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92 Cards in this Set

  • Front
  • Back
What are the 5 p's
Pain
Pallor
Pulselessness
Paresthesia
Paralysis
Loss of bone density, leaving the bone
porous and easily fractured, especially
the wrist, hip, and vertebrae
Osteoporosis
causes of __________________:
drop in estrogen levels
aging
genetic influences- stature, race
diet- chronic low Ca, caffeine,smoking
and alcohol
sedentary lifestyle
medications- steriods
Osteoporosis
manifestations of __________:
-back pain with movement& muscle spasm
-Dowagers hump
-loss of height (2-3 in)
-wrist fracture (colles fracture)
-hip fracture (75%)
Osteoporosis
Management of _____________-
-dx early- bone mineral density
-estrogen replacement
-dietary supplemental Ca, Vit D
-calcitonin injections, nasal spray
-fosimax- inhibit bone resorption
-evista- decreased cholesterol
-diet, exercise -falls prevention
-prophylaxis- best approach
osteoporosis
revisible metabolic bone disease with softening and deformity of bone marked increased in abnormal bone.
osteomalacia
Causes of ___________:
-lack of minerals-phosphorous, Vit D
-poor dietary intake,decreased sunlight
-GI problems that hinder absorption
-many pregnancies
-excessive excretion of Phosporous
by the kidneys
-long term med use of dilantin, phenobarb, steriods
Osteomalacia
Manifestations of ______________:
-bone pain, muscle weakness, fractures
-skeletal deformitites
Osteomalacia
Chronic bone disease of the elderly.
2%-4% of people over 60
characterized by excessive bone resorption and deposition, softening , enlargement and severe deformity of the skeleton.
-affects all bones of the skeleton
caused by viral infection, biochemical defect, precancerous
Paget's disease
symptoms of ________________:
-bone pain, back pain, headache, fractures, skull enlargement, impinge on nerves causing deafness, blindness, paralysis, flushed warm skin.
diagnosed by elevated serum alkaline phosphatase, hyperuricemia, X-Ray, CT, MRI
Paget's disease
infection of bone
symptoms include: fever, swelling, tenderness, redness, pain
treatment is with antibiotics and surgical management
osteomyelitis
compression of median nerve in wrist, causing pain, numbness.
seen more at night
Carpal tunnel syndrome
break in the continuity of the bone
fractures
cause of fracture -
break at point of contact is called ___
direct force
break distant from point of contact is called__________
shear force
uneven pull, weakened muscle called_____
muscle fatigue
a type of fracture where the skin is intact
simple
a type of fracture where the skin is broken
compound
a type of fracture where it effects only one side of the bone
Incomplete
a type of fracture that goes through the bone
complete
a type of fracture where one part is driven into another
telescoped
a type of fracture where the fracture site is separated
displaced
a type of fracture where injury is from bone to body organ
complicated
a type of fracture where you have a thin break line
hairline
a type of fracture where the bone is pulled away from the tendon
Avulsion
a type of fracture where it breaks in several pieces
comminuted
a type of fracture that goes straight across
transverse
a longitudinal fracture
Linear
an angled fracture
Oblique
fracture of the distal radius
Colles fracture
a type of fracture where one leg is shortened and externally rotated. different types include femoral head, intertrochanter, sub-trochanteric
Hip fracture
pre-op management of _________fracture:
-Bucks traction
-Bucks care (turn toward fracture side)
hip fracture
The following will you do or not do?
