M/S Flashcards
(185 cards)
1
Q
The human skeleton has ____ bones.
A
206
2
Q
What do bones provide?
A
structure, support for soft tissue, protect vital organs, movement
3
Q
What minerals are stored in the bones?
A
calcium and phosphorus
4
Q
What production happens in the bones?
A
blood production (hematopoiesis)
5
Q
What are bones covered with that contain blood vessels and nerves?
A
periosteum (double layer of connective tissue)
6
Q
What kind of bone is smooth, dense bone that forms shaft of long bones and outside layer of other bones?
A
compact bone
7
Q
What kind of bone is contained within bone spaces that is light weight?
A
spongy bone
8
Q
What does red bone marrow make?
A
blood cells and hemoglobin
9
Q
Where is red bone marrow found?
A
flat bones of sternum, ribs, and ilium
10
Q
What does yellow bone marrow consist of?
A
fat and connective tissue
11
Q
Where is yellow bone marrow found?
A
shaft of long bones
12
Q
What is needed for bones to be remodeled?
A
weight bearing
13
Q
Area where two or more bones meet
A
articulations
14
Q
What joint is 2 bones joined together, immovable?
A
synarthrosis
15
Q
What joint is slightly movable?
A
amphiarthrosis
16
Q
What joint is freely movable?
A
diarthrosis or synovial
17
Q
What joint requires the most pain relief?
A
diarthrosis/synovial joints
18
Q
Inflammation of synovial joint may indicate need for synovial fluid sample. The procedure is called _____
A
arthrocentesis
19
Q
Synovial joints are found where?
A
at all limb articulations
20
Q
The surface of synovial joints are covered with ____
A
cartilage
21
Q
The joint cavity of synovial joints are covered with _____ filled with _____
A
synovial capsule and synovial fluid
22
Q
Connect bone to bone
A
ligaments
23
Q
Connect bone to muscles
A
tendons
24
Q
___ muscles allow for voluntary movement
A
skeletal
25
___ and ___muscles allow for involuntary movement
smooth and cardiac
26
Musculoskeletal changes can be due to what 3 things, and can they be avoided?
aging process (unavoidable), decreased activity (avoidable), lifestyle factors (avoidable)
27
Loss of bone mass is called _____
osteoporosis
28
Who is at higher risk for osteoporosis?
older asian and caucasian women
29
Why does osteoporosis occur in women?
menopause and lack of estrogen
30
Keeping active prevents ____ and maintains ____
prevents bone loss and maintains muscle strength
31
Osteoporosis poses a higher risk for _____
fracture
32
Joint and disk cartilage dehydrates causing loss of flexibility and contributes to which degenerative joint disease?
osteoarthritis
33
Osteoarthritis causes what?
joints to stiffen and lose range of motion
34
When joint and disk cartilage dehydrate, this can cause a loss of height (1.5-2in), a stooped posture called _____
kyphosis
35
Kyphosis is a stooped posture which changes the center of gravity (hips and knees flex) creating a higher risk for ____
falling
36
What 5 things to include in the verbal assessment?
1. health history
2. chief complaint
3. onset of problem
4. effect on ADLs
5. precipitating events
37
What 5 things to include in the physical examination?
1. posture
2. gait
3. ability to ambulate with/without assistive devices
4. ability to feed, toilet, and dress self
5. muscle mass and symmetry
38
What 2 things are signs of a fractured hip?
shortened and internal rotation
39
Never attempt to move a joint past ______ or ______
normal ROM or past point where patient experiences pain
40
_____ test is performed when hip flexion contracture is suspected (usually done by physician)
Thomas
41
What forms bone?
osteoBlasts (Builders)
42
What reabsorbs bone?
osteoCLasts (CLeaners)
43
What cell is responsible for mineral deposit in bones?
osteocytes
44
What are 8 diagnostic tests?
1. blood tests
2. arthrocentesis
3. x-ray
4. bone density scan
5. CT scan
6. MRI
7. ultrasound
8. bone scan
45
____ occurs when tissues are subjected to more force than they are able to absorb
trauma
46
The severity of trauma depends on what two things?
the amount of force and the location of the impact
47
_____ bones cannot with stand force as well because they do not absorb as much energy
smaller
48
Musculoskeletal trauma ranges from ____ to ____
mild to severe
49
When soft tissue is damaged, it can lead to what?
bruise/contusion
50
Fractures can be severe enough to affect the function of ____, ____, and ____
muscles, tendons, and ligaments
51
True or False: musculoskeletal trauma can be so severe that is results in complete amputation
true
52
How can older adults maintain muscle strength?
by moving and exercising
53
In older clients what is the HIGHEST RISK for musculoskeletal trauma?
falls (which can lead to a deterioration of health)
54
What are 5 things that should be included in HOME SAFETY?
