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80 Cards in this Set
- Front
- Back
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The functions of the musculoskeletal system
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To give the body shape, to protect internal organs, to provide for movement, to store salts and other materials needed for metabolism, to produce red blood cells necessary for oxygen transport
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Three kinds of muscles
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Voluntary (skeletal - under persons own will) Involuntary muscles (smooth - found in walls of organs and help move food through digestive system) Cardiac muscles (only found in heart)
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Tendons and Ligaments
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Tendons connect muscle to bone, ligaments connect bone to bone
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Cartilage
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An extension of the bone end and is composed of connective tissue. It is strong, smooth, flexible, compressible, and slippery substance found at the point of articulation of two bones.
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Flexion / Extension
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Flexion : Bending motion that moves the extremity toward the body. Extension - Bending motion that moves the extremity away from the body
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Adduction / Abduction
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Adduction - Movement of a body part toward the midline of the body. Abduction Movement of a body part away from the midline of the body.
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Rotation / Circumduction
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Rotation - Turning along the axis of the bone or joint. Circumduction - Movement through an arc of a circle or in a circular motion from a central point.
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Six basic components of the skeletal system
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The skull, spinal column, thorax, pelvis, lower extremities, and upper extremities.
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The appendicular skeletal system is made up of the?
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Bones in the extremities, including the shoulder girdle and the pelvis
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Femur articulates at the?
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Acetabulum
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Articulation point of the radius and ulna?
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Elbow
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The axial skeletal system is composed of
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The head, the thorax and the vertebral column.
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The upper extremity consists of?
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The shoulder girdle, arm, forearm, and hand. (Clavicle, scapula, humerus, radius, ulna, carpal/metacarpal, Phalanges.
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The lower extremity consists of?
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Pelvis, Thigh, leg and foot. (Pelvis including ilium, ischium,pubis - Femur, patella, tibia, fibula, calcaneus, tarsals, metatarsals, phalanges)
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The pelvis is made up of what?
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The ilium, ischium and pubis. The large flat bone is the ilium, The iliac crest is what is palpated on the anterior-lateral body at the belt line, the ischium and pubis form the floor of the pelvis.
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Fractures.
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A fracture is a break in the continuity of a bone. Occur through direct force, Indirect force, and twisting force.
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Open / Closed fractures.
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An open fracture is a fracture with an associated open wound. If there is no break in the skin the fracture is considered to be closed.
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Signs/Symptoms of a fracture.
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Pain, tenderness, deformity, discoloration, paresthesia distal to fracture site (Tingling or abnormal sensation) Anesthesia distal to fracture site (Loss of feeling) Paresis (Weakness) Paralysis (Loss of muscle control) Decreased pulse amplitude, increased cap refill time, pale and cool skin distal to fracture site
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Paresthesia
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Tingling or abnormal sensation; may indicate nerve injury.
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Anesthesia
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Loss of feeling; May indicate nerve injury.
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Paresis
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Weakness; May indicate nerve injury
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Paralysis
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Loss of muscle control, may indicate nerve injury.
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Inability to move the extremity.
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May indicate muscle or tendon damage.
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A pathologic fracture results from?
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A disease that causes degeneration and dramatically weakens the bone and makes it prone to fracture. Often with patients suffering from cancer. Not caused by a trauma.
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Complications that may result from a fracture include
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Hemorrhage and the bone itself; instability of the extremity leading to an increased incidence of tissue, nerve or vessel damage; surrounding tissue damage; infection associated with open fractures.
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After ___ years of age bones start to become less flexible, more brittle, and more easily fractured.
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40 years of age.
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Osteoporosis.
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Is a degenerative bone disorder associated with an accelerated loss of minerals, primarily calcium, from the bone.
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Strain
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A strain is an injry to a muscle or a muscle and tendon, possibly caused by overextension, or overstretching. Overstretching tears muscle fibers and causes pain that increases with muscle use. Does not present with edema or discoloration because there is no bleeding.Typically only complains of pain on palpation, usually localized to a specific site, and pain or weakness with use of the muscle.
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Sprain
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A sprain is an injury to a joint capsule, with damage to or tearing of the connective tissue, and usually involves ligaments. The shoulder, knee, and ankle are the joints most vulnerable to sprains.Typically feels immediate pain and tenderness at the joint upon entry.
