Adult - Musculoskeletal Flashcards Preview

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Flashcards in Adult - Musculoskeletal Deck (38):
1

connecting bone to bone

ligament

2

connecting muscle to bone

tendon

3

dense connective tissue with no blood supply

cartilage

4

contusion

bruise

5

hematoma

bruise you can feel

6

strain has to do with -

muscle and associated tendon

7

sprain has to do with -

joint

8

Non-pharm management for acute musculoskeletal injury

RICE
rest - ice - compression - elevation

9

Pharm management of acute musculoskeletal injury

3 to 4 rule -
3 to 4 ibuprofen
3 to 4 times a day
3 to 4 days

10

What lab should be checked before high dose NSAID?

BUN and especially creatinine

11

celecoxib (Celebrex)
class?
caution?

COX-2
not used much
cousin Vioxx caused valve problems

12

What is naproxen typically used for?

more chronic pain

13

metaxalone (Skelaxin)
class?

muscle relaxant

14

Ultram
what is generic?
class?

tramadol

narcotic

15

Vicodin / Lortab / Lorcet
what is generic?
class?

hydrocodone + acetaminophen

narcotic

16

Tylenol #3
what is generic?
class?

acetaminophen + codeine

narcotic

17

Percocet / Tylox
what is generic?
class?

acetaminophen + oxycodone

narcotic

18

Typical meniscal tear presentation?

"locking"
immediate and significant swelling after injury (grapefruit within 30 minutes)

19

McMurray's test

patient recumbent, audible/palpable click when, with foot externally rotated, knee is flexed and then extended with one hand on the joint line

+ for medial meniscal tear

MMM - mcmurray - medial meniscal

20

Lachman's test

otherwise known as drawer test

knee at 20-30` put anterior force to proximal tibia

graded 1+ to 3+

assessing anterior and posterior cruciate ligament (ACL-PCL)

LL - lachman - ligament

21

Apley's grind test

patient PRONE
knee 90` rotate lower leg internally and externally

pain or click = + for medial or lateral collateral ligament
damage and/or meniscal injury

22

Which type of arthritis can be assessed with bloodwork?

rheumatoid

23

Diagnostics for knee pain -

bloodwork only if RA is suspected
Xray to evaluate joint
MRI only if really needed and after Xray

24

Ankle sprain involves what type of structure?

ligaments - stretched, partially torn, or completely ruptured

25

How are ankle sprains classified?

Grade 1 - 2 - 3

26

What level of mobility impairment is present with each of the grades of ankle sprain?

grade 1 - no impairment
grade 2 - difficulty walking
grade 3 - impossible to ambulate

27

Diagnostics for ankle sprain

consider X-ray to rule out fracture
MRI if unresolved in a few days and after X-ray

28

What is a common cause of muscle strain?

repetitive movement resulting in inflammation

29

Signs and symptoms of muscle strain

pain during ROM
edema
ecchymosis

30

Definition of bursitis

inflammation of the small fluid filled cushion in a joint

31

Olecranon bursitis affects the --

elbow

32

Subdeltoid/subacromial bursitis affects the --

shoulder

33

Ischial bursitis affects the --

ischial tuberosity at the base of the pelvis

34

Prepatellar bursitis affects the --

front of the knee cap

35

What is the characteristic pain found with bursitis?

pain with MOVEMENT

36

What diagnostics are considered if infection is a concern with bursitis?

o aspiration - with gram stain and C & S
o WBC

37

What is the management of bursitis?

o splinting
o RICE
o heat x 30 min TID
o NSAIDS
o steroid injection

38

What is the total number of steroid injections, for all sites total, that a patient should have? Why?

3 total per year

o can break down joint surface
o can trigger Addisonian crisis