NUR 370 MUSCULOSKELETAL Flashcards
(78 cards)
1
Q
Bone
A
- living metabolically active tissue
- specialized form of connective tissue
- blocks oxygen and food diffusion - must contain blood vessels
- crystals of calcium phosphate salt make bone rigid
2
Q
Types of Bone
A
- long bones
- short bones
- flat bones
- irregular bones
- sesamoid bones
3
Q
Long Bones
A
- bodies that are longer than they are wide
- growth plates at each end (epiphyses)
- compact bone outside
- spongy bone inside (contains marrow)
- ex: femur, tibia
4
Q
Short bones
A
- wide as they are long
- provide support and stability
- large amounts of bone marrow
- ex: carpals and tarsals
5
Q
Flat bones
A
- strong, level plates of bone protecting vital organs
- anterior and posterior formed from compact bone
- center has spongy bone
- most RBC formed in flat bone
- ex: scapula, sternum, skull
6
Q
Irregular bones
A
- non-uniform shape
- spongy bone with thin layer of compact
- ex: vertebrae, mandible
7
Q
Sesamoid bones
A
- short or irregular bones in a tendon
- ex: patella
8
Q
Bone growth from long bones
A
- epiphyseal growth plate
- cartilage multiply and enlarge
- epiphysis and metaphysics fuse
- growth cells stop diving at puberty
- cartilage changes into hardened bone at puberty
9
Q
Osteoblasts
A
- contained in outer surface of periosteum
- aid in remodeling and repair
- building of bone through collagen
10
Q
Osteoclasts
A
- break down spongy bone to regulate blood calcium level
11
Q
Osteocytes
A
- mature cells that help maintain bone matrix
- form when osteoblasts are calcified
12
Q
Red bone marrow
A
- blood-cell factory
- as we age, red bone marrow decreases
13
Q
Yellow bone marrow
A
- forms during adolescence
- appears more as we age
14
Q
Cartilage
A
- shiny connective tissue that is tough and flexible
- avascular tissue consisting of chondrocytes
15
Q
Types of cartilage
A
- hyaline cartilage
- fibrocartilage
- elastic cartilage
16
Q
Hyaline cartilage
A
- most abundant type
- ex: found in joints
17
Q
Fibrocartilage
A
- shock absorber
- ex: intervertebral disk
18
Q
Elastic cartilage
A
- flexibility
- ex: ears
19
Q
Types of muscle
A
- skeletal
- cardiac
- smooth
20
Q
Skeletal muscles
A
- connect to bone
- most frequently occurring muscle type
21
Q
Smooth muscles
A
- line walls of hollow organs and tubes
- involuntary
22
Q
Cardiac muscle
A
- makes up the heart
- under involuntary control
23
Q
Kyphosis
A
- increased curvature of thoracic spine outward
- causes hunchback
- occurs during puberty (poor posture) or when older
24
Q
Lordosis
A
- exaggerated concave of lumbar spine
- occurs during puberty (poor posture), when older, extra abdominal fat, frequent pregnancies
- commonly associated with dwarfism
25
Scoliosis
- lateral deviation of spine
- imbalance in osteoclast activity
- before puberty as growing quickly, trauma or posture can develop older as well
26
How to monitor congenital MS disorders?
- can be monitored with physical therapy
- if dramatic surgery may be involved
- compressing/putting stress on certain vital organs (GI tract, lungs, etc.)
- pain from how spine has grown and deviated
27
Fractures
- break in the bone
- main diagnostic tool is x-ray
- most common type of traumatic musculoskeletal disorders
28
Simple fracture
- fracture with a single break in the bone and which bone ends maintain their alignment and position
29
Simple fracture types
- transverse
- oblique
- spiral
30
Transverse fracture
- fracture straight across the bone shaft
31
Oblique fracture
- fracture at an angle to the bone shaft
32
Spiral fracture
- fracture that twists around the bone shaft
33
Comminuted fracture
- fracture characterized by multiple fracture lines and bone pieces
34
Greenstick fracture
- incomplete fracture in which the bone is bent and only the outer curve of the bend is broken
35
Compression fracture
- fracture in which the bone is crushed or collapses into small pieces
36
Complete fracture
- bone is broken into two or more pieces
37
Incomplete fracture
- bone is partially broken
38
Closed fracture
- skin is intact
39
Open fracture
- skin is open
40
Fracture assessment
- loss of function distal to fracture
- compromised blood flow distal to fracture
- loss of nerve function
- muscle spasms around affected bone
41
Compartment syndrome definition
- swelling within the muscle compartment
- trauma begins inflammatory response to increase swelling, capillary permeability
- fascia not able to expand
- causes pressure within compartments, blood vessels, and nerves
42
Signs/symptoms of compartment syndrome
- can happen within a few hours of trauma
- decreased pulses distal to trauma
- excruciating pain
- dusky fingers or toes
- area looks swollen
43
Treatment of compartment syndrome
- IV narcotics
- elevation
- diuretics
- fasciotomy (cutting fascia to decrease pressure)
44
Fat embolism syndrome definition
- some yellow bone marrow leaks out of fracture into the bloodstream
- causes inflammatory/immune response
- deadly if embolism gets into vital organs
45
Signs/symptoms of fat embolism syndrome
- 5-12 hours
- pain
- acute respiratory stress (decreased RR)
- changes in consciousness
- petechiae rash starting on chest (can spread to other areas)
46
Treatment of fat embolism syndrome
- emergency help
- ventilate to give oxygen
- corticosteroids to decrease inflammation
- prevention of fracture is reduced in timely manner
47
Dislocation
- abnormal displacement of articulating surfaces of a joint
| - subluxation (partial) or total
48
Causes of dislocations
- congenital (hip dysplasia)
- traumatic (anterior shoulder dislocation most common)
- pathologic (arthritis, paralysis)
49
Treatment for dislocation
- x-ray main diagnostic tool
- reduction
- sometimes surgery
50
Assessment for dislocation
- distal for nerve function
| - distal for muscle function
51
Causes of hip dislocation
- bone cancers
- osteoporosis
- most common: after car accidents
- ALWAYS A MEDICAL EMERGENCY
52
Tendons
- connect muscles to bone
53
Ligaments
- connect bones to bones
54
True or False
| Tendons and ligaments tear with fast, strong movements
- True
55
Sprain
- stretch or tear of ligament
56
Sprain grade I
- minimal damage or disruption
- tender without swelling
- no bruising
- active/passive ROM painful
- no expectation of instability or functional loss
57
Sprain grade II
- moderate damage
- moderate swelling/bruising
- very tender
- ROM painful and restricted
- joint unstable, functional loss as result
58
Sprain grade III
- complete disruption of the ligament
- prognosis variable (may require surgery)
- prolonged healing/rehab period
59
Strain
- muscle and tendon tearing
- due to sudden stretch
- causes inflammatory response with tissue injury
60
Treatment of strain
- NSAID to decrease inflammation
- skeletal muscle relaxants (Lidocaine)
- RICE
61
Herniated intervertebral disk
- nucleus pulposus (gelatinous component) protrudes through the annulus fibrosis (tough covering) and starts pressing on the nerve
62
Causes of herniated disk
- improper body mechanics
- lifting heavy objects
- trauma
- obesity
- aging
63
Signs/symptoms of herniated disk
- sciatica
- pain or weakness in lower back and one leg, or neck, shoulder, chest, arm, etc.
- severe pain with flexion and radiating to back leg
- bowel or bladder changes (EMERGENCY SITUATION!)
64
Treatment of herniated disk
- wait pain out
- NSAIDs
- keep moving
65
Osteoporosis
- progressive loss of bone calcium that leaves the bones brittle
- decrease in bone density based on person's age or gender
66
- Risks of osteoporosis
- women at the time of menopause
- thin, small framed people
- deficient intake of protein, Vitamin C/D
- excessive intake of phosphorus
- caucasians/Asians
- smoking
- excessive alcohol/nicotine
- prolonged use of reflux medication (antacids, PPI, histamine-2 blockers)
67
Scurvy
- decrease in vitamin C intake
| - slows growth at epiphyseal plate and diaphysial growth
68
Rickets
- softening and weakening of bones in children
- prolonged vitamin D, calcium, or phosphate deficiency
- softening with weight bearing changes shape
- called osteomalacia in adults
69
Paget's disease
- progressive condition characterized by abnormal bone destruction and remodeling, resulting in bone deformities
- bone remodeling happening 20x the rate than normal
- creating new larger bones and blood vessels, but bones are weak
- fragile, misshapen, thick bones
- thickened structure can push on soft tissues (headaches, GI distress, difficulty breathing)
70
Medications for bone disorders
- calcium supplements
- selective estrogen receptor modulator
- bisphosphonates
- calcitonin
71
Selective estrogen receptor modulator
- Raloxifene (Evista)
- agonist estrogen for blood clotting and decreasing bone resorptions but selective antagonist to estrogen on breast tissue
- decreasing bone break down but do not enhance risk for cancers
- increased risk for blood clotting when taken with oral contraceptives (decrease other risks of blood clots)
72
Bisphosphonates
- decrease number and action of osteoclasts, inhibit bone resorption
- Fosamax
- need to drink with glass of water
- stand/sit upright to make sure it is in stomach
- if it does go back into the esophagus, can erode esophagus and cause perforation
Slow down rate of osteoporosis
73
Osteoarthritis
- degenerative, destruction of articular cartilage "wear-and-tear"
- involves weight bearing and finger joints
- normal synovial aspirate (no immune response involved)
- better in the morning
- older population
- unilateral
- pain worsens as day goes on
- injection of corticosteroids 2-3 times/year
- joint replacement
74
Rheumatoid arthritis
- systemic autoimmune disease causing inflammation of connective tissue
- hands and wrists (non-weight-bearing places)
- worse in morning
- WBC in synovial fluid
- pain management w/ corticosteroids, DMARDs
- bilateral joints
- pain worse in the morning but when moving gets better
75
Signs of late stages of uncontrolled rheumatoid arthritis
- ulnar deviation of MCP joints
- boutonniere deformity of thumb (flaring outward)
- swan-neck deformity of DIP joints
- systemic symptoms: fatigue, muscle spasms, low-grade fever
- blood work for rheumatoid factor: factor present = worse type of rheumatoid arthritis
76
Gout
- inflammatory disease resulting from deposits of uric acid crystals in tissues and fluids within the body
- enzyme defects that result in overproduction of uric acid and/or inadequate elimination of uric acid by the kidney
77
Gout treatment/prevention
- decrease joint inflammation (ibuprofen)
- Colchicine (analgesic effective for reducing gout pain)
- Allopurinol (lowers serum acid)
- reduce weight, decrease alcohol consumption, increase fluids, avoid purine-rich foods, avoid meals that inhibit renal excretion of uric acid
78
Ankylosing spondylitis
- progressive inflammatory disorders affecting sacroiliac joints, intervertebral spaces, and costovertebral joints
- vertebrae appear square and vertebral column becomes rigid and loses curvature