-force hip into more than 90 of flexion
-force hip into adduction
-force hip into internal rotation
-cross legs
-put on own shoes or stockings until 8 weeks after surgery
-sit on chairs without arms to aid rising to a standing position
DO NOT
The following will you do or not do for hip fx care:
-use toilet elevator on toilet seat
-place chair inside shower and remain seated while washing
-use pillow between legs when supine or laying on good side
-keep hip in neutral position
-notify dr with increased pain, loss of function, or deformity occurs
DO
Sign of a fracture that causes disruption of soft tissues or bleeding into the surrounding tissues
Edema and swelling
signs of a fracture that you have muscle spasm due to involuntary reflex action of muscle; direct tissue trauma; increased pressure to sensory nerve; movement of fracture parts
pain and swelling
signs of a fracture where you have a protective response to injury and fracture
muscle spasm
signs of a fracture where you have abnormal position of bone caused by original forces of injury and by action of muscles pulling fragment into abnormal position
deformity
signs of a fracture where you have discoloration of skin due to extravasation of blood in subcutaneous tissues
ecchymosis
signs of a fracture where you have disruption of bone that prevents functional use
Loss of function
sign of a fracture where you have grating or crunching together of bony fragments producing palpable or audible crunching sensation.
crepitation
for healing of a fracture what is necessary?
immobilization
heals by regeneration of fibers
muscle
heal by creating new bone
bone
a blood clot provides a structure upon which a fibrin network can build (48 to 72 hours)
hematoma
cells at the torn ends multiply and form a soft tissue bridge
cellular proliferation
loosely worn cartilage and bone matrix 6-21 days
callus formation
calcium deposits- bone become rigid and healed in 2-6 weeks
ossification
bone returned to its normal shape and contour one to several years
remodeling
Length of time it takes to _____ depends on:
-type of fracture
-good immobilization
-age (younger are faster)
-general health (good nutrition increases this)
heal
restore bone's normal alignment, position, length
reduction
manuel manipulation of fracture without surgery (bandage, splint, cast, traction)
closed reduction
type of reduction that requires surgery
open
a type of reduction where a surgical incision with the application of pins, nails, plates, screws to the bone
Open reduction with internal fixation
ORIF
a type of reduction whare a metallic device to compress fractures and to immobilize.
attached to the bones by percutaneous pins
external fixation
Complication of fracture where you have a long bone or pelvis fracture that releases yellow bone marrow into the blood stream
fat embolism
this complication occurs within the first 12-72 hours
-lodge in the lung, causing hemorrhagic interstitial pneumonitis that produce symptoms of acute Resp distress syndrome
-serum lipase will be elevated
-will see peteciae
fat embolism
complication of a fracture that has increased tissue pressure within a closed space that compromises the circulation to the area
compartment syndrome
______________:
-sheaths of fascia surround muscle and do not allow for expansion
-muscles are injured and swell and bleed
-seen in leg and arm
-onset 2 hrs to 6 days after trauma
-early sx- increasing pain
later sx- numbness, tingling,,pallor, coolness, loss of movement and pulse
compartment syndrome
bone death due to a lack of supply of blood
avascular necrosis
complication of fracture where you have failure to heal
delayed and nonunion
complication of fracture where it heals in an abnormal position that predisposes to degenerative arthritis, angulation
Malunion
infection of the bone that is direct or indirect route and treated with long term IV antibiotics, or for chronic treated with surgical debridement and IV antibiotics
osteomyelitis
RICE stands for:
R- rest
I- ice
C- compression
E- elevation
amputation where in the surgical procedure there is a drain left in because of ______
Infection
An open (guillotine)
amputation where in the surgical procedure there is a flap
closed
another name for real pain felt where you no longer have a limb or digit. still feel the discomfort, hard for the patient to explain
phantom limb pain
__________ disorders involve muscle, bones , joints, and if systemic other body organs often related to immunological problems (rheumatology)
Connective tissue disorders
disease to weight bearing joints (hips, knees, vertebrae and hands)
cause is unknown but age, genetics, obesity, trauma, lack of exercise, congenital, metabolic diseases predispose
The cartilage thins, joint space narrows, bone grates against bone, bony enlargement of joint, deformity and pain
DJD
Degenerative joint disease
immobilize the joint
arthrodesis
surgically reconstructed
arthroplasty
a chronic progressive systemic disease characterized by inflammation and destruction of synovial tissue in joints.
