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Medical Surgical Nursing - Second Sem > Intro to Musculoskeletal Disorders > Flashcards

Intro to Musculoskeletal Disorders Flashcards

1
Q

What are the 6 functions of the skeletal system? (FSPMMS)

A 
Framework - solid structure
Support organs
Protect organs, function safely
Movement
Manufacture blood cells - hematopoiesis
Storage of minerals - calcium, phosphorous
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2
Q

What are the 3 main components of bones?

A

CCM

Cells - osteocytes
CHON matrix - collagen + ground substances
Mineral deposits

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3
Q

What makes up the ground substances?

A

glycoCHON (glycoprotein) and proteoglycans

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4
Q

Ground substances are made by ____. These type of cells are known to be ___

A

Osteoblasts

Bone forming cells

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5
Q

Total body calcium: %

Mineral deposits: %

A

Total body calcium: 98%

Mineral deposits: <2%

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6
Q

What makes up mineral deposits?

A

Phosphorous, magnesium, fluoride

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7
Q

What are the 4 guidelines to Calcium? (IKLA)

A

Intake thru milk and dairy products
Calcium tablets can cause Kidney stones
Lose 1% calcium starting from age 30
Calcium is also an Antacid = dont take w/other meds

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8
Q

How long should a patient on Calcium tablets wait before taking other meds? Why is this necessary?

A

2-4 hrs

To avoid hindering absorption since Ca is also an antacid

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9
Q

How many bones do we have?

A

206

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10
Q

Name the 5 types of bones acc to shape and describe (FLSIS)

A

Flat – hematopoiesis and protect vital organs (skull, sternum)

Long – weight bearing and mobility (arms, legs)

Short – wrist, ankle

Irregular – facial, vertebra

Sesamoid – within tendon (kneecap/patella)

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11
Q

Name the 2 types of bones acc to composition and describe (CC)

A

Cancellous/trabecular/spongy – epiphysis (end) + red marrow

Cortical/compact – diaphysis (mid) + yellow marrow

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12
Q

Red marrow = function + in what bone

Yellow marrow = function + in what bone

A

Red marrow = hematopoiesis (flat and long – epiphysis)

Yellow marrow = fat (long only – diaphysis)

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13
Q

Describe the ff

Medullary cavity
Periosteum
Epiphyseal line

A

Medullary cavity – canal that holds yellow marrow

Periosteum – outer covering of bone, like envelope

Epiphyseal line – closes at 21-22 y/o = wont grow taller

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14
Q

Bone marrow suppression refers to?

A

Red bone marrow

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15
Q

Which marrow do we get medications and transplants from?

A

Yellow bone marrow

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16
Q

What are the 3 bone cells? Describe acc to location and function

A

Osteoblasts – bone forming by secreting CHON matrix, located in periosteum (outer)

Osteoclasts – bone resorption/destroy, located in endosteum (inner)

Osteocytes – mature bone cells for bone maintenance

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17
Q

How do osteoclasts work “from inside out”?

A

Inside: destroy bone

Outside: secrete new bone

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18
Q

Osteoblastic activity = calcium ____

Osteoclastic activity = calcium ____

A

Osteoblastic activity = calcium goes to Bones (B-B)

Osteoclastic activity = calcium goes to Cells/outside (C-C)

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19
Q

What promotes osteoblastic activity?

A

Movement

Intake of Ca rich food

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20
Q

What happens if a px does not eat Ca rich food, is bed bound/ has a cast?

A

This promotes osteoclastic activity = bone gets thinner, weaker, smaller, brittle

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21
Q

Brittle bones are prone to?

A

Fractures

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22
Q 
Differentiate 
Cartilage
Ligament
Tendon
Joint
A

Cartilage – thick flexible connective tissue usually seen in the joints

Ligament – connects bone to bone (LBB)

Tendon – connects muscle to bone (TBM)

Joint – where bones meet

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23
Q

Damage of cartilage can be caused by?

A

Chronic use and abuse (sports players, elderly)

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24
Q

Describe the 7 types of joints (PBEH SGC)

A

Pivot – circular neck mvt

Ball and socket – shoulders and hips

Ellipsoid – wrist 180 deg

Hinge – knee and elbow, like a door

Saddle – thumb, up down and around (more than one axis)

Gliding – ankle

Condyloid – fingers

25
Q

Match the type of joint movement to its example

A. Gliding
B. Inversion & eversion
C. Abduction & adduction
D. Rotation
E. Plantar flexion & dorsiflexion
F. Circumduction
G. Protraction & retraction
H. Extension, flexion, hyperextension
I. Supination & pronation
J. Elevation & depression
K. Opposition
  1. Thumb to fingers
  2. Arms away and towards trunk
  3. Arms stretched and form circle
  4. Face forward and double chin
  5. Flapping of hands
  6. Feet inward and outward
  7. Head to left and right
  8. Palm up and palm down
  9. Tiptoe and babinski sign
  10. Head up, head down, head up beyond 180 deg
  11. Teeth together and teeth apart
A 
1K
2C
3F
4G
5A
6B
7D
8I
9E
10H
11J
26
Q

What is osteogenesis? When does it begin?

A

Osteo: bone

Genesis: begin

Begins inside the womb

27
Q

What occurs during ossification?

