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NURS1543 > WEEK 10- MUSULOSKELETAL > Flashcards

WEEK 10- MUSULOSKELETAL Flashcards

(60 cards)

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1
Q

Conduct an independent review of anatomy & physiology (know landmarks & bony prominences).

A
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2
Q

indications for measuring bone mineral density to assess for osteoporosis

A

Up to 90% of peak
bone mass is deposited by age 18 years in girls and age 20 years in
boys; thus, maximizing bone mineral density early in life reduces
effects of bone loss during aging.
After age 40, resorption occurs
more rapidly than deposition. The net effect is a loss of bone density
(osteoporosis).

Osteoporosis Canada recommends that all women and men
older than age 50 be assessed for risk factors for osteoporosis and
fracture. Bone mineral density (BMD) testing is used to diagnose
osteoporosis and predict fracture risk.
‡ BMD testing is
recommended for all women aged 65 and older and for those with
clinical risk factors for fracture such as fragility fracture after age
40, prolonged use of glucocorticoids, or parental hip fracture (see
Table 24.1, p. 645).

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3
Q

Identify equipment needed for physical examination & safe infection prevention & control practices

A
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4
Q

Describe abnormal findings: measure leg length discrepancies; assess for lordosis, kyphosis, scoliosis, contractures, & atrophy,

A

scoliosis- s curve- spinal curvature is not straight and instead curved left or right
lordosis- abdomen is pushed forward, spinal curvature is pushed forwards
kyphosis- slumping motion,
atrophy- muscles get smaller when they are not used.

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5
Q

A 75 year old client has come to the clinical for a health examination – which is a common age related change in curvature of the spinal column?

A

kyphosis

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6
Q

During an assessment of the spine the client should be asked to :

A

flex, extend, rotate

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7
Q

The nurse knows that when assessing gait the client should:

A

walk straight with arms swinging back and forth

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8
Q

Assessment of a synovial joint includes: Select all that apply

A

Crepitation
Temperature
Hypertrophy
effusion

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9
Q

range of motion of the knee includes

A

flexion and extension

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10
Q

The nurse knows that for assessment of the musculoskeletal system ROM consists of

A

active ROM

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11
Q

The nurse understands that osteoporosis can be: ( Select all that Apply)

A
  • found in women mainly
  • can cause compression fractures
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12
Q

A client has ankylosis of the wrist- The nurse knows that the client:

A

cant move the wrist any longer

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13
Q

An infant that presents with 2 folds of skin on the thigh on one leg and 3 folds on the other thigh should have what type of assessment?

A

Ortolani test

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14
Q

Examiner is going to measure a client’s legs for length discrepancy. Normal finding would be:

A

within 1.0 cm difference between the two legs.

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15
Q

musculoskeletal system consists of

A

Bones
Muscles
Joints

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16
Q

functions of the MSK system

A

Support & protection
Movement
Hematopoiesis
Storage of minerals

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17
Q

Be prepared to know & name every bony prominence/landmark related to the skull, neck/spine, shoulder, elbow, wrist, hand, ankle, feet, knee, hip

A
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18
Q

2 types of joints

A

non synovial
synovial-

Joint is where bones meet

  • Non synovial joints
    Immovable or slightly movable
  • Synovial joints
    Freely movable
    Synovial fluid
    Bones are separated from each other
    Cartilage
    Ligaments
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19
Q

types of muscles

A

Smooth
Cardiac
Skeletal
Conscious control
Attached to skeleton by tendons

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20
Q

subjective data

A

joints: pain, stiffness, swelling, heat, redness
muscles: pain, weakness
bones: pain, deformity, trauma
self care behaviors: occupational hazards, exercise, weight gain, medications

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21
Q

health history questions- infants and adolescence

A

For infants and children
Birth trauma
Anoxia
Milestones
Bone injuries
Bone deformities
For adolescents
Athletics
Sports equipment
Warming up
Injury
Time management

