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Musculoskeletals
Test 3
| Question | Answer |
|---|---|
| Determines if the disorder is inflammatory or noninflammatory | ESR (Erythrocyte Sedimentation Rate)C-reactive protein |
| detects antibodies present w/ rheumatoid arthritis | RF (rheumatoid factor) |
| evaluates for anemia, infection or inflammation | CBC (complete blood count) |
| may indicate bone tumor & healing fractures | Elevated alkaline phosphatase level |
| may indicate Paget's disease (disease characterized by excessive bone destruction & disorganized repair) & metastatic cancer | Elevated acid phosphatase level |
| May indicate osteomalacia (rickets), osteoporosis & bone tumors | Decreased serum calcium |
| may indicate bone tumor & healing fracture | increased serum phosphorus level |
| may indicate gout | elevated serum uric acid level |
| may indicate lupus erythematosus (connective tissue disorder) | elevated antinuclear antibody (ANA) level |
| most commonly used for knee joint, arthroscope-internal inspection of a joint using arthroscope, need to be NPO, need consent form | Arthroscopy |
| can be done same time as arthoscopy, aspiration of synovial fluid | Arthrocentesis |
| radiographic exam of a joint (shoulder or knee) w/ use of a contrast medium | Arthrogram |
| Estimates bone density: pt w/ osteoporosis. radiography of wrist, hip or spine to determine bone mineral density | Bone Densitometry |
| uses intravenous injection of a radio-nuclide to detect uptake of the radioactive substance by the bone. detects metastatic bone lesions, fractures & certain types of inflammatory disorders | Bone Scan |
| Test electrical potential of the muscle & nerves leading to muscle, done to differentiate muscle & nerve problems: usually done w/ back surgery | electromyography |
| detects levels of uric acid & calcium excretions | 24hr urine |
| aspirated & examined to diagnose disorders such as traumatic arthritis, septic arthritis, gout, rheumatic fever & systemic lupus | synovial fluid analysis |
| Degenerative Joint Disease, most common form of arthritis | Osteoarthritis |
| affected leg must be kept in a position of abduction to prevent dislocation no greater than 45 degrees | Replaced Hips |
| CPM goal of 90 flexion | Replaced Knees |
| Chronic progressive inflammatory disease, systemic disorder of connective tissue & joint | Rheumatoid Arthritis |
| Result is loss of bone mass makes the pt more susceptible to fractures | Osteoporosis |
| measures bone mineral density of the spine & hip | DEXA |
| treated w/ percutaneous vertebroplasty | spinal compression fractures |
| painful metabolic disorder involving an inflammatory reaction in joint, usually affects the feet | Gout |
| Severe dieting or starvation, excessive ingestion of purines, heredity | Primary Hyperuricemia |
| abnormal purine metabolism, increased rate of protein synthesis w/ overproduction or under-excretion of uric acid | Secondary Hyperuricemia |
| scleroderma | progressive systemic sclerosis |
| spasm of the digital arteries w/ blanching & numbness or pain in fingers: red, white, blue | Raynaud's Phenomenon |
| inflammation of the bursa, a fluid filled sac that cushions bone ends to enhance a gliding movement | Bursitis |
| elbow, shoulder, & knee | common sites for bursitis |
| connective tissue disorder, may be autoimmune & has heredity tendencies | Ankylosing Spondylitis |
| Tick bites, Borrelia burgdorferi, results in chronic inflammatory process & multi-system disease | Lyme disease |
| Infection in the bone, formation of new bone around devitalized bone tissue, difficult to treat | Osteomyelitis |
| Autoimmune, antibodies destroy connective tissues, affected structures undergo inflammation, fibrosis, scarring & dysfunction, butterfly | lubus erythematosus |
| kidney failure | proteinuria/hematuria |
| chronic bone disorder characterized by abnormal bone remodeling, affects long bone, spine, pelvis & skull | Paget's Disease |
| deformity of the great toe at its matatarsophalangeal joint | hallux valgus/bunions |
| flexion deformity of the interphalangeal joint & may involve several toes | hammer toe |
| inflammation of a tendon cased by overuse | tendonitis |
| group of symptoms located in the wrist where the carpal bones, carpal tendons & median nerve pass through a narrow, in-elastic canal | Carpul Tunnel Syndrome |
| Tennis elbow, pain that radiates down the dorsal surface of the forearm & a weak grasp | Epicondylitis |
| a cystic mass that develops near tendon sheaths & joints in the wrist | ganglion |
| usually result of misplaced or overgrown clusters of normal bone or cartilage cells that cause the structure to enlarge & impair function | Benign Bone Tumors |
