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Advanced Med Surg
Musculoskeletal Function Assessment
| Question | Answer |
|---|---|
| What is ossification? | Bone matrix is formed and hard mineral crