Musculoskeletal Flashcards
(108 cards)
1
Q
What are the basic functions of bones in the musculoskeletal system?
A
- structural support
- assist in movement
- protect vital organs and tissues
- bone marrow
- storage of calcium and phosphorus
2
Q
What is the role of joints in the musculoskeletal system?
A
Articulation of bones occurs at the joints, permitting a variety of movement.
3
Q
What is the function of muscles in the musculoskeletal system?
A
Provide shape to the body, protect bones, maintain posture, and contract to allow movement.
4
Q
What is cartilage and its role in the musculoskeletal system?
A
Form of connective tissue that cushions bony prominences and offers protection where resiliency is required.
5
Q
What is the difference between ligaments and tendons?
A
Ligaments attach bone to bone, while tendons attach muscle to bone.
6
Q
What are common causes of low back pain?
A
- muscle strain
- unstable ligaments
- intervertebral disc problems
- unequal leg lengths
- vertebral fractures
- cauda equina syndrome
7
Q
What are common causes of non-musculoskeletal back pain?
A
- Kidney problems
- Retroperitoneal tumors
- Abdominal aortic aneurysms
8
Q
What is Cauda Equina Syndrome?
A
Compression of the cauda equina (bundle of nerves that arise from the lower portion of the spinal cord) and is a medical emergency
9
Q
What are the signs and symptoms of cauda equina syndrome?
A
- lower back pain
- bowel and bladder dysfunction
- saddle anesthesia (paresthesia in perineal, inner thigh, buttock)
10
Q
What is the treatment for cauda equina syndrome?
A
Surgical removal of vertebral fragments or
decompression of a mass
11
Q
What is the initial evaluation for acute low back pain?
A
history, physical exam, gait assessment, and neurologic testing.
12
Q
What imaging is used to assess low back pain?
A
X-ray, bone scan, CT, MRI, myelogram, and ultrasound
13
Q
What does an x-ray of the spine show?
A
fracture, dislocation, infection, osteoarthritis, or scoliosis
14
Q
What does a bone scan or blood studies show in regards to low back pain?
A
infections, tumors, and bone marrow abnormalities
15
Q
What does a CT scan show in regards to low back pain?
A
identifying underlying problems, such as obscure soft tissue lesions adjacent to the vertebral column and problems of vertebral discs
16
Q
What does a MRI show in regards to low back pain?
A
permits visualization of the nature and location of spinal pathology
17
Q
What does a myelogram show in regards to low back pain?
A
permits visualization through contrast dye of segments of the spinal cord that may have herniated or may be compressed
18
Q
What does an ultrasound show in regards to low back pain?
A
useful in detecting tears in ligaments, muscles, tendons, and soft tissues in the back
19
Q
What is the treatment goal for chronic low back pain?
A
30% reduction from baseline
20
Q
What pharmacologic treatments may be beneficial for chronic low back pain?
A
antidepressants, atypical anticonvulsants (gabapentin), or SNRIs (duloxetine)
21
Q
What nonpharmacologic treatments are effective for chronic low back pain?
A
heat/cold therapy, spinal manipulation, cognitive-behavioral therapy, physical therapy, acupuncture, massage, and yoga.
22
Q
What are some nursing interventions for low back pain?
A
- assess emotional well-being
- assess posture, position changes, gait
- managing pain
- consulting PT
- body mechanics
- stress reduction
23
Q
What are the key components of body mechanics to prevent low back pain?
A
- practicing good posture
- avoiding twisting
- using large leg muscles for lifting
- Push objects
- avoid overreaching or a forward flexion position
24
Q
What is bursitis and its common treatment?
A
inflammatory condition typically found in the shoulder, treated with rest, ice/heat therapy, and NSAIDs.
25
What causes bursitis?
Irritation of bursae or muscle tendon sheaths from repetitive motion.; inflammation can lead to restricted joint movement
26
What is carpal tunnel syndrome?
Compression of the median nerve at the wrist
27
What causes carpal tunnel syndrome?
repetitive movements, hormonal changes, or conditions like RA, diabetes, acromegaly, or hyperthyroidism.
28
What are the clinical manifestations of carpal tunnel syndrome?
Pain, numbness, tingling, and weakness in the thumb, index, and middle fingers.
29
What are the treatment options for carpal tunnel syndrome?
Corticosteroids, NSAIDs, acupuncture, wrist splints, and surgical options if conservative treatment fails
30
What indicates a positive Tinel sign?
pin and needle sensation felt when the skin above the median nerve is palpated
31
What is Dupuytren disease?