1. lighting
2. handrails
3. throw rugs (bad)
4. bath mats and grab bars
5. shoes w/ good tread
55
What is the term used for significant bleeding into tissues causing build up/pooling of blood?
hematoma
56
What is the term used for the breakage of small vessels that leads to bleeding into soft tissues; causing swelling and discoloration?
contusion/bruise
57
What are the 6 neurovascular assessments?
pain, pulses, sensation, skin color, temperature, movement (and cap refill)
58
True or False: strains and sprains are NOT usually associated with soft tissue trauma
false. Strains and sprains are usually associated with soft tissue trauma
59
What is injured with a SPRAIN?
ligaments
60
What is injured with a STRAIN?
muscles and Tendons (sTrain)
61
True or False: Nurses usually grade sprains
false. Nurses do NOT usually grade sprains
62
Grade III (highest grade of sprain) means that what happened to the ligament?
complete tear of the ligament (leading to instability)
Grade I (overstretch)
Grade II (partial tear)
63
What is a microscopic tear in a muscle or tendon?
strain
64
Which field of work is at high risk for strains?
healthcare workers (usually due to unplanned movements)
65
How is soft tissue trauma diagnosed?
xray to rule out fracture (if pain continues an MRI is ordered because it is more in-depth than a CT)
66
What are the 5 assessments for soft tissue trauma?
1. mechanism of injury
2. protective devices
3. pain assessment
4. inspection for redness, swelling, and deformity
5. ROM
67
Soft tissue trauma can be serious, what are the nursing teachings to provide the patient?
1. promote comfort (RICE)
2. prevent further injury
3. allow healing (adequate resting time)
68
How to control pain with a soft tissue injury?
RICE, heat (after several days), NSAIDs
69
Impaired physical mobility can be a risk for what?
skin breakdown
70
True or False: fractures place the patient at risk for complications
true
71
Can severe muscle contractions lead to fractures?
yes
72
The nursing focus for a patient with a fracture should be what?
-assessing
-promoting comfort
-preventing complications
-re-enforce teaching
73
Closed/simple fractures...
skin remains intact
74
open/compound fractures...
bone protrudes through skin (would want to prevent infection)
75
Complete or incomplete fractures...
entire or partial
76
Stable or unstable fractures...
non-displaced or displaced
77
A spiral or greenstick fracture line can indicate what?
abuse (report to charge nurse)
78
Fracture healing is affected by what two things?
age (elderly = longer recovery) and overall condition (malnutrition may lengthen recovery)
79
A local inflammatory response to a fracture does what?
fights infection and starts healing process
80
How long does it *typically* take for a bone to heal?
6-8 wks (12-16 wks for fractured hip)
81
When does fracture healing begin?
within 48hrs
82
Signs of hypovolemic (low blood volume) shock?
LOC (progressively worsens)
feeling cold (moves blood to vital organs)
pale
bp drops
hr increases
83
Excess pressure that restricts blood vessels and nerves within a compartment
compartment syndrome (fascia does not stretch with swelling, which puts pressure on nerves and blood vessels) *will have neurovascular changes*
84
What are the 6 P's in compartment syndrome?
-pain
-pallor (pale)
-paresthesias (numbness/tingling)
-paresis (weakness)/paralysis
-pulselessness
-poikilothermia (low core body temp)
85
Fracture complications that can delay healing
-delayed fracture reduction
-inadequate immobilization
-infection
-age
86
Surgical reduction is called what?
open reduction (stabilized with hardware)
87
Reduction without surgery is called what?
closed/manual reduction
88
What is the goal when a patient has a fracture?
reduce (restore alignment) and immobilize
89
The way to get a definitive fracture diagnosis is to do what?
xray
90
When a limb is immobilized/splinted ______ ____ should be ongoing
neurovascular checks (should be the same or improved, but never worse)
91
Rigid device to immobilize bones and promote healing
cast
92
How long does it take for a plaster cast to dry?