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22
Q

health history questions: older adults

A

For older adults
Weakness
Injury
Mobility

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23
Q

objective data

A

drape, bilateral, proximal to distal, asses joint above and below affected joint

Inspection:
- skin and tissues over joint
- size and contour of joint

palpation:
skin temperature,
muscles, bony articulations, area of joint capsule,

ROM
muscle strength

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24
Q

ROM

A

note findings:
pain/tenderness
crepitation
ROM (full or limited)
muscle testing (apply opposing force, grading muscle strength)

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25
testing muscle strength
0-5 0- no ROM 1- slight contraction 2- FULL ROM, passive motion 3- FULL ROM, slight resistance 4- FULL ROM, some resistance 5- FULL ROM, full resistance
26
temporomandibular joint- TMJ
inspection - size and contour - colour - swelling - masses/deformites palpation: - temperature, tenderness, swelling, masses - two fingers over TMJ and ask client to open and close jaw ROM - vertical motion - lateral motion - protrusion - retraction Muscle strength - repeat ROM and apply resistance - test CNV- trigeminal, clench teeth
27
wrist and hand- IPRM
radiocarpal joint- articulation of radius, ulna, carpal bones inspect: symmetry, contour, shape, deformities, masses, atrophy, swelling, colour palpate:Palpate Temperature, swelling/edema, muscle spasm/atrophy, masses/deformities, pain Wrist Flexion, extension, hyperextension, ulnar & radial deviation Fingers Flexion, hyperextension, abduction (fist & spread) Muscle testing of wrist (flex & extend)
28
inspection- hands
Size & contour Colour, swelling, masses Deformities Dislocation Subluxation Contracture Ankylosis
29
palpation- hands
bony articulations, joint muscle, and capsule -Temperature Tenderness Swelling, atrophy, masses, edema/palpable fluid, muscle spasm
30
assessment of hands
ROM Without resistance and with resistance to assess muscle strength
31
the elbow- hinge joint
Palpable landmarks Olecranon process of ulna & medial & lateral epicondyles of humerus Inspect Symmetry/size/contour, deformities/masses/atrophy, swelling, & colour Palpate Temperature, swelling/edema, muscle spasm/atrophy, masses, pain ROM Flexion, extension, pronation, supination Muscle strength testing (flex and extend)
32
The shoulder
Glenohumeral joint (ball & socket) Inspect Symmetry/size/contour, colour, swelling, deformity/masses/atrophy Palpate Spasm/atrophy, swelling/edema, temperature, masses/deformities, pain ROM Flexion, hyperextension, internal & external rotation, abduction, adduction Muscle strength testing Shrug, flex, extend, adduct, & abduct (also, tests CNXI – spinal nerve)
33
the shoulder ROM
Flexion, hyperextension, internal & external rotation, abduction, adduction
34
knee joint
Articulation of 3 bones Inspection Symmetry/size/contour/ deformities, colour, swelling, masses Palpation Temperature, swelling/edema, muscle spasm/atrophy, masses/nodules, pain, fluid ROM - Flexion & extension Muscle testing All ROM can also ambulate for strength and flexion while standing
35
hip joint (ball and socket joint)
Inspect Symmetry/size, colour, swelling, deformities/masses/atrophy Palpate Temperature, swelling/edema, masses, pain, muscle spasm/atrophy Range of motion Flexion (knee straight & bent), abduction, adduction, internal & external rotation, hyperextension while standing) Muscle strength testing Flex, extend, abduct, & adduct
36
ankle and foot
Ankle joint & foot Ankle: hinge joint & articulation tibia, fibula & talus Medial & lateral malleoli Inspection Symmetry/size/contour, deformities/masses/atrophy, colour, swelling Palpation Temperature, swelling/edema, muscle spasm, atrophy, masses, pain ROM Dorsiflexion, plantar flexion, inversion & eversion, & flex & extend toes Muscle testing – dorsiflexion & plantar flexion
37
spine conditions
- degenerative disk - bulging disk - thinning disk - herniated disk - disk degeneration with osteophyte formation
38
cervical spine and spine