Slow, progressive contracture of the palmar fascia causing flexion of the 4th, 5th, and sometimes middle finger
32
What is osteoarthritis?
noninflammatory degenerative disorder of the joints
33
What is the distinguishing characteristics of osteoarthritis?
* does not involve autoimmunity or inflammation
* limited to the affected joints
* no systemic symptoms
34
What is the pathophysiology of osteoarthritis?
Articular cartilage breaks down, leading to progressive damage to the underlying bone and eventual formation of osteophytes (bone spurs) that protrude into the joint space
35
What are the risk factors for osteoarthritis?
* older age
* female
* obesity
* certain occupations
* sports activities
* history of previous injuries
* genetic predisposition
36
What are the management goals for osteoarthritis?
Reducing pain and stiffness and maintaining or improving joint mobility
37
What are pharmacological therapies for osteoarthritis?
* Acetaminophen (first-line)
* Tramadol, opioids (severe)
* Intra-articular corticosteroid injections
* Topical agents
38
What is joint arthroplasty?
Surgical removal of an unhealthy joint and replacement of joint surfaces with metal or synthetic materials.
39
What is the difference between total and partial joint arthroplasty?
Total arthroplasty replaces all surfaces of the joint, while partial arthroplasty replaces only some surfaces.
40
What is a common management strategy to prevent dislocation of the hip prosthesis?
Use abduction splints or pillows between legs
## Footnote
This helps maintain proper alignment of the hip joint.
41
What should be avoided to prevent complications after hip arthroplasty?
Hip flexion beyond 90°
## Footnote
This position can increase the risk of dislocation.
42
What is a key nursing intervention to prevent leg rotation and heel pressure injuries after hip arthroplasty?
Use cradle boots
## Footnote
Cradle boots help stabilize the leg and protect against pressure injuries.
43
What are signs and symptoms of hip dislocation that should be monitored?
* Increased pain
* Shortening of affected extremity
* Abnormal rotation
* Inability to move leg
* Reported 'popping' sensation in hip
44
What additional complications should be monitored for in hip arthroplasty?
* Excessive wound drainage
* Heel pressure injury
* Immobility
* Heterotopic ossification
* Avascular necrosis
* Loosening of the prosthesis
45
What is the purpose of neurovascular checks after knee arthroplasty?
To assess movement, color, pulse, sensation, and capillary refill
## Footnote
These checks are done every 2–4 hours.
46
What is the typical recovery time for knee arthroplasty?
6+ weeks
## Footnote
Recovery may take longer for patients over 75 years of age.
47
What are common complications to monitor after knee arthroplasty?
* VTE
* Peroneal nerve palsy
* Infection
* Bleeding
* Limited ROM
48
What is osteoporosis characterized by?
Reduced bone mass and deterioration of bone matrix
## Footnote
This leads to increased fragility and risk of fractures.
49
What is the pathophysiology of osteoporosis?
Normal homeostatic bone turnover is altered, and the rate of bone resorption is greater than the rate of bone formation, resulting in loss of total bone mass; Bone becomes porous, brittle, and fragile and breaks easily under stress
50
What dietary components are crucial for preventing bone loss in osteoporosis?
* Calcium
* Vitamin D
## Footnote
Key sources include dairy, broccoli, and canned salmon with bones.
51
What are risk factors for osteoporosis?
* Small-framed women
* Asian and Caucasian women
* Men older than 60
* Alcohol intake of 3 or more drinks daily
* Long-term corticosteroid use
* Family history
* Inadequate calcium and vitamin D intake
* Low body mass index
* Malabsorption disorders
52
What is the management for osteoporosis?
* Calcium and Vitamin D rich diet
* Exercise
* Avoid excessive alcohol/tobacco use
* Pharmacologic therapy
53
What is osteomalacia?
A metabolic bone disease characterized by inadequate bone mineralization
## Footnote
This leads to softening and weakening of bones.
54
What causes osteomalacia?
Softening and weakening of the long bones causes pain, tenderness, and deformities resulting in the bowing of bones
55
What is Paget Disease primarily characterized by?
Localized rapid bone turnover
## Footnote
This affects the skull, femur, tibia, pelvic bones, and vertebrae.
56
What is the pathophysiology of Paget Disease?
excessive bone resorption by osteoclasts is followed by increased osteoblastic activity. This causes the developing bone to be disorganized, weak, and highly vascular, making it prone to fractures
57
What is a common clinical manifestation of Paget Disease?
