mmusculoskeletal Flashcards
(85 cards)
osteoarthritis
breakdown of articular cartilage leading to damage of bone; osteophytes form in joint space causing narrowing and decreased movement causing progressive degen.
risk factors of osteoarthritis
old age, female, obesity, labor-intensive occupations, sports activities
manifestations of osteoarthritis
pain when moving under stress (relieved by rest), hard & boney, stiff joints, morning stiffness (~30 min), usually impacts weight bearing joints (hips, knees, cervical spine, lumbar spine)
osteoarthritis bony growths
heberden- distal and bouchard- proximal
osteoarthritis assessment
crepitus over joint, mild effusion from inflammation, non-systemic, xray shows decreased joint space and osteophyte formation, subchondral bones may appear thick
osteoarthritis does not appear
bilaterally, it can but it does not have to
osteoarthritis management
decrease pain/stiffness, improve/maintain mobility, exercise t preserve joint, weight loss, OT/PT, orthotics and walking devices, NSAIDs/steroids, severe cases may require arthroplasty
osteoporosis
bone resorption (osteoclast) > bone formation (osteoblast) causing thinning of the bone
osteoporosis can lead to…
compression FX in T and L spine, FX in hips and wrists
osteoporosis risk factors
small frame, female gender, ethnicity, aromatase inhibitor use, nutritional factors, autoimmune diseases, steroid use, immobility, diabetes
onset of osteoporosis age
men around 60-70 and women around 50-60
manifestations of osteoporosis
low bone mineral density on DEXA scan, rounding of upper back (dowagers hump), osteoporotic FX, otherwise asymptomatic
osteoporosis assessment
Xray show radiolucency if significant demineralization (undetectable otherwise), dual energy xray (DEXA) provides bone mineral density of spine and hips
prevention of osteoporosis
balanced diet high in calcium and vit. D, regular weight bearing exercises (20-30 min/day)
weight training stimulates…
bone mineral density
management of osteoporosis
pharmacologic therapy to improve bone density (bisphosphenates or alendronate), hip FX managed with joint replacement, compression FX managed conservatively
osteoporosis nursing interventions
teach pt how to prevent worsening, manage pain, improve bowel elim. to avoid FX, injury prevention
osteomalacia
inadequate mineralization of bone caused by Vit. D deficiency causing soft/weakened bones
causes of osteomalacia
failure to absorb calcium, excessive calcium loss, GI disorders, liver disease, kidney disease, renal insufficiency, hyperparathyroidism, malnutrition
osteomalacia assessment
xray shows general demineralization and can show compression FX; labs show low Ca, low Phos, elevated alkaline phosphatase; bone biopsy show increased osteoid
osteoid
demineralized cartilaginous bone matrix aka pre-bone
why low calcium and low phosphorus in osteomalacia?
d/t bone unable to mineralize
why elevated alkaline phosphatase in osteomalacia?
indicative of increased bone turnover
management of osteomalacia
treat underlying cause if possible, Vit. D and Ca supps, sun exposure, if kidney disease is problem then activated form of vit D prescribed, if dietary is cause then recommend diet change, deformities may require braces