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Musculoskeletal System
Med Surg I: Musculoskeletal Disorders
59
Medical
Not Applicable
04/13/2009

Additional Medical Flashcards

 


 

Cards

Term
osteoclasts
Definition
break bone down
Term
osteoblasts
Definition

build bone up

 

*not stimulated without mobility (immobile clients need ROM)

Term
bursa
Definition
a cushion over a bony prominence
Term
bursitis
Definition
inflammation of a bursa
Term
tendons
Definition
connect muscle to bone
Term
ligaments
Definition
connect bone to bone
Term
Musculoskeletal Assessment (pt history)
Definition
need to know: work/hobby (bricklayer, extreme base jumper), diet, socioeconomic status, family hx of MS disorders, current health problems (Crohns, gastrectomy- hinder absorption), medication use (steroids eat up bone with chronic use)
Term
Musculoskeletal Assessment (Physical Exam)
Definition

mental status

general inspection, ht, wt, skin, nutritional status

Head and Neck: TMJ and crepitus

Skeletal: posture, spine, joint function, upper/lower extremities, gait, ROM, deep tendon reflexes, muscle strength/ tone, neurovascular, symmetry

Pain/stiffness

Visible/nonvisible deformity

Term
Ballotment Test
Definition
checks for fliud build-up in KNEE
Term
Phalen and Tinel's
Definition
two seperate tests for CARPAL TUNNEL SYNDROME
Term
Scoliosis
Definition

"sideways curve"

Abnormal spinal curvature (various degrees)

can involve shortening of muscles/ligaments characterized by one shoulder becoming higher than the other

 

TX: milwaukee brace, internal fixative devices

Term
kyphosis
Definition

"humpback"

usually a result of osteoporisis

curvature of cervical/thoracic spine

Term
lordosis
Definition

"swayback" "pregnancy stance"

 

curvature of lumbar spine

Term
MRI
Definition

BEST test for soft tissue info

 

-usually used to produce detailed pictures of soft tissue like tendons, ligaments, and muscles

Term
Bone Scan
Definition
Images of ENTIRE SKELETAN are obtained to detect malignancies, stress fractures, and osteomyelitis
Term
arthrogram
Definition
radiographic exam of soft tissue joint structures after dye injection
Term
radiography (X-Ray)
Definition
most common noninvasive test to detect bony abnormalities
Term
Indium Imaging
Definition
Use of a substance connected to leukocytes to detect infections in bone or jint implants
Term
Arthrocentesis
Definition
Aspirating fluid, blood, or pus via a needle inserted into a joint cavity
Term
Arthroscopy
Definition

fiberoptic arthroscope allows endoscopic visual examination of various joints

  • Clients must be able to flex joint
  • ROM exercises/analgesics are prescribed
  • Monitor for complications
  • Ice the Joint
Term
Electromyography
Definition

needle into nerves + electircity= determination of exactly where nerve impulse problems are located.

Inspect neddle sites for s/s hematomas

 

Used to assess problems such as muscle weakness, altered gait

Term
DEXA scan
Definition

"gold standard" for diagnosing osteoporosis

 

T-Score 1.0-2.5 = osteopenia

T-Score >2.5 = osteoporisis

Term
Urine deoxypyridinoline (lab test)
Definition
used to detect multiple sclerosis
Term
Serum muscle enzyme (blood test)
Definition
+ biopsy= tests for rare muscle diseases
Term
Rheumatoid Factor (blood test)
Definition
tests for RA
Term
LE prep/ Antinuclear Antiboties (ANA) (blood test)
Definition
tests for arthritis
Term
Erythrocyte Sedimentation Rate (SED rate) (blood test)
Definition
tests how much inflammation is in body
Term
Calcium, Phosphorous, Alkaline phosphatase (blood test)
Definition
checks amount of electrolyte/enzyme levels in BONES
Term
Why do you need to check a CBC on orhtopedic patients?
Definition
because you need to be aware of their HCT and Hgb levels: they lose alot of blood
Term
What type of physical assessment should always be done on orthopedic patients?
Definition

NEUROVASCULAR!!!!