* Thicken skull/enlarged cranium
* Bowing of femurs and tibiae
* Forward bent spine
* Tenderness and warmth over bones
* Mild to moderate deep aching pain
58
What diagnostic findings are associated with Paget Disease?
* Elevated serum alkaline phosphatase
* Increased urinary hydroxyproline excretion
* X-ray confirms diagnosis with characteristic mosaic patterns
59
What is the management of Paget Disease?
* NSAIDs
* walking aids
* shoe lifts
* physical therapy
* Diets adequate in calcium and vitamin D
60
What are the common causes of osteomyelitis?
* Hematogenous spread
* Contiguous-focus infections
* Vascular insufficiency
* Spread from adjacent infections
61
What is hematogenous osteomyelitis?
bacterial travels through bloodstream and infects bone
62
What is Contiguous-focus osteomyelitis?
bacterial enters the bone through direct contamination from surgery, open fracture, or traumatic injury
63
What is Osteomyelitis with vascular insufficiency?
seen in patients with diabetes or peripheral vascular disease
64
What is a common causative organism of osteomyelitis?
Staphylococcus aureus/ Methicillin-resistant Staphylococcus aureus (MRSA)
## Footnote
Methicillin-resistant strains (MRSA) are also common.
65
What are initial treatment goals for osteomyelitis?
* Control infection
* Provide supportive care
* Immobilize the affected bone
66
What are common benign tumors?
* Osteochondroma
* Bone cysts
* Osteoid osteoma
* Enchondroma
* Giant cell tumors
67
What should be monitored during the management of bone tumors?
* Coping with diagnosis
* Soft tissue swelling
* Limit palpation of mass
* Pain and tenderness
* Neurovascular status and ROM
68
What is the typical management for benign bone tumors?
Observation, medication, and surgery
## Footnote
This is often sufficient as benign tumors typically grow slowly.
69
What is the typical management for primary malignant?
surgical excision, radiation therapy, chemotherapy
70
What is the most common and most fatal type of primary malignant bone tumor?
Osteosarcoma; common in rapidly growing bones (distal femur, proximal tibia, proximal humerus) and manifests as localized bone pain or soft tissue mass; long metastasis is common
## Footnote
It is also the most fatal bone cancer.
71
What is the goal of treatment for secondary malignant bone tumors?
Palliative care
## Footnote
Focused on relieving pain and promoting quality of life.
72
What are complications of bone tumors?
* Delayed wound healing
* Osteomyelitis and wound infection
* Hypercalcemia
73
What should be included in nursing interventions for bone disorders?
* Encourage strength training
* High calcium and vitamin D diet
* Implement safety measures
* Educate about vitamin D supplements
74
What is the RICE method?
Rest, Ice, Compression, and Elevation
## Footnote
RICE stands for Rest, Ice, Compression, and Elevation.
75
What is a strain?
Pulled muscle injury to the musculotendinous unit
76
What is a sprain?
injury to ligaments and supporting muscle fiber around a joint
77
What is a dislocation?
articular surfaces of the joint are not in contact/alignment
78
What is a subluxation?
Partial or incomplete dislocation
79
What is acute compartment syndrome?
Increased pressure within a muscle compartment, restricting blood flow leading to muscle and nerve damage
80
What are common symptoms of acute compartment syndrome?
* Severe pain
* Tightness
* Numbness
* Tingling
* Potential weakness or paralysis
81
What is a Type I fracture?
Clean wound less than 1 cm long
## Footnote
Types are classified based on the severity and characteristics of the wound.
82
What is a Type II fracture?
larger wound with minimal soft tissue damage
83
What are the characteristics of a Type III fracture?
highly contaminated with extensive soft tissue injury, vascular injury, or traumatic amputation.
## Footnote
This classification indicates a severe level of injury.
84
List the types of fractures.
* Transverse
* Oblique
* Comminuted
* Avulsion
* Stress
## Footnote
These are common classifications based on the fracture pattern.
85
What are common clinical manifestations of fractures?
* Pain
* Loss of function
* Deformity
* Shortening of extremity
* Crepitus
* Edema
* Ecchymosis
* Muscle spasm
## Footnote
These signs help in diagnosing fractures.
86
What is the medical management for fractures?
* Reduction (close and open)
* Immobilization
* Restore function
* External fixator
## Footnote
ORIF is a common procedure for fracture management.
