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Musculoskeletal System Alterations
Chapter 42
114
Nursing
Graduate
04/10/2012

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Term
What are types of musculoskeletal injuries?
Definition
Fractures
Dislocations
Sprains
Strains
Term
What types of alterations in bones, joints, and muscles?
Definition
Metabolic disorders
Infections
Inflammatory and non-inflammatory diseases
Tumors
Term
What is the leading cause of death ages 1-44 years?
Definition
Trauma (regardless of race, socioeconomic level)
Term
What is a fracture?
Definition
Break in continuity of a bone
Term
What are different ways of categorizing fractures?
Definition
Complete or incomplete
Closed or open
Term
What happens during a fracture?
Definition
Force applied to bone exceeds the tensile or compressive strength of the bone
Term
What is a pathologic fracture?
Definition
Due to underlying disease process
Term
What is a stress fracture?
Definition
Fatigue and insufficiency
Term
During a fracture that is damage to?
Definition
Surrounding tissues
Term
What forms during a fracture?
Definition
Hematoma
Term
What can a fracture trigger?
Definition
Inflammatory response
Term
What are clinical manifestations of a fracture?
Definition
Unnatural alignment
Swelling
Muscle spasm
Tenderness, pain
Impaired sensation
Decreased mobility
Term
What is treatment for a fracture?
Definition
Closed manipulation
Traction
Open reduction
Term
What happens during nonunion healing of a fracture?
Definition
-Failure of bone ends to grow together
-Gap fills with dense fibrous and fibrocartilaginous tissue
Term
What happens during delayed union healing of a fracture?
Definition
Union occurs 8-9 mos after fracture
Term
What happens during malunion healing of a fracture?
Definition
Bone heals in a non-anatomic position
Term
What is a strain?
Definition
Tear or injury to a tendon
Term
What is a sprain?
Definition
Tear or injury to a ligament
Term
What is an avulsion?
Definition
Complete separation of tendon or ligament from its bony attachment site
Term
What is bursitis?
Definition
-Inflammation of bursae
-Sac filled with synovial fluids
Term
What is epicondylitis?
Definition
Inflammation of tendon where it attaches to bone
Term
What is an example of lateral epicondylitis?
Definition
Tennis elbow
Term
What is an example of medial epicondylitis?
Definition
Golfer's elbow
Term
True of False: Myoglobinuria (Rhabdomyolisis) is a life threatening condition?
Definition
True
Term
What happens during myoglobinuria (rhabdomyolisis)?
Definition
Severe muscle trauma with muscle cell loss
Term
What are two syndromes associated with myoglobinuria (rhabdomyolysis)?
Definition
Crush syndrome
Compartment syndrome
Term
What is crush syndrome?
Definition
the edema, oliguria, and other symptoms of renal failure that follow crushing of a part, especially a large muscle mass
Term
What is compartment syndrome?
Definition
a condition in which increased tissue pressure in a confined anatomic space causes decreased blood flow leading to ischemia and dysfunction of contained myoneural elements, marked by pain, muscle weakness, sensory loss, and palpable tenseness in the involved compartment; ischemia can lead to necrosis resulting in permanent impairment of function.
Term
What is osteoporosis?
Definition
Porous bone; poorly mineralized bone
Term
What is there an imbalance of in osteoporosis?
Definition
Bone resorption and formation
Term
What is there a decrease in with osteoporosis?
Definition
Bone density
Term
What is normal bone density?
Definition
833 mg/cm2
Term
What is osteopenic bone density?
Definition
648-833 mg/cm2
Term
What is osteoporosis bone density?
Definition
<648 mg/cm2
Term
Who is osteoporosis most common with?
Definition
Women
Term
What is the primary cause of fractures in the elderly?
Definition
Osteoporosis
Term
What is the etiology of osteoporosis?
Definition
Decreased estrogen and testosterone
Decreased physical activity
Inadequate vitamins D, C
Inadequate Mg, Ca
Term
What are the manifestations of osteoporosis?
Definition
Pain
Bone deformity
Fractures
Kyphosis
Term
What is kyphosis?
Definition
Extreme curvature of the upper back
Also known as a hunchback
Term
What is osteomalacia?