48hrs
93
Hoe long does it take for a fiberglass cast to dry?
1-2hrs
94
What is the process called when splitting a cast to allow for expansion?
bivalving a cast
95
When a cast is removed what is the patient at risk for?
skin break down
96
What is used to maintain alignment by using weights?
traction
97
Surgery can be used to align and stabilize fractured bones. What is it called when pins are placed through the bone, but the stabilizers are outside the body?
external fixation
98
Surgery can be used to align and stabilize fractured bones. What is it called when there is an open reduction and pins, plates, and screws are used PERMANENTLY?
internal fixation
99
What does ORIF stand for?
open reduction, internal fixation
100
It is important to become mobile when it is ordered because it helps do what?
-increase circulation
-decreases risk of complications
101
Older adults suffer from what kind of fracture?
hip
102
Separation of contact between two bones of a joint
dislocation
103
Partial separation of contact between two bones of a joint
subluxation
104
True or False: Both dislocation and subluxation can lead to neurovascular problems
true (important to reduce and assess neurovascular)
105
How are dislocations are usually reduced?
manual traction (closed reduction) *could require surgery*
106
Once a dislocation is reduced, what will the patient need to comply with?
immobilization
107
Partial or total removal of a body part
amputation
108
Amputation can be caused by what two things?
-traumatic injury
-chronic illness (diabetes, peripheral vascular disease, and cancer) *used to treat cancer*
109
Who is at a higher risk for a traumatic amputation?
men
110
What is the most common amputation site?
lower extremity
111
True or False: A limb CANNOT be reattached after a traumatic amputation
false. If there is not too much nerve/tissue damage and if acted quickly (4hr time limit) the limb could be reattached
112
Death of body tissue due to lack of blood or an untreated infection
gangrene (can lead to amputation)
113
True or False: Joints are preserved *when possible* in amputation for easier mobility after procedure
true
114
Open wound at the end of stump (after amputation procedure) and why
guillotine (to let bacteria out (drain), when infection is present) *wound is closed when infection is cleared*
115
Skin is formed to cover end of wound in an amputation procedure
closed (flap)
116
What are the 4 amputation complications?
1. infection
2. delayed healing
3. contractures
4. phantom pain
117
True or false: There can be significant physical and psychosocial effects to an amputee and their family
true. Adaptation takes time and effort
118
What is the nurses role when caring for a new amputee?
relieve pain, promote healing, and prevent complications
119
What is the main goal for an amputee?
to gain independence
120
What is DDH?
developmental dysplasia of the hip (congenital defect)
121
DDH reflects what 3 varieties of hip abnormalities?
-shallow acetabulum
-subluxation
-dislocations
122
Mildest form of DDH; osseous hypoplasia of acetabular roof, femoral head remains in the acetabulum
acetabular dysplasia (preluxation)
123
Partial dislocation
subluxation
124
Most serious DDH when femoral head loses contact with acetabulum
dislocation
125
True or false: It is important to be diagnosed with DDH at birth (early intervention) so that the hip can be reduced and immobilized
true
126
When a newborn is diagnosed with DDH what immobilizer are they put in?
Pavlik harness
127
How to tell if an infant has DDH?
-shortened limb on affected side
-restricted abduction of hip on affected side
-unequal gluteal folds (when prone)
128
Test that moves hip up and out
Ortolani (reduce)
129
Test that moves hip down and in
Barlow (dislocate)
130
Are hips immobilized in adduction or abduction?
abduction
131
Foot turns inward (letter J)
talipes varus
132
Foot turns out (letter L)
talipes valgus
133
Plantar flexion with toes lower than heel
talipes equinus
134
Dorsiflexion with toes higher than the heel
talipes calcaneus
135
What intervention usually works with congenital clubfoot?
serial casting (casts in infants need to be changed around every 2-4 wks)
136
Head tilt caused by rotation of cervical spine
torticollis (stretching exercises and occasionally caused by visual impairment)
137
Complex spinal deformity in three planes, may be congenital or develop during childhood
scoliosis (more common in girls)
138
Treatment for scoliosis includes _____, _____, and/or _____
bracing, exercise (PT), surgery (stabilizing rods)
139
What is a TLSO?
a brace for scoliosis to limit movement
140
Progressive degeneration of muscle fibers, increasing disability and deformity with loss of strength
muscular dystrophies
141
Must use upper extremities to stand up straight with MD
Gower's sign
142
The most severe form of MD, also called pseudohypertrophic muscular dystrophy
Duchenne Muscular Dystrophy (DMD)
143
DMD affects mostly males or females?
almost affects males exclusively because it is x-linked
144
Serum ___ and ____ levels are high in the first 2yrs of life, before onset of weakness; levels diminish as muscle deterioration continues
CPK and AST
145
What 3 things to confirm DMD?