87
What is the purpose of an external fixator?
To manage open fractures with soft tissue damage and provide support for complicated or comminuted fractures.
## Footnote
Patients may need reassurance due to the appearance of the device.
88
How long can fracture healing take?
Fracture healing can take weeks to months.
## Footnote
Healing time varies based on fracture type and location.
89
What factors impair fracture healing?
* Inadequate fracture immobilization
* Inadequate blood supply
* Multiple trauma
* Extensive bone loss
* Infection
* Cigarette smoking
* Excessive alcohol use
* Malignancy
* Certain medications (e.g., corticosteroids)
* Older age
* Some disease processes (e.g., RA)
## Footnote
Each factor can significantly affect the healing process.
90
What are the nursing management strategies for fractures?
* Control edema and pain
* Encourage exercise for unaffected muscles
* Use assistive devices
* Educate about modifying home environment
## Footnote
These strategies enhance recovery and safety.
91
What early complications can arise from fractures?
* Shock
* Fat embolism
* Acute compartment syndrome
* Rhabdomyolysis
* VTE/DVT/PE
* Infection
* Loss of bladder control
## Footnote
Recognizing these complications early is crucial for patient safety.
92
What are late complications of fractures?
* Delayed union, Malunion, Nonunion
* Avascular necrosis (AVN) of bone
* Complex regional pain syndrome
* Heterotopic ossification
## Footnote
These complications may develop after the initial healing phase.
93
What is the purpose of casts?
To immobilize reduced fractures to correct or prevent deformities.
## Footnote
They allow non-affected body parts to move freely while stabilizing the affected parts.
94
What are splints used for?
Used for stable fractures, sprains, tendon, and soft tissue injuries
95
What are the 5 Ps to assess for neurovascular compromise?
* Pain
* Pallor
* Pulselessness
* Paresthesia
* Paralysis
## Footnote
These indicators help in early detection of complications.
96
Fill in the blank: Traction must be _______ to be effective in reducing and immobilizing fractures.
continuous
97
What are the two types of traction?
* Skin traction
* Skeletal traction
## Footnote
Each type has specific methods and purposes for treatment.
98
What is the role of skin traction?
A noninvasive method for short-term immobilization and muscle spasm relief before surgery.
## Footnote
It involves the use of adhesive materials, bandages, or boots.
99
What is the effect of skeletal traction?
* Invasive method where pins, wires, or screws are inserted into the bone.
* Provides long-term, continuous traction for more complex fractures or alignment needs.
## Footnote
This method is used for complex fractures needing long-term traction.
100
What are common complications associated with traction?
* Atelectasis and pneumonia
* Constipation and anorexia
* Urinary stasis and infection
* Venous thromboembolism
## Footnote
Regular monitoring and preventive measures are necessary.
101
What are clinical manifestations of a hip fracture?
* Pain over outer thigh
* Limited ROM
* Discomfort with flexion and rotation of the hip
* Shortening of the leg
*Adducted and externally rotated
102
What is the primary goal for a patient with a hip fracture?
* Relief of pain
* Functional and stable hip
* Healed wound
* Normal urinary elimination
## Footnote
Other goals include maintaining normal urinary patterns and absence of complications.
103
What is a common cause of rib fractures?
Blunt trauma from car crashes or falls.
## Footnote
They usually cause minimal functional impairment.
104
What is crucial for managing pain in rib fractures?
Pain control is crucial to prevent decreased lung aeration, atelectasis, and pneumonia.
## Footnote
Regular analgesics and incentive spirometry are part of treatment.
105
What are common sports-related injuries?
* Fractures: clavicle, wrist, ankle, metatarsal stress
* Dislocations: shoulder, elbow
* Sprains: wrist, ankle
## Footnote
These injuries are prevalent among athletes.
106
What common injuries are associated with occupation-related injuries for nurses?
* Strains
* Sprains
* Tears
* Cuts
* Lacerations
* Contusions
## Footnote
Prevention measures are important to minimize these injuries.
107
What are potential complications of amputation?
* Postoperative hemorrhage
* Infection
* Skin breakdown
* Phantom limb pain
* Joint contracture
## Footnote
Awareness and management of these complications are essential.
108
What nursing management strategies are important for patients with an amputation?
* Resolving grief
* Enhancing body image
* Promoting independent self-care
* Assisting with physical mobility
## Footnote
Support and rehabilitation are crucial for recovery.
