301: Musculo-Skeletal Alterations

Front 1

X-ray

Back 1

views bone structure

Dx fractures and degenerative conditions

-Remove jewelry/metal

Front 2

CAT scan

Back 2

views serial slices of tissues

with/without contrast

-Lie still, asses for allergies(iodine)

Front 3

MRI

Back 3

electromagnetic waves, better picture than CAT

Dx muscular issues, spinal/neurological, infection,

-Highly magnetic, assess pt for claustrophobia, lie still

Front 4

Bone Scan

Back 4

radioisotope injected into pt 2-3hrs prior to scan

-Dye collects in kidney and bladder and sticks to problem areas in bone

Dx: cancer, arthritis, infections

-Lie still 30-60 minutes

Front 5

Arthrogram

Back 5

visualization of joint with contrast/dye

Dx: traumatic event, bone chips, torn ligaments

-Asses allergies, avoid strenuous exercise for 12-24hrs, apply ice

Front 6

Arthroscopy

Back 6

exam joint tissues with lighted scope

Dx: knee and shoulder interior joint, loose bodies, tears in cartilage/ligaments, or synovial tissue issues

Complication: bleeding @ joint, edema, possible infection

CI: cant flex 40degrees, infected joint

Post op: compression&ice, SLR(straight leg raises), avoid excessive use for 24-48hrs, neurovascular assessment, Tylenol/Percocet

Front 7

Joint Aspiration

Back 7

gauge needle inserted into joint, synovial fluid is aspirated to analyze or relieve pressue

Front 8

Arteriogram

Back 8

check integrity of blood vessel

-Encourage fluids, keep artery straight and immoble

Front 9

Pertinent labs

Back 9

Serum Ca, P, ESR-rate that RBCs settle (increased indicates some diseases)

Front 10

Contusion

Back 10

Bruise, discoloration and soreness 7-10days, pain may not occur

-If it coagulates, it needs removed w/ I&D

Front 11

Strain

Back 11

stretching of a muscle beyond its capacity

Severe pain->dull and achy

1-3 degree: 3rd degree=sx

Front 12

Sprain

Back 12

tear in ligament

1-3 degree:

1st=few fibers

3rd=complete separation of ligament from bone=>sx

Front 13

Subluxation

Back 13

PARTIALLY dislocated

edema, pain & possible functional changes

Tx: manual traction, compression, immobilization, ice, use joint when edema resolves

Front 14

Dislocation

Back 14

COMPLETE separation or two bones of a joint

Immediate functional alteration

Tx: Manual traction, wrapping, sasting or splints

Front 15

ACL injury

Back 15

Twisting of knee with fixed foot

-Partial, complete or Avulstion(away from bone)

M/B: clicking sound in knee, knee locking

Dx: MRI

Management: rest, ice NSAIDS, immobilize, PT

Sx:cartilage trimmed, repaired or removed

Post op: physician ordered ROM, Brace, PT, progressive weight bearing

Front 16

Ruptured Achilles Tendon

Back 16

Contraction of calf muscle when foot is fixed

s/s: sharp pain, inability to plantar flex the foot

Tx: Immediate repair sx (young/athletes)

Conservative tx: cast then PT

Front 17

RICE

Back 17

(72hrs)
Rest

Ice

Compression

Elevation(above heart)

Front 18

Low back pain

Back 18

80% effected don't know cause

-Many times related to work/poor body mechanics

-Associated with musculoskeletal system

Risk Factors: depression, bone metastasis, osteoporotic vertebral fractures, obesity, stress

Front 19

Acute Back Pain

Back 19

Sciatica(herniated disc impingement on nerve)

SLR->pain in back and posterior thigh at 60 degrees or less is positive test

-Loss of normal curve of back, muscle spasms

**Dependency on alcohol and analgesic drugs

Front 20

Dx Back pain

Back 20

4wk waiting period before testing

CT

MRI

Myelogram

-usually muscular

Front 21

Tx Back pain

Back 21

rest 2 days

exercise program: endurance/stamina->strength (abdominal and back extensor muscles)

PT: heat, US, whirlpool, traction, braces, TENS, acupuncture

Rx: analgesics, muscle relaxants

Front 22

Nursing Assessment Back pain

Back 22

description of discomfort

Aggravates/relieves

posture, position, gait

spasms/tenderness

muscle weakness/paralysis

obesity

Front 23

NI Back Pain

Back 23

Avoid sitting, standing, walking long periods

Straight backed chair

firm mattress

well fitted shoes

PROPER BODY MECHANICS

avoid jumping

legs bent

Front 24

Chronic Low Back Pain

Back 24

>3 months

changes quality of life/morbidity

Medical & psychological treatment