Definition
Inadequate and delayed mineralization
Term
What type of disease is osteomalacia?
Definition
Metabolic disease
Term
What is a major risk factor for osteomalacia?
Definition
Vitamin D deficiency
Term
What is vitamin D deficiency a risk factor for osteomalacia?
Definition
Lowers absorption of calcium from intestines
Term
What doesn't occur in osteomalacia?
Definition
Calcification does not occur; thus results in soft bones
Term
What are clinical manifestations of osteomalacia?
Definition
Pain
Bone fractures
Vertebral collapse
Bone malformation
Term
What is osteomalacia in children called?
Definition
Rickets
Term
What happens in paget disease (osteitis deformans)?
Definition
-Abnormal and excessive resorption of spongy bone
-Accelerated formation of soft bone
-Increased metabolic activity in bone
-Disorganized, thickened, but soft bones
Term
What bones does paget disease (osteitis deformans) usually affect?
Definition
Bones of axial skeleton
Term
What does paget disease (osteitis deformans) cause?
Definition
-Abnormal bone curvatures
-Brain compression
-Impaired motor function
-Deafness
-Atrophy of the optic nerve
Term
What is the etiology of paget disease (osteitis deformans)?
Definition
Unknown
Term
What is a bone infection called?
Definition
Osteomyelitis
Term
What is osteomyelitis most commonly caused by?
Definition
Bacteria (Staph)
Term
What is exogenous osteomyelitis caused by?
Definition
-Open wound
-Fracture
-Surgical procedure
Term
What is endogenous osteomyelitis caused by?
Definition
Pathogen in blood
Term
What are clinical manifestations of osteomyelitis?
Definition
Acute and chronic inflammation
Fever
Pain
Necrotic bone
Term
What is treatment of osteomyelitis?
Definition
Antibiotics
Debridement
Surgery
Hyperbaric oxygen therapy
Term
Osteoarthritis (Degenerative Joint Disease) is what type of disorder?
Definition
Inflammatory
Term
What is there a loss and damage of in Osteoarthritis (Degenerative Joint Disease)?
Definition
Articular cartilage in synovial joints
Term
What happens during Osteoarthritis (Degenerative Joint Disease)?
Definition
Sclerosis of bone and formation of bone spurs (osteophytes)
Term
There are varying degrees of what in
Definition
Osteoarthritis (Degenerative Joint Disease)
Term
True or False: Incidence of Osteoarthritis (Degenerative Joint Disease) decreases with age?
Definition
False
Term
True or False: Primary Osteoarthritis (Degenerative Joint Disease) is idiopathic?
Definition
True
Term
Clinical manifestations of osteoarthritis?
Definition
Pain
Usually with wt bearing joints
Stiffness
Joint enlargement
Tenderness
Limited motion
Deformities
Term
What type of disease is rheumatoid arthritis (RA)?
Definition
Inflammatory joint disease
Term
What is RA?
Definition
Systemic autoimmune damage to connective tissue
Term
Where do you primarily see RA?
Definition
Joint synovial membrane
Term
What are the symptoms of RA similar to?
Definition
Osteoarthritis
Term
What is there a presence of in RA?
Definition
Rheumatoid factors - RA or RF
Term
What antibodies are present in RA?
Definition
IgG
IgM
Term
What is in the joint fluid in RA?
Definition
Inflammatory exudate
Term
Who is RA more common in?
Definition
Women
Term
What joints are commonly affected in RA?
Definition
Wrists
Knees
Term
You need 4 or more of the following to have RA?
Definition
-Morning joint stiffness lasting at least 1 hour
-Arthritis of three or more joint areas
-Arthritis of hand joints
-Symmetric arthritis
-Rheumatoid nodules
-Abnormal amounts of serum rheumatoid factor
-Radiographic changes
Term
What type of disease is ankylosing spondylitis?
Definition
Chronic, systemic, immune inflammatory joint disease
Term
What happens during ankylosing spondylitis?
Definition
Stiffening and fusion of the spine and sacroiliac joints
Term
What is the cause of ankylosing spondylitis?
Definition
Unknown cause (strong association with a specific antigen)
Term
What is treatment for ankylosing spondylitis?
