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Nursing 2 > Exam 2 - neuromuscular/musculoskeletal > Flashcards

Exam 2 - neuromuscular/musculoskeletal Flashcards

1
Q

Neural tube defects (3 kinds)

A

spina bidifia occulta
meningocele
myelomeningocele

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2
Q

spina bifida occulta

A

defective vertebrae bodies with NO PROTRUSION

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3
Q

spina bifida occulta has…

A

no protrusion, hair patch, small back dimple, discoloration

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4
Q

spina bifida occulta TX:

A

will close with time; surgical intervention if does not

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5
Q

Meningocele is…

A

little to no neural problem, with small protrusion (meninges herniate through defect in vertebrae)

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6
Q

meningocele TX:

A

surgical intervention

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7
Q

myelomeningocele is…

A

large protrusion that happens in utero; neural tubes fail to close, leaving an external sac that encases the meninges, spinal fluid, and spinal nerves

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8
Q

myelomeningocele TX

A

surgical intervention

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9
Q

myelomeningocele risks

A

seizures
meningitis
hypoxia
hemorrhage
paralysis

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10
Q

myelomeningocele linked to…

A

maternal drug/alcohol use
malnutrition

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11
Q

the spinal cord ends…

A

WHERE THE MYELOMENINGOCELE BEGINS

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12
Q

odd finding for myelomeningocele

A

latex allergy

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13
Q

Pectus excavatum

A

also known as funnel chest; when sternum goes inward; leaves oblong dimple midline

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14
Q

pectus excavatum S/S

A

SOB
withdrawal from physical activities
poor body image

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15
Q

pectus excavatum TX

A

surgical intervention depending on severity (preferably before puberty b/c skeleton is more pliable)

PT to help correct musculoskeletal defect

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16
Q

pectus carinatum

A

sternum goes outward

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17
Q

pectus carinatum S/S

A

decreased exercise tolerance
tachycardia
recurrent respiratory infections
wheezing/coughing
chest pain
fatigue/dizziness

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18
Q

pectus carinatum TX

A

bracing while still young

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19
Q

clubfoot

A

one or both feet; foot twisted out of shape

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20
Q

clubfoot TX

A

series of casts in different phases to correct defect

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21
Q

metatarsus adductus

A

metatarsal bones deviated inward; only affects one foot

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22
Q

metatarsus adductus TX:

A

series of casts in different phases to correct defect

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23
Q

polydactyly

A

extra digits; either center, preaxial, postaxial

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24
Q

preaxial

A

extra digit on thumb side (radial side)

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25
Q

postaxial

A

extra digit on pinky side (ulnar side)

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26
Q

polydactyly TX

A

surgical intervention to have extra digit removed

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27
Q

Syndactyly

A

webbing of the skin, and possible fusion of bones

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28
Q

simple syndactyly

A

joined by skin and soft tissue

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29
Q

complex syndactyly

A

underlying bones joined together

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30
Q

complicated syndactyly

A

extra bones and abnormal tendons and/or ligaments

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31
Q

dysplasia of hips

A

dislocation of the hip joints

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32
Q

dysplasia of the hips TX

A

Pavlik harness

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33
Q

pavlik harness rules

A

NEVER REMOVE UNLESS INSTRUCTED TO DO SO BY PROVIDER
do not apply lotion, otherwise can cause maceration of the skin
supine for sleep
diaper goes under harness

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34
Q

torticollis

A

preferential turning of head and stiffening of neck when laying down

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35
Q

Tibia Vara

A

idiopathic structural defect of the legs

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36
Q

tibia varum

A

bow legged , knees spread apart

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37
Q

tibia valgum

A

knees touched; X shaped legs

38
Q

Osteogenesis Imperfecta

A

bone disorder that results in low bone mass, increased fragility of bones, connective tissue problems

39
Q

Osteogenesis Imperfect S/S

A

BLUE SCLERA
brittle teeth
mutiple fractures
hearing loss
joint hyper mobility

40
Q

Osteogenesis Imperfecta TX

A

surgical intervention to decrease fractures and maintain mobility
splints/braces for breaks
insertion of rods
PT/OT to prevent contractures and maximize mobility

41
Q

Osteogenesis Imperfecta medications

A

biphosphonate (for moderate to severe OI) to slow to loss of existing bone

42
Q

Muscular Dystrophy

A

GENETIC DISORDER: motor neuron disease that affects spinal nerve communication with muscles

43
Q

Muscular Dystrophy complication

A

muscles lose function over time d/t misuse –> atrophy; progressive

44
Q

Duchenne

A

diagnoses early in childhood; fatal, generalizes weakness, muscle wasting, limbs and trunk go first

45
Q

Becker

A

similar to Duchenne but less severe; not fatal
DXed at ages 2-16

46
Q

congenital muscular dystrophy

A

present at birth; generalized muscle weakness, joint deformity. contractures, hypotonia

47
Q

emory dreifuss

A

weakness, wasting of shoulders, upper arms, shins

48
Q

limb girdle

A

DXed teens to middle age; weakness and wasting away of pelvic girdle

49
Q

fascioscapulohumeral

A

DXed late childhood to early teens; facial muscles weaken first, then upper arms

50
Q

Myotonic

A

DXed teens to adulthood
generalized weakness, wasting of the face, feet, neck, hands
delayed relaxation of muscles after contractures

51
Q

Muscular Dystrophy TX

A

administer analgesics for pain management
passive strengthening and stretching exercises
manage elimination
maintain cardiopulm. function (deep breathing and CPT)

52
Q

spinal atrophy

A

motor neurons are affected –> muscles cannot respond to signals from the nerves –> atrophy d/t inactivity