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Dislocation.
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The displacement of a bone from it's normal position in a joint. The joint is found in an abnormal position with obvious deformity and usually swelling. Pain and tenderness at the site typically unable to move the extremity. Dangerous becase blood vessles and nerves compressed or torn. Usually well beyond it's normal range of motion, causes dislocation.
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Direct / Indirect / Twisting force
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Direct - Direct blow, injuries from direct force occur at the point of impact. Indirect - A force that causes injury some distace away from the point of impact. Twisting force - A force that twists a bone while one end is held stationary.
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A patient can lose approximately how much blood around each femur.
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1500 ML or 1.5 liters. A principle in splinting a femur is not only to mmobilize the bone ends but also to reduce the amount of bleeding. Traction splints 1 - The bone ends are realigned 2 - The size of the thigh will be decreased.
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The pelvis can lose __ liters of blood if fractured?
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2 liters, PASG will not only stabilize the fracture but also decrease the size of the compartment into which the pelvis can bleed,
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If pulseless or cyanotic on an injured extremity?
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Immobilize immediately, transport immediately.
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If PT. is unresponsive or there are multiple injuries or injury is significant?
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Conduct a rapid secondary assessment. If responsive and oriented, Conduct a modified secondary assessment.
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Suspect fracture if these signs are present.
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Deformity, contusions, tenderness, swelling, discoloration and open wounds at the injury site. assess skin temp, color and condition, pulse and cap refill time distal to the site
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S/S of Bone and joint injury
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Deformity or angulation, pain and tenderness, grating or crepitus, swelling, Disfigurement, severe weakness and loss of function, Bruising, Exposed bone ends, Joint locked into position
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Splint
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Any device used to immobilize a body part
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Six P's of assessing an extremity
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Pain - On palpation
Pallor - the skin distal to the injury site may be pale and cap refill delayed if an artery is compressed -Paralysis -Parasthesia- numbness / tingling Pressure - Within the extremity Pulses - the pulse distal to the injury may be absent. indicates damage to arterial vessel |
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Splint joint or bone where?
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Above and below the injury, don not replace bones.
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2 basica reasons for splinting
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Prevents movement of any fragments, bone ends, or dislocated joints, reducing the chance for further injury. Second, splints usually reduce pain and minimize complications from bone and joint injuries.
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Assess PMS when, when splinting?
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Before and after you apply the splint asses pulse, motor function, and sensation distal to the injury. Evaluate these signs every 15 minutes to make sure the same.
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If there is a severe deformity or distal extremity is cyanotic, align the injured limb with manual traction before splinting
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Make one attempt to align the extremity, if met with pain resistance or crepitus, STOP.
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If the patient shows signs of shock?
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Align in normal anatomical position, treat for shcok and xport immediately without taking time to apply the splint. if femur or pelvis suspected to be fractured, splint for bleeding control
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Traction splints
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Provide a counterpull, alleviating pain, reducing blood loss, and minimizing further injury. TRACTION SPLINTS are not intended to correct the fracture, simply to immobilize the bone ends and reduce the diameter of the thigh.
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Improvised splints
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Must be lightweight, wide as the fractured lib, long enough to prevent movement, and padded.
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S/S of long bone injury.
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Exposed bone ends, joints locked in position, Paresthesia (prickling/tingling) paralysis, pallor at injury site, loss of distal pulse
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If the limb is severely deformed, cyanotic, or lacks distal pulses?
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Align it with gentle traction, stop if pain or crepitus increase.
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The position of function for the foot is at?
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a 90 degree angle to the leg with the foot bent at the normal angle to the leg. not upward or downward toward the shin.
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In a dislocation what happens?
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The ligaments holding the bones in proper position are often stretched and sometimes torn loose.
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Traction splinting does what
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Reduces the diameter of the thigh, decreases the space in which bleeding can occur, and realigns the fractured femur.
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If the femur is painful, swollen, or deformed, you should?
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Treat the femur as if it is fractured,
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Do NOT use a traction splint if?
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The injury is within 1-2 inches of the knee/ankle. The knee itself has been injured, the hip has been injured, the pelvis has been injured, there is partial amputation or avulsion
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Compartment syndrome.