 

always check distal to the injury/surgical site

 

ex: pedal pulses on a knee replacement

Term
Osteoporosis
Definition
a disease in which loss of bone exceeds rate of regrowth and is replaced with fibrous vascular tissue
Term
Risk Factors for Osteoporosis
Definition

older women (post menopausal)

 caucasion

smokers 

steroid users

nulliparity (0 pregnancies)

slight build

 

 

Term
After menopause, when who do not recieve supplemental estrogen lose ______% of bone
Definition
50%
Term
Clinical Manisfestations of Osteoporosis
Definition
bone pain, decrease in movement
Term
How does estrogen protect bones?
Definition

by inhibiting parathyroid hormone

 

(PTH triggers release of Ca+ from bones)

Term
Tx for Osteoporosis
Definition
  • Ca+, vit D, estrogen replacement
  • Parathyroid hormone replacement- Stops Ca loss
  • Bisphophonates-inhibit osteoclasts:  (Fosamax, Boniva, Actonel)
  • Calcitonin (IM, subcut, or nasal-redness & irritation)
  • fluoride, estrogen with progestin
  • SERM with antioxidents (Evista)
  • Forteo: PTH **BUILDS BONE**watch s/s hypocalcemia
  • Exercise
  • Pathologic fracture safety
Term
Pathologic fracture
Definition

"no reason fracture"

 

a fracture without the use of the bone

 

Term
Osteoporosis patients can have a high level of _______ in their blood because it is being taken out of the bone.
Definition
Ca+
Term
_________________ is a "silent disease" that commonly affects the wrist, hip, and spine
Definition
Osteoporosis
Term

True/False

 

Osteoporosis is a bilateral disease

Definition

False

 

patient can have osteoporosis in 1 limb if not being used for a long time

Term

Young adults need ____ mg Ca+ with vit D/day

 

Post menopausal pts need ______ mg

 

Osteoporosis pts need ______ mg

Definition

1200

 

1500

 

3000

Term

Secondary osteoporosis results from an associated medical condition such as:

_______1_______

_______2_______

_______3_______

Definition

1) hyperparathyroidism: pulls Ca+ out of bones

 

2) long-term immobility: osteoblasts need

stimulation to build bone

 

3) long-term med therapy: corticosteroids,

antiseizure, heparin, and thyroid hormones affect Ca+ absorption and metabolism

Term
Meds that can cause secondary osteoporosis with long-term therapy
Definition

Corticosteroids

thyroid meds

anticonvulsants (Dilantin, Phenobarbitol)

Lasix (pee out Ca+)

Heparin

ETOH

Depo Provera (has lots of progesterone)

Term
How can osteoporosis affect the respiratory system?
Definition

while affecting the spine the patient bends farther and farther over.

 

eventually the lower ribs may actually tough the iliac crests, leaving minimal room for lung expansion

Term
What type of exercise will benefit the osteopenia/osteoporosis patient?
Definition

Weight bearing:

 

Walking

Swimming

Term
Paget's Disease
Definition

A metabolic disorder where increased reabsorption (osteoclasts) of bone make the osteoblast overwork.  They build disorganized, lousy bones

 

*possibly caused by a latent virus

(20-30 yrs prior)

Term
Paget's Disease primarily affects which 4 areas?
Definition

spine

femur

skull

pelvis

 

*watch for pathological fractures of femur & tibia

Term
Risk factors for Paget's Disease
Definition

>80 yrs old

Europeans

Term
Clinical Manisfestations of Paget's Disease
Definition

80% are asymptomatic

 

20% experience aching bone pain, esp. at rest,

Lethargy,

bony enlargement/deformitits (usually bilateral),

Kyphosis

Term
Tx of Paget's Disease
Definition

1) Calcitonin, some bisphosphonates (Boniva), mithramycin, NSAIDS,

 

2) Assistance devices, hot/cold therapy

 

3) Surgery: tibial osteotomy, partial/total joint replacement. Removal of thickened bone

Term
Biphosphonates
Definition

(Fosamax, Boniva, Actonel)

-inhibits osteoclasts from tearing down bone

  • Contraindicated with GERD or renal pts
  • can cause esophagitis
  • take in morn with 8oz H2O, sit up for 30 min
Term
Post menopausal women need estrogen or _____________ and ______________
Definition
Biphosphonates and Calcium
Term
Osteomalacia
Definition

Lack of Vitamin D

 

softening of the bone tissue characterized by inadequate mineralization of osteoid

 

Diagnostic findings: X-Ray shows perpendicular lines on bones: Loser's Lines

Term
Causes of Osteomalacia
Definition

lack of sunlight

malabsorption of vit D in small intestine

 

Meds: anticonvulsants, barbiturates, fluoride

Term
Risk Factors for Osteomalacia
Definition

Any disease/surgery that affects absorption of GI tract

 

In US: elderly, poor nutrition, homeless

 

3rd world countries: children (Ricketts) big belly, bowed legs

Term
Tx for Osteomalacia
Definition
Supplemental Vitamin D from sun exposure and certain foods
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