53
Q

Rickets

A

softening and weakening of bones

54
Q

Rickets complications

A

nutritional deficiencies d/t inadequate consumption of calcium and vitamin D, inadequate exposure to sunlight
body cannot regulate calcium and phosphorus in appropriate balance –> chronic renal disease

55
Q

Rickets TX

A

calcium and phosphorus supplements
vitamin D supplements

56
Q

slipped capital femoral epiphysis (SCFE)

A

femoral head dislocated from shaft of femur
if chronic, may lead to shortening of affected leg and atrophy

57
Q

SCFE TX

A

needs early surgical intervention to decrease long term deformity (prevents slippage, minimize deformity, avoid complication of future fractures)

58
Q

legg-calves-perthes disease

A

condition where femoral head temporarily loses blood supply (avascular necrosis) –> femur collapses –> area becomes inflammed

59
Q

legg-calves-perthes S/S

A

limping
pain or stiffness of hip, groin, thigh
limited ROM of hip
pain that worsens with activity and improves with rest

60
Q

legg-calves-perthes TX

A

surgical intervention - femoral ostomy (reorients the femoral head to fit perfectly into hip socket)
should be done at ages 18-24 months

61
Q
A
62
Q

transient synovitis

A

inflammation of hip d/t infection; most common in children ages 3-8

63
Q

transient synovitis S/S

A

limping
refusal to bear weight
low grade fever
previous viral infection

64
Q

transient synovitis TX

A

complete rest (typically lasts for weeks, some 3-6 weeks)
NSAIDS to decrease inflammation

65
Q

Cerebral Palsy

A

disorder of movement, muscle tone
most common disorder in childhood; longlong impairment

66
Q

CP S/S

A

motor impairments
spasticity
muscle weakness,
ataxia (lack of coordination of muscle movements during voluntary muscle movements)
abnormal brain functions (NOT PROGRESSIVE)

67
Q

CP complications

A

mental impairments
seizures
growth problems
impaired vision and hearing
abnormal sensation or perception
hydrocephalus (abnormal buildup of CSP in ventricles of brain)

68
Q

CP pathophysiology

A

damage to motor areas of the rain, resulting in neurologic lesion
lesion cannot change over time
considered nonprogressive since the brain cannot progress

69
Q

types of CP

A

spastic
dyskinetic (athetoid)
ataxic
mixed

70
Q

spastic CP description

A

permanent contractures and hypertonicity
hemiplegia
quadriplegia
di/paraplegia

71
Q

spastic CP TX

A

ORAL: baclofen, cantrolene sodium, diazepam
PARENTERAL: botulinim toxin, phenol block
SX: surgical placement of baclofen pumo, correction of deformities , placement of shunt if hydrocephalus present

72
Q

Dyskinetic CP description

A

abnormal involuntary movements
infant is limp and flaccid
uncontrolled, slow, worn-like writhing or twisting movements
affects all 4 extremities and involvement of head, face, neck
movements increase during periods of stress
dysarthria

73
Q

dyskinetic CP TX

A

anticholinergics (blocks and inhibits activity of acetylcholine <– helps decrease abnormal movements
scopalamine
glycopyrrolate

74
Q

Ataxic CP description

A

affects balance, depth perception
poor coodination
unsteady gait
wide based gait
motor milestones and language skills delayed

75
Q

SCOLIOSIS description

A

lateral curvature of spine that exceeds 10 degrees
congenital, associated with disorder (neuromuscular), or idiopathic

76
Q

idiopathic scoliosis

A

cause unknown

77
Q

neuromuscular scoliosis

A

associated with neurologic or muscular disease like…
CP
myelomeningocele
spinal cord tumors
spinal muscular atrophy
muscular dystrophy

78
Q

congenital scoliosis

A

results from anomalous vertebral development

79
Q

scoliosis pathophysiology

A

involved vertebrae rotate around a vertical axis –> results in lateral curvature and asymmetry of the shoulder and waistline
vertebrae rotate on convex side, spinous process rotates on concave side

80
Q

scoliosis TX

A

braces (boston brace, milwaukee brace, nighttime bending brace)

81
Q

NEUROVASCULAR CHECKS INCLUDE

A

changes in gait
activity level compared to peers
recent trauma
poor feeding
lethargy
fever
weakness
alteration in muscle tone
history of developmental milestone
inspet/observe motor function, reflexes, sensory function
palpate muscle strength and tone
auscultate for adventitious lung sounds

82
Q

scoliosis post op care

A

neurovascular checks
log roll q2 hours
pain management (before repositioning and ambulation)
ABX prophylaxsis
assess drainage
strict I/O
EOM
ambulation done slowly
assess skin for redness, breakdown, inflammation
deep breathing and coughing q2

83
Q

neurogenic bladder is…

A

lack of bladder control d/t brain, spinal cord, nerve problems

84
Q

neurogenic bladder interventions

A

clean intermittent catheterization to promote bladder emptying

85
Q

neurogenic bladder meds

A

ditropan (oxybutin chloride)

86
Q

neuorogenic bladder SX

A

continent urinary reservoir or vesicotomy
(vesicotomy is small opening made in lower abd. just below umbilicus to allow urine to drain from opening)

87
Q

indications of spinal cord damage

A

numbness
tingling
weakless
paralysis (the higher the injury in the spinal cord, the more extensive the damage)

88
Q

HIGH SPINAL CORD INJURY BIG COMPLICATION

A

may damage phrenic nerve (phrenic nerve in the nerve that innervates the diaphragm –> can’t breath without assistance

89
Q

Spinal cord injury DX tests

A

radiograph
MRI
CT

90
Q

spinal cord injury cord TX

A

cervical traction
surgical intervention
ongoing therapeutic rehab post surgery

91
Q

fracture is…

A

broken bone

92
Q
A

Nursing 2 (6 decks)

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