..etc
Acute lower back pain prevention Role model-proper body mechanics, transfer/turn technique, Diet, exercise, good nutrition, rest, quit smoking.
Created by: theresareed