occurs in 20-40 age group 3:1 females
periods of remission and exacerbations
is an autoimmune disease
rheumatoid arthritis
symptoms include:
-morning stiffness,fatigue,weakness, anorexia, fever
symmetrical joint inflammation often beginning in both hands
-synovitis- edema,warmth,redness,and pain on joint movement-destroys the synovium
systemic sx- vasculitis, myositis, ocular changes, cardiac dysfunction
Rheumatoid arthritis
chronic multi-system autoimmune disease with remissions and exacerbations. it is an inflammatory disease of connective tissue involving the skin, joints, heart, kidneys, blood and central nervous system. Females 5:1 prevalence occurring in ages 20-40
Systemic Lupus Erythematosus
(SLE or LUPUS)
sx include:
red, raised rash, alopecia, polyarthritis, fever, fatigue, anorexia, nephritis (leading cause of death), pulmonary changes, pericarditis, Raynauds, CNS effects, GI, psychosocial
Lupus
inflammatory disorder resulting from deposition of uric acid crystals in the joints usually the great toe
GOUT
____________-
uric acid is the end product of purine (a type of protein) metabolism. Purine comes from the diet and is also made by the body.
crystal deposition- nodules called tophi (ear, arms, fingers)
GOUT
a progressive systemic disorder caused by excessive collagen deposition characterized by inflammation, fibrosis, sclerosis of skin and with organs
-mask like face and finger and toes become thinned.
Systemic sclerosis (scleroderma)
symptoms indicating poorer prognosis in systemic sclerosis:
C
R
E
S
T
S
C- calcinosis
R- raynauds syndrome
E- esophagal motility changes
S- sclerodactyly-fingers and toes
T- Telegiectasia- permanent dilation of blood vessels
chronic musculoskeletal pain disorder or unknown cause, found in 2% of the population mainly girls and young women.
Sx include fatigue, morning stiffness, sleep difficulties, muscle pain. often associated with irritable bowel syndrome, depression, sleep disturbances
Fibromyalgia
Type of drug used to decrease inflammation and pain.
Does not stop underlying disease
-contraindicated in GI ulcer
-take with food, milk, antacids
Examples: trilisate, dilsalcid, naprosyn, motrin, ASA, indocin, toradol,
celebrex, vioxx, zantac, pepcid
NSAID's
Non steriodal anti-inflammatory drugs
Type of drug used to decrease inflammation, suppress immunological response and reduce pain.
-take with food, decrease salt, don't stop drug abruptly.
Ex: Prednisone, Depo-medrol, Kenalog, ACTH, Decadron, Aristocort, Celestone
Steriods
Type of drug that suppresses the Immune system which is causing the damage to the body.
Example:
Imuran
Cytoxan
Methotrexate Remicade
Remicade
Cytotoxic Drugs
Type of drug used for treatment of GOUT, decrease the formation of uric acid
-instruct in low purine diet
Examples:
Allopurinol
Zyloprim
Uricosurics
Type of drug that increases uric acid excretion.
-used in long term managment of arthritis- not used during acute attack
-ck for allergies to sulfa drugs
Examples:
Benemid
Anturane
Probenecid
Type of drug used for osteoporosis and Paget's disease
Example:
Calcimar
Calcitonin
Type of drug used to relax muscle spasms associated with acute painful musculoskeletal condition.
Example:
Flexeril, Robaxin, Valium, Paraflex, Soma, Dantrium, Lioresal
Muscle relaxants
Type of drug that decreases pain signal to the brain. Used for acute strong pain.
-not good for chronic pain
Example:
Ultram
Non-Narcotic Analgesic
Type of drug that binds to receptor sites in the CNS and blocks pain transmission.
Examples: Darvon, Darvocet, Codeine, Morphine, Percodan, Percocet, Demeral, Talwin, Dilaudid, Vicodan, Duragesic Patch, Roxanol, MS Contin
-may need to give antiemetics and laxatives
Narcotic analgesic
Type of drug that reduces pain by blocking pain.
-give in the evening
Examples:
Elavil
Tofranil
Sinequan
Serotonin Blockers
Type of drug that reduces bone loss and increases bone mass.
-for use with women after menopause
-take once a day on empty stomach with full glass of water
Fosimax
Type of drug that prevents osteoporosis.
-non-hormonal
-decreases cholesterol
Evista