-EMG
-muscle biopsy
-serum enzyme measurement
146
Curvature in the lumbar of the back
lordosis
147
"Hunchback"
kyphosis
148
Waddling gait, frequent falls, and Gower's sign
DMD
149
There is no effective treatment of which congenital disorder?
DMD
150
What is the primary goal with a patient that has DMD?
maintain function in unaffected muscles as long as possible
151
What are some therapeutic treatments for DMD?
-ROM
-bracing
-performance of ADLs
-surgical release of contractures prn
152
What are some nursing considerations of DMD?
-help patient and family cope
-teach child self help skills (be independent as long as possible)
-appropriate health care assistance as child's needs intensify (home health, skilled facility, respite care for family)
153
Severe form of clubfoot, present with other abnormalities, and is resistant to standard treatment
tetralogic/syndromic
154
Clubfoot that may correct spontaneously or require passive exercise or serial casting
postural/mild
155
Clubfoot when no other abnormalities are present and responds well to treatment
congenital/idiopathic
156
pain in a joint
arthralgia
157
Medical term for bunion
Hallux valgus
158
Enlargement and lateral displacement of the great toe
bunion/hallux valgus
159
Are bunions more prevalent in males or females?
females (shoes)
160
How are bunions fixed?
surgery
161
Flexion of the proximal interphalangeal joint with hyperextension of the MTP and distal interphalangeal joints (inability to straighten toe)
hammertoe
162
caused by pressure/friction; thickened skin on top/side of toe (usually from shoe that does not fit properly)
corn
163
caused by pressure/friction; large thick patch of skin from overuse
callus
164
Sprain of the big toe joint (MTP joint)
turf toe
165
Inadequate mineralization of bone due to insufficient amounts of calcium or phosphate in ADULTS
osteomalacia
166
Osteomalacia, but in children
Rickets
167
How is osteomalacia treated?
give Calcitriol
168
Umbrella term that describes diseases that affect joints, tendons, ligaments, muscles, and bones
rheumatism
169
inflammation of a join, can be local or systemic
arthritis
170
Degenerative joint disease with progressive loss of joint cartilage; most common form of arthritis
osteoarthritis
171
Leading cause of disability in older adults and occurs in synovial joints
osteoarthritis
172
What are the 6 risk factors for osteoarthritis?
1. age
2. repetitive joint use/trauma
3. heredity
4. obesity
5. congenital and acquired defects
6. immobility
173
Is osteoarthritis localized or systemic?
localized
174
Reconstruction or replacement of the joint (total joint replacement)
arthroplasty
175
Complications that come from arthroplastys
-infection
-impaired circulation
-thromboembolism (blood clot, DVT)
176
Chronic systemic autoimmune disease that causes an inflammatory disorder of the joints (affects women more than men)
rheumatoid arthritis
177
Patients may experience what 3 things with rheumatoid arthritis?
1. joint swelling
2. warmth of joint (does not occur with osteoarthritis)
3. tenderness
178
What is an ESR?
erythrocyte sedimentation rate: nonspecific test for inflammation 10-20 is normal
179
Surgical immobilization of a joint by fusion of the adjacent bones
arthrodesis
180
A metabolic disorder that leads to an accumulation of urate crystals in joints
gout
181
normal uric acid lvl scale
3.5-8
182
what is the treatment for gout?
-reduce uric acid lvls
-diet and exercise
-stay away from foods with purines (organ meats, alcohol, some seafood and shellfish, drinks w/ high fructose corn syrup)
183
Uric acid crystals can deposit where and cause what?
kidneys and cause kidney failure
184
What med is avoided with gout?
aspirin because it can increase uric acid lvls
185
What meds decrease uric acid lvls?
-colchicine
-allopurinol
-probenecid
