MSK Flashcards

1
Q

osteoblasts

A

form bone, mature and turn into osteocytes

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2
Q

osteocytes

A

maintain bone, respond to parathyroid hormone

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3
Q

osteoclasts

A

break down bone

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4
Q

neurovascular assessment

A

5 P’s - pain, pulse, pallor, paresthesia, paralysis, poikilothermia

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5
Q

antiarthritic drugs

A

NSAIDs, glucocorticoids, disease modifying antirheumatic drugs (DMARDs) such as methotrexate

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6
Q

Methotrexate

A

DMARD, rheumatoid arthritis, slows down destruction of joint by slowing down immune and inflammatory response

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7
Q

Antigout drugs

A

NSAIDs, glucocorticoids, anti uric acid agents (allopurinol)

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8
Q

allopurinol

A

antiuricemic acid, reduce gout, prevents uric acid from forming, avoid foods high in purine (beer, wine, cheese, beans), side effects of leukopenia, fever, rash

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9
Q

drugs for bone health

A

calcium, vitamin D, calcitonin, biphosphonates

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10
Q

calcium and vitamin D help to

A

increase calcium

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11
Q

calcitonin and biphosphonates help
to

A

decrease amount of calcium

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12
Q

alendronate

A

biphosphonate, used for osteoporosis, decreases bone resorption of osteoclasts, remain upright for 30 min after taking and take with full glass of water, side effect of esophagitis

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13
Q

baclofen

A

muscle relaxer, acts within spinal cord to suppress hyperactive reflexes, monitor for CNS depression, do not discontinue abruptly (can cause seizure), need to taper over 1-2 weeks

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14
Q

dislocation

A

complete loss of contact between surfaces of two bones

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15
Q

subluxation

A

partial loss of contact between two bones

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16
Q

sprain

A

ligament tears

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17
Q

avulsion

A

complete separation of tendon or ligament from its attachment

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18
Q

types of fractures

A

open, closed, stress, fatigue, insufficiency, direction (transverse, spiral, green stick, comminuted, oblique)

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19
Q

Traction nursing considerations

A

temperature of extremity, ropes should be hanging freely, alignment, circulation 5 P’s! , tension (should be none on skin), I&Os, overhead trapeze to assist with ROM, no weights on floor (if they are proper alignment will
not occur as there is no weight on extremity)

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20
Q

Bucks traction

A

weight used on extremity (femur or pelvis) to align bone

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21
Q

Halo device

A

used for spinal cord injury to cervical spine, can be mobile while maintaining alignment, pain at pin sites may indicate infection, pin site cleaning done regularly

22
Q

external fixators

A

keep together broken bone, pins inserted through skim to connect to bone, pin sites require frequent cleaning to prevent infection

23
Q

pin site care

A

hand hygiene and assess appearance of pin site, sterile gauze soaked in NS, remove any drainage or pus that has formed, dry with new sterile gauze, cleanse length of pin moving upwards from the site

24
Q

osteoporosis

A

metabolic disease where bones demineralize; loss of calcium and phosphorus lead to fragile bone and increase risk for fractures, may be asymptomatic until bones get to weak or fragile and injury occurs

25
Q

osteoporosis risk factors

A

women, early menopause, smoking, family hx, ETOH excessive use, sedentary lifestyle, thin small frame, older age

26
Q

osteoporosis interventions

A

assess risk for injury and prevent, gentle movement, assist with ambulating, gentle ROM, exercises to strengthen, high calcium and vitamin D, increase iron and protein, avoid alcohol

27
Q

rheumatoid arthritis

A

chronic systemic inflammatory disease, destruction of connective tissue and synovial membrane within joints, weakens joints leading to dislocations and deformity, pannus forms at junction of joint causing necrosis, occurs in flare ups

28
Q

Rheumatoid arthritis specific S&S

A

pain early in morning (more than 30 min), spongy soft boggy feeling joints, redness to joints, joint deformities, elevated ESR and positive rheumatoid factor, xray shows deterioration, synovial fluid shows inflammation

29
Q

rheumatoid arthritis tx

A

NSAIDs, DMARDs, glucocorticoids, heat or cold as prescribed, consistent exercise, avoid weight bearing on inflamed joints, surgery for when affecting ADLs

30
Q

osteoarthritis

A

age related as cartilage in bones decreases and bones become sclerosed leading to bone spurs (osteophytes), most common in hands, knees, hips, spine

31
Q

OA S&S

A

outgrowths, morning stiffness (less than 30 min), tenderness (hard bony tender joints), exacerbated by exercise (pain goes away with rest), only in joints (no autoimmune so labs normal, no inflammation)

32
Q

Herberden’s node

A

bone spur close to fingernail

33
Q

Bouchard’s node

A

bone spur on middle finger joint

34
Q

OA tx

A

low impact exercise, encourage weight loss (if needed, less pressure on joints), corticosteroids, analgesics, NSAIDs

35
Q

Gout

A

body cannot control uric acid production or exertion, it crystallizes and deposits in connective tissues, causes inflammation and destruction of joints, common location is great toe, can cause gouty arthritis

36
Q

gout S&S

A

pain gets worse as day goes on, inflammation, redness, decreased mobility, tophi, high uric acid level

37
Q

tophi

A

large clumps of uric acid crystals and that have accumulated over time, white or yellow, can permanently damage joints

38
Q

gout tx

A

rest, NSAIDs, corticosteroids, allopurinol, low purine diet

39
Q

foods high in purine

A

organ meats, red meats, anchovies, sardines, scallops, alcohol

40
Q

strain

A

tendon tears

41
Q

contractures

A

permanent muscle shortening caused by muscle spasticity

42
Q

foot drop

A

plantar flexi on contractor, prevent with boots and promoting mobility

43
Q

myopathy

A

muscle disorder causing weakness and atrophy, deceased muscle strength and tone, caused by drugs, alcohol abuse, or can be idiopathic

44
Q

rhabdomyolysis

A

damage to muscle (burn, trauma, compartment syndrome), muscle releases contents into blood (myoglobin, creatinine kinase, lots of potassium and phosphorus), these substance are toxic in circulation, major kidney damage as they have to filter these toxins out

45
Q

rhabdomyolysis S&S

A

weak, tired, n/v, bruising, dark cola colored urine

46
Q

rhabdomyolysis tx

A

fluids (flush kidneys), diuretics (decrease swelling, increase UOP, flush out toxins), dialysis (if K to high kidneys unable to clear on own), bed rest, monitor electrolytes and CK

47
Q

compartment syndrome

A

increased pressure within confined space, compromises circulation, distal tissue becomes ischemic, tissue and nerve damage occur

48
Q

compartment syndrome assessment

A

extremely painful, limb feels tight, swelling, numbness, tingling, paralysis, diminished or absent pulses, decreased sensation

49
Q

compartment syndrome tx

A

fasciotomy to relieve pressure

50
Q

avascular necrosis

A

tissue does not get oxygen and dies, can happen in any bone and joint can collapse, permanent damage

51
Q

fat embolism and S&S

A

fat gets released into blood stream and releases into circulation, fatty tissue in bone marrow gets released; hypoxia, dyspnea, tachypnea, confusion, altered LOC, petechial rash (sometimes), associated with long bone and pelvic fractures (symptoms depend on where clot goes)

52
Q

osteomyelitis

A

infection of bone, usually staph, spreads through bone shaft or bone marrow, treatment: abx