| Primary tumors include osteosarcoma, Ewing's sarcoma, chondrosarcoma & fibrosarcoma. most common site is lungs | Malignant bone Tumors |
| pain, tingling, burning or itching | phantom limb |
| breaks fun along a slant to the length of the bone | oblique |
| splintered into fragments | comminuted |
| breaks coils around the bone | spiral |
| incomplete fracture, common in children | greenstick |
| one bone fragment if forcibly wedged against another bone fragment | impacted |
| fracture that remains contained, does not break the skin | simple |
| fracture in which damage also involves the skin or mucus membranes | compound |
| fracture in which bone has been compressed as seen in vertebral | compression |
| pulling away of a fragment of bone by a ligament or tendon & its attachment | avulsion |
| fracture in which fragments are driven inward as seen in skull & facial bone fractures | depressed |
| fracture that occurs through an area of diseased bone, can occur w/out trauma or a fall | pathologic |
| grating sound of bone ends moving over one another | crepitus |
| occurs immediately after a fracture along w/ edema. in 48-72 hours, hematoma forms btwn 2 broken ends of a bone | Stage 1 |
| hematoma does not reabsorb. instead other cells enter the clot & granulation tissue forms becoming firm & making a bridge btwn 2 broken ends | stage 2 |
| end of first week, granulation tissue turns into callus which is made up from cartilage, osteoblast, calcium & phosphorus | stage 3 |
| within 2-3 weeks, woven bone forms, ends of the broken bone begin to knit | stage 4 |
| excess bone is naturally chiseled away by stress to the affected part from motion, exercise & weight bearing | stage 5 |
| condition in which fat globules are released from the marrow of the broken bone into the blood stream, lodge in capillaries of the lung & obstruct blood flow | fat embolism |
| venous stasis, vessel damage & altered clotting mechanisms may all contribute to the formation of blood clots | deep vein thrombosis: Virchow's Triad |
| once bone cells are deprived of oxygen & nutrients, they die & the cell walls collapse | avascular necrosis |
| improper alignment of the bone ends resulting in external deformity | malunion |
| fractures never heals | nonunion |
| failure of the fracture to heal in the expected time | delayed union |
| fracture of the foot, ankle or distal tibia or fibula | short leg cast |
| fracture of the distal femur, knee or lower leg | long leg cast |
| fractures of the femur, acetabulum or pelvis | hip spica cast |
| fracture of the wrist of hand | short arm cast |
| fracture of the forearm, elbow or humerus | long arm cast |
| exerts a pulling force on a fracture extemity to provide alignment of the broken bone fragments, decreases muscle spasms, aids w/ pain relief | traction |
| provides a strong steady pull & can be used for longer periods of time: gardner-wells, crutchfield, vinke tongs & halo vest | skeletal traction |
| breaks in distal radius, usually when an outstretched hand is used to break a fall | colles' fracture |
| motor vehicle accidents are most common cause in young adults where falls are the most common in older adults, heal w/in 6-8 wks | Fracture of Pelvis |
| sudden and severe chest pain & shortness of breath | pulmonary embolism |
| weakness, slurred speech, & confusion | stroke |
| severe CP, jaw pain, irregular pulse, chest pressure | MI |
| internal or external pressure on the affected area | Compartment syndrome |
| can be caused by bleeding or edema into a compartment | internal pressure |
| can be caused by a cast or tight dressing | external pressure |
| within 4-6 hrs irreversible muscle damage may occur, partial paralysis can occur in 24 hrs, complete paralysis can occur in 24-48 hrs | compartment syndrome |
| process of bringing the ends of the broken bone into proper alignment | reduction |
| nonsurgical realignment of the bone; done w/ traction, angulation, rotation or a combo of these | closed reduction |
| surgical procedure where the bones are realigned, done for commuted fractures or open fractures | open reduction |
| an attempt to attach the fragments of the bone together when the reduction alone is not reasible because of the type & the extent of the break | fixation |
| includes the use of rods, pins, nails, screws, or metal plates to align the bone fragments & keep them in place for healing | internal fixation |
| similar to internal fixation but the pins in the bone are attached to an external frame | external fixation |
| initially cast is hot, then becomes damp & cool | plaster of paris |
| weights must hang freely | traction |
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