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May occur when an extremity is fractured or injured, If the pressure in the space around the capillaries exceeds the pressure needed to perfuse the tissues, the blood flow is cut off and the cells become hypoxic.
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S/S of compartment syndrome
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Severe pain/burning, decreased STR in the extremity, paralysis of the extremity, pain with movement, extremity feeling hard to palpation, distal pulses, motor, and sensory function possibly normal.
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Meninges
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Layers of tissue protecting the brain,, they include the dura mater, the arachnoid and the pia mater.
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Cerebrospinal fluid CSF
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A clear fluid that surrounds the brain and spinal cord, protects from impact.
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Cerebrum
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Part of the brain controlling conscious and sensory functions, emotions and personality.
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Cerebellum.
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Part of the brain controlling equilibrium and muscle coordination
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Brainstem
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Part of the brain that controls most automatic functions of the body. Funnel shaped inferior part of brain. most primitive and best protected part of brain. Controls cardiac, respiratory, vasomotor and vital to life functions.
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Linear skull fracture.
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Most common type, resembles a line, no gross deformity and can only be diagnosed through radiograph
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Depressed skull fracture
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Occurs when the bone ends are pushed inward toward the brain. Can be palpated.
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Closed skull fracture
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An injury in which the skull is fractured but there is no wound to the overying scalp
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Open skull fracture
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A fracture of the skull with an associated open wound to the scalp, allows for infection.
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Basilar skull fracture
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Fracture to the floor or bottom of the cranium. Often cause leakage of CSF from nose mouth or ears.
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Direct / Indirect / Secondary brain injuries.
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Direct (penetrating injury) Indirect (From a blow to the skull) secondary (lack of oxygen, buildup of carbon dioxide or change in blood pressure)
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Injury to the brain results from
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Shearing, tearing, and stretching of nerve fibers, called a diffuse axonal injury. (DAI)
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Concussion
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Normally causes some disturbance in brain function (confusion/LOC) usually brief and does not recur. Mild Diffuse axonal injury. Presents with altered mental status that progressively improves.
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S/S of concussion
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Momentary confusion that may last for several minutes, inability to recall the incident, repeated questioning about what happened, combativeness, nausea and vomiting, restlessness.
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Contusion
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Bruising and swelling of the brain tissue, can accompany concussion. Causes bleeding into the surrounding tissues and may or may not cause intracranial pressure. Usually caused by Coup/Contrecoup injuries.
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S/S of contusion
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Decreasing mental status, paralysis, unequal pupils, vomiting, alteration of vital signs, profound personality changes. Contusion can lead to swelling of the brain tissue, which can result in permanent disability or death.
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Subdural Hematoma - Most common type of severe head injury. more common in patients 60+.
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A collection of blood between the dura mater and the arachnoid layer of the brain. Typically due to low pressure venous bleeding from small bridging vens that are torn during impact to the head.
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make a flash card about the three meninges
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yo
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S/S Of subdural hematoma
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Weakness or paralysis to one side of the body, deterioration in level of responsiveness, vomiting, dilation of one pupil, abnormal respirations or apnea, possible increasing systolic blood pressure, decreasing heart rate, headache, seizures, confusion, personality change.
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Epidural Hematoma
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Bleeding between the duramater and the skull, arterial or venous bleeding pools between the skull and the dura (protective covering of the brain)
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S/S of epidural hematoma include
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Loss of responsiveness followed by return of responsiveness, with rapidly deteriorating responsiveness, decreasing mental status, severe headache, fixed and dilated pupil, seizures, increasing systolic blood pressure and decreasing heart rate, vomiting, apnea or abnormal breathing, systolic hypertension and bradycardic, (cushing reflex) posturing (withdrawal or flexion)
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Laceration
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Can occur either an open or closed head injury. often occurs when an object penetrates the skull and lacerates the brain.
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Brain injury may be worsened by any one of the following
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Hypoxia, Hypercarbia (high carbon dioxide) hypoglycemia, hyperglycemia, hyperthermia, hypotension - systolic < 90mmHg
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Emergency care of traumatic brain injury regardless of the type should focus on what?
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Airway, Ventilation, adequate oxygenation (>95%) Systolic blood pressure greater than 90 mmHg, Normal body core temperature, normal blood glucose level.
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Brain Herniation
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Compression and pushing of the brain through the foramen magnum (Opening in the base of the skull)
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