A

Bone matrix thickens + mineral deposits harden

28
Q

Differentiate the 2 processes under ossification

A

Endochondral: hyaline cartilage is replaced by bone

Intramembranous: bone forms inside a membrane (skull)

29
Q

Bone maintenance requires a balance between ___ and ___

A

Bone maintenance requires a balance between bone resorption (osteoclastic) and bone formation (osteoblastic)

30
Q

Describe the 6 regulating factors of bone maintenance (SDPCBH)

A

Stress – inc movement = inc calcium to bones = stronger

Vit D – promotes calcium absorption

Parathyroid hormone (PTH) – promotes bone resorption = calcium goes out to fix hypocalcemia (<8mg/dL)

Calcitonin – inhibits bone resorption = calcium goes inside = stronger

Blood supply – affects osteogenesis

Hormones – inc corticosteroid = brittle bones + menopause/andropause = more osteoclastic activity

31
Q

(T/F) Men lose more Ca than women

A

FALSE, women lose more

32
Q

What time is it advisable to expose the skin to the sun for vitamin d?

A

before 9/10 am or after 4/5 pm

33
Q

Where is PTH and Calcitonin produced?

A

PTH: parathyroid gland

Calcitonin: thyroid gland (T3/T4)

34
Q

What drug is used to elevate Calcitonin level? (MCC)

A

Miacalcin (Calcitonin) Nasal Spray – one spray per nares, for elders

Calcitonin-Salmon – refrigerated

Calcijex – activated vitamin D

35
Q

Crepitus is?

A

cracking sound

36
Q

Describe the 3 stages of bone healing (RRR)

A

Reactive – starts bleeding and inflammation immediately = angiogenesis and tissue granulation

Reparative/ossification – granulation tissue is replaced by procallus (thickened cartilage) and lamellar bone

Remodeling – mold new bone into former structure

37
Q

What is angiogenesis

A

Create new small vessels

38
Q

How long does it take for

Procallus to replace granulation tissue

Lamellar bone to form

Remodeling of new bone into former structure

A

Procallus to replace granulation tissue – 3-4 weeks post injury

Lamellar bone to form – months

Remodeling of new bone into former structure – months-years

39
Q

What are the 6 skeletal changes related to

aging (DPK CRA)

A

Decreased density – more bone resorption

Inc bony prominence – decreased skin thickness

Kyphotic – dec density = struggle to support weight = 1-2 dec in height

Cartilage degeneration – causes crepitus

Decreased ROM – slower

Muscle atrophy – dec bone density = dec muscle attached to bone

40
Q

What is the basic unit of muscles? What is it comprised of?

A

Sarcomeres

Actin – thin
Myosin – thick

41
Q

A group of sarcomeres are called?

A

Myofibrils/myofilaments

42
Q

How many muscles and joints do we have?

A

650 muscles

187 joints

43
Q

Purpose of muscles (HMP)

A

Generate heat
Mobility
Postural support

44
Q

Differentiate the 3 types of muscles (SCS) according to

Involuntary/voluntary

Appearance

Attachment

A

Skeletal – voluntary, striated and long, attached to bones

Cardiac – involuntary, has intercalated disc, attached to itself

Smooth – involuntary, circular or long, attached to visceral organs

45
Q

What muscle makes up 40% of body weight?

A

skeletal muscle

46
Q

Differentiate the 2 muscle tones

Flaccid
Spastic

A

Flaccid – no muscular contraction, paralyzed

Spastic – spasms, lots of tension

47
Q

Isometric contraction: muscle ___ = ___ tension

Isotonic contraction: muscle ___ = ___ tension

A

Isometric contraction: muscle lengthens = increase in tension (close fist)

Isotonic contraction: muscle shortens = no tension (flex arm)

48
Q

Isometric contractions lead to increase in? This is done for which pxs?

A

ICP and blood flow

Those in a cast

49
Q

Match the muscle strength rating to its description

A. Up and down, 10 pounds
B. Side to side
C. Place hand over, can feel muscular contraction
D. Put down (no gravity) = yes, put up = need help
E. Up and down, 2-4 pounds
F. No muscular contraction, flaccid

A 
A5 = normal
B2 = poor
C1 = trace
D3 = fair
E4 = good
F0 = zero
50
Q

What are the 3 types of joints according to movability?

A

Immovable – skull

Movable – knee

Partly movable – ribs

51
Q

Give at least 5 things we assess for in pxs with musculo problems

A

PQRST (pain/provoke, quality, radiate/relief, severity, timing)

ADL Functioning

Weakness, paresthesia, neurovascular (compartment)

Past surgeries, injuries

Assistive devices

Diet (purine, calcium)

Weight gain

Meds (calcium, vit d)

Deformity, edema, gait, posture, muscle strength and size, ROM/joint function

52
Q

What are the 5 ADL’s we assess for (GBDEF)

A 
Grooming
Bathing
Dressing
Elimination
Feeding
53
Q

Hand grip should be ___

A

symmetrical

54
Q

Neurovascular assessment is done Q_? Why?

A

Q1 not greater than 4 hrs

> 4 hrs can lead to compartment syndrome and necrosis

55
Q

Procedure done by making an incision to decrease pressure on blood vessels

A

Fasciotomy

56
Q

What are the 4 components of a neurovascular assessment (CMST)

A

Circulation – color, temp, pulse, refill
Motion
Sensation – pain, paresthesia

57
Q

what are the least and most reliable neurovascular tests

A

least: capillary refill
most: transcutaneous oxygen pressure (TcPO2)

58
Q

Match the assessment
Muscle
Joints
Both

  1. Tremors – after 15 mins
  2. ROM – smoothness
  3. Contractures – stiffness
  4. Swelling – crepitus
  5. Tonicity – at rest
  6. Size – symmetry
A 
1M
2B
3M
4J
5M
6M

Medical Surgical Nursing - Second Sem (7 decks)

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