Definition
Physical therapy
Exercise
NSAIDs
Surgery
Term
What does ankylosing spondylitis begin with?
Definition
Inflammation of fibrocartilage, particularly in vertebral and sacroiliac joint
Term
What happens after inflammation of fibrocartilage in ankylosing spondylitis?
Definition
Inflammatory cells infiltrate, erode fibrocartilage
Term
As repair begins in ankylosing spondylitis, what happens?
Definition
Scar tissue ossifies and calcifies
Joint eventually fuses
Term
What are early symptoms of ankylosing spondylitis?
Definition
Low back pain
Stiffness, pain, and restricted motion
Term
What is there a loss of in ankylosing spondylitis?
Definition
Normal lumbar curvature
Term
What is gout?
Definition
Metabolic disorder of uric acid metabloism
Term
What is there an excess or undersecretion of from the kidnesy in gout?
Definition
Uric acid production
Term
What are there high levels of in gout?
Definition
Uric acid in blood and body fluids
Term
What happens during gout?
Definition
-Uric acid concentration increases & causes crystallization
-Crystals deposit in connective tissues
Term
What is gouty arthritis?
Definition
Crystals deposit in synovial fluid
Term
What is disuse atrophy?
Definition
Pathologic reduction in normal size of muscle cells due to prolonged inactivity
Term
What are some things that can cause disuse atrophy?
Definition
Bed rest
Trauma
Casting
Local nerve damage
Term
What is treatment for disuse atrophy?
Definition
Isometric movements
Passive lengthening exercises
Term
What are contractures?
Definition
Contractures are the chronic loss of joint motion due to structural changes in non-bony tissue. These non-bony tissues include muscles, ligaments, and tendons.
-This makes it hard to stretch the area and prevents normal movement.
Term
What types of patients are at risk for contractures?
Definition
??HELP PLEASE??
Term
What is fibromyalgia?
Definition
Chronic musculoskeletal syndrome
Term
What are clinical manifestations of fibromyalgia?
Definition
Vague symptoms
Diffuse pain
Increased sensitivity to touch
Absence of inflammation
Fatigue
Sleep disturbances
Term
Who does fibromyalgia primarily affect?
Definition
Women
Term
What are possible factors that lead to fibromyalgia?
Definition
Flu-like viral illness, chronic fatigue syndrome, HIV infection, Lyme disease, medications, physical or emotional trauma
Term
Where do bone tumors originate from?
Definition
bone cells
cartilage
fibrous tissue
marrow
vascular tissue
Term
True or False: Bone tumors are only malignant?
Definition
False (benign or malignant)
Term
Who has the highest incidence for bone tumors?
Definition
adolescents
equals incidence for all at age 60
Term
What is a malignant bone-forming tumor called?
Definition
Osteosarcoma
Term
Where do you see osteosarcoma?
Definition
Adolescents
Young adults
Elderly treated with radiation therapy
Term
What does bone look like in osteosarcoma?
Definition
Moth eaten pattern
Term
Where is osteosarcoma usually located?
Definition
Metaphyses of long bones
Term
What is treatment form osteosarcoma?
Definition
Surgery
Term
What is another type of malignant bone tumor?
Definition
Chondrosarcoma
Term
Who is usually affected with chondrosarcoma?
Definition
Middle aged
Older
Term
What happens in chondrosarcoma?
Definition
Infiltrates trabeculae in spongy bone
Term
Where do you usually see chondosarcoma?
Definition
-Frequent in metaphyses or diaphysis of long bones
-Femur and Pelvis
Term
What does chondrosarcoma cause?
Definition
-Erosion
-Can expand into neighboring soft tissues
Term
What is treatment for chondrosarcoma?
Definition
Surgery
Term
What is rhabdomyosarcoma?
Definition
Highly malignant tumor of striated muscle
Term
True or False: Rhabdomyosarcoma is a rapid metastases?
Definition
True
Term
Who commonly gets rhabdomyosarcoma?
Definition
Infants
Children
Teenagers
Term
What does rhabdomyosarcoma affect?
Definition
Muscles of
-head
-neck
-genitourinary tract
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