Flashcards in Musculoskeletal - #1 - Unit 2 Deck (58):
What affect does Growth Hormone have on bone growth?
It causes bone growth through IGF-1
What affect do the Adrenal Glands (Glucocorticoids) have on bone growth?
They inhibit bone formation. Things like prednisone could eventually cause osteoporosis.
What does the thyroid gland (thyroxine and calcitonin) have to do with bone growth?
Thyroxine - regulates bone turnover and Bone Mineral Density.
Calcitonin - Stops bone resorption. Bone resorption means bone breakdown.
What does Estrogen do to bone growth?
Stimulates bone formation, inhibits PTH. This is good for bone.
PTH - Good or bad for bone growth?
Testosterone - what does it do for bone growth?
Promotes anabolixm, which promotes tissue/bone growth.
If someone comes in with a possible break, and one leg or extremity is shorter...could this be a sign a break did happen?
Groin pain - is this a sing of a break? (Hip)
What is an open fracture?
This is when the bone comes through the surface/skin.
What is a closed fracture?
When the bone doesn't protrude through the skin.
What is a non-displaced fracture?
It hasn't shifted.
What is a displaced fracture?
It has shifted/separated.
What is an impacted fracture?
Bone ends have smashed together.
What is a comminuted fracture?
Bone fragments are present - this is the hardest to heal!
What is a transverse fracture?
The break happened in a "straight" manner - it's a straight line.
What is a oblique fracture?
The break is at an angle.
What is a spiral fracture?
It's kind of "around" - the break is kind of in a circle.
Is pain a very important thing to assess for patients with fractures?
Demerol - it's okay to give to older patients, right?
What are some things we look for, neurovascularly, in a patient with a fracture?
Skin color & temp, movement, sensation, pulses, cap. refill and pain!
Osteomyelitis - what is it?
Bone infection - these can be very difficult to heal!
What are some closed reduction types of interventions for fractures?
Bandages, Splints, casts, traction (which reduces spasms, etc)
What is ORIF?
Open Reduction Internal Fixation - Reduction means realigning, btw.
What are the differences between skin traction and skeletal traction?
Skin - attached to skin.
Skeletal - drilled into bone.
ORIF - how common is it?
It's the most common. It allows for quick ambulation (about 24 hours after) surgery!
Is there a special bed pan for fracture patients?
Yes - it's a fracture pan! Shocking, I know!
Why do we need to assess for signs of shock in fracture patients?
The bone is made up of a lot of blood - sometimes 200-400 ml/min of blood is pushed through the bones!
Can an open fracture affect the vessels in the area?
Definitely - s0 assess for this!
Hemothorax - involves...located where?
Blood - located more at the lower parts of the longs (if this is where it was). Chest tube would be placed lower.
Pneumothorax - involves...located where?
Air - the chest tube would be higher, because this is in a higher place.
We should also check skin color, sensation, movement, pain, pulses, etc, at the areas DISTAL to the injury, right?
Compartment Syndrome - can occur when?
Within 6 hours of initial injury. The tissue damage can occur distal to injury as well.
What is a fasciotomy?
This is for compartment syndrome - when the pressure builds up, they cut the skin back so the muscle is exposed.
What is Fat Embolism Syndrome?
This is when fat globules from damaged bone are released into blood stream. This may cause occlusion of small vessels that supply the organs. It really can do damage on the lungs, too. So watch for LOC changes, SOB, etc.
What is Rhabdomyolysis?
This is a breakdown of muscle tissue that releases a damaging protein to the blood. This myoglobin is released but the kidney's can't get rid of it. So it becomes a problem. So if urine output isn't good.......
Can patients get addicted to pain meds while in the hospital?
Drainage of the surgery site for the first 24 hours is okay. T/F?
Fall Risk Prevention - look for bed position, rails (3 can be up without it being considered a restraint), call light in reach, don't leave unattended, etc. T/F?
Braden Risk - for ___ assessment.
To prevent delirium in the post-op fracture patients, what can we do?
Keep them hydrated, help them maintain sleep/wake cycle, etc.
To prevent pneumonia, have the patient do what?
Turn, cough and deep breathe!
What is a malunion of bones?
This is when the bones didn't come back together properly. This is now a weaker bone!
What is a nonunion of bones?
This is when the bones didn't form back together at all!
What is Ischemic Necrosis of the bone?
This is when the bone is not getting blood, so it dies.
If a patient has already broken their hip, they're 4 times as likely to break it again. T/F?
Estrogen - inhibits bone resorption. T/F?
If calcium is low, they'll have less bone density over time. T/F?
Parathyroid increases calcium through bone destruction. T/F?
What is the DEXA scan?
This is a scan of bone mineral density. The score (T-Score) is compared to that of a healthy 30 year old of the same sex. A score of -2 is osteopenia (bone loss, but not like osteoporosis) and a score of -2.5 is Osteoporosis.
What happens in osteopenia?
The space between the bone matrix grows bigger, so the bone is weaker.
What happens with a patient that's on bedrest?
Bone breakdown is increased!
This is when cement is placed in the area.
What is kyphoplasty?
This is when a balloon is placed in the area!
Degenerative Disc - a problem with the ___, not the __.
Disc, not the bone.
20-25% of elderly patients will die as a result of hip fractures. T/F?
True! :( :( :(
What does Reclast do?
It inhibits osteoclasts.
Calcitonin - can decreases pain in bone patients. T/F?