Musculoskeletal

Question 1

Abbreviations

Answer 1

• fracture: #
• osteoarthritis: OA
• Rheumatoid: RA
• Osteoporosis: OP

Question 2

kyphosis

Answer 2

the curvature of the spine

Question 3

prevention (fracture)

Answer 3

Fall prevention:

 -orthostatic hypotension: inform them to take a minute when standing or sitting

treatment & prevention of bone fragility:

  - promote proper nutrition
  - are they using the assistive devices (hearing aids, glasses, etc) properly?

use of hip protectors &/or fall mats

Question 4

osteoarthritis (OA)

Answer 4

• non-inflammatory
• affects any weight-bearing joint
• related more to excess use of joints through weight-bearing
• obesity

Question 5

signs & symptoms (OA)

Answer 5

• crepitus (crackling sound)
• bone spurs (abnormal bone growth)
• limited motion, stiffness is relieved after movement
• blood tests are normal
• symptoms of inflammation (fever, malaise, fatigue) is absent

Question 6

treatment (OA)

Answer 6

• acetaminophen
• corticosteroid injections directly onto the affected joint(s). used if oral meds don’t work
• judicious exercise: avoid strenuous repetitive activities
• schedule alternate periods of rest
• Sx (surgery) may be necessary
  - hip/knee replacement

Question 7

Rheumatoid arthritis (RA)

Answer 7

• autoimmune disorder with a familial tendency (hereditary)

- the synovium becomes inflamed, causing an excess synovial fluid & the cartilage becomes rough & pitted @ a later stage

Question 8

signs & symptoms (RA)

Answer 8

• usually affects the joints symmetrically
• pain
• swelling
• warmth
• other symptoms related to inflammation

Question 9

Tx (RA)

Answer 9

• rest, positioning with splints to maintain full ROM and help prevent contractures
• exercise rehab with physical therapy
• pain meds
• heat application for chronic pain; cold application for acute pain
  - allow the area to go back to body temp before reapplying the compress
• avoid anxiety to help decrease exacerbations (worsening the condition)

Question 10

Gouty arthritis

Answer 10

• excess uric acid (from purines) in the blood can cause uric acid crystals to accumulate in the joint
• sudden, severe attacks of pain, swelling, redness, and tenderness in the joints, limited ROM
• occurs more often in men

Question 11

Purines (sources)

Answer 11

red meat, alcohol, high fructose products

Question 12

Tx (Gout)

Answer 12

• diets low in purines
• exercise
• weight maintenance

Question 13

osteoporosis (OP)

Answer 13

-bone demineralization, leading to brittle and porous bones
-bone resorption is greater than bone absorption
-“silent” disease
risk factors:
-Alcohol use
-Corticosteroid use
-Calcium low
-Estrogen low
-Smoking
-Sedentary lifestyle
-Additional: advanced age, ethnicity, early menopause

Question 14

Tx (OP)

Answer 14

-education
-meds that stop loss and increase bone formation (calcium & vitamin D supplements)
-Weight-bearing activity can not regain the bone loss
but prevents any further bone loss.

Question 15

Managing pain

Answer 15

• hot or cold compress
• passive stretching & massages to the area
• correct positioning: splints & braces
• meds: pt needs to be monitored

Question 16

Normal changes (muscles)

Answer 16

• enlarged joints
• flabby muscles
• decreased height
• sarcopenia: loss of skeletal muscle mass and function.

Question 17

Sarcopenia

Answer 17

loss of muscle mass, strength & function

Question 18

Normal changes (skeletal system)

Answer 18

• kyphosis
• bone mineral and bone mass decreases, causing the bones to be brittle. more prominent among older women due to accelerated rate of bone loss after menopause
• decreased calcium absorption
• thinning disks & shortening of the spinal column
• enlarged joints
• flabby muscles
• muscle atrophy
• decrease in muscle fibers, with fibrous tissue gradually replacing muscle tissue
• muscle mass, strength & movements are decreased (sarcopenia)
• diminished calcium absorption and gradual resorption (breakdown) & slower bone deposition (building) outside of the bone