Four curves “double S” 33 vertebrae Cervical spine (7) Thoracic spine (12) Lumbar spine (5) Sacral spine (5) Coccyx (4)
39
spinal curvatures
Scoliosis Lordosis Kyphosis
40
the cervical spine- inspection
size and contour, color, swelling, masses/deformities, alignment of head and neck.
41
the cervical spine- palpation
spinous process and sternomastoid, trapezius, and paravertebral muscle for symmetry - temp, pain, swelling/masses, spasm, deformities
42
the cervical spine- ROM
- flexion - hyperextension - lateral bend - rotation
43
the cervical spine- muscle strength testing
all rom movements - CNXI- Accessory
44
ROM- skeletal muscles
Flexion Extension Pronation Supination Circumduction Elevation Lateral bend Rotation Protraction Retraction Abduction Adduction Inversion Eversion Dorsiflexion Plantarflexion Ulnar & radial deviation
45
developmental considerations- infants
- ossification of cartilage - spinal curvature - developmental dysphagia of hip - growing pains
46
developmental considerations- pregnancy
lordosis- spinal curvature - increased joint mobility
47
developmental considerations- older adults
osteoporosis- predom in women decreased height( Long bones do not shorten with age; decrease in height results from shortening of the vertebral column caused by loss of water content and thinning of the intervertebral discs, which occurs more in middle age.) influence of exercise on skeletal mass
48
social considerations
Arthritis is a leading cause of pain, disability, and health care utilization in Canada Increased prevalence in women and with age Higher among those with lower education and income level Osteoarthritis risk factors Hip fractures and falls Injuries: sprains, strains, and fractures
49
why are women more likely to get osteoporosis?
Although some degree of osteoporosis is nearly universal, women are more affected than men because lack of estrogen after menopause causes bone loss to accelerate.
50
kyphosis
- usually older adults - after 60+ Other postural changes are kyphosis, a backward head tilt to compensate for the kyphosis, and a slight flexion of hips and knees
51
health promotion- fight against osteoporosis
Physical exercise increases skeletal mass, helping prevent or delay osteoporosis in postmenopausal women and older men.
52
why does osteoporosis happen?
bones can become “spongy,” weak, and more likely to break with even the slightest of twists or bumps. This condition is called osteoporosis. The bones of the wrist, hip, and spine are most often affected.
53
arthritis
Arthritis is one of the most prevalent chronic health conditions and a leading cause of pain, physical disability, and health care system use in Canada.
54
lordosis
- pregnant women - infant during full term pregnancy shows a protruding abdomen such that the spial vertebrae is curved inward.
55
health promotion
Posture & body mechanics Exercise Calcium & vitamin D Caffeine & alcohol Smoking Talk with health care professionals
56
phalen test- hands
A close up view of the hands of a patient for Phalen test. The elbows of the patient are flexed such that dorsal side of both the hands and fingers are together with the wrists positioned at the center of the chest. Positive Phalen test: numbness and burning sensation occurs with carpal tunnel syndrome
57
complete musculoskeletal exam
A complete musculo-skeletal examination, as described in this chapter, is appropriate for patients with articular disease, a history of musculo-skeletal symptoms, or any problems with ADL
58
screening- musculoskeletal exam
Inspection and palpation of joints, integrated with inspection of each body region * Observation of ROM as patient proceeds through motions described earlier * Age-specific screening measures, such as the Ortolani manoeuvre for infants or scoliosis screening for adolescents
59
subjective data
Joints: Pain Stiffness Swelling, heat, redness Limitation of movement 2. Knee joint (if injured) 3. Muscles: Pain (cramps) Weakness 4. Bones: Pain Deformity Trauma (fractures, sprains, dislocations) 5. Functional assessment (ADLs) 6. Self-care behaviours
60

NURS1543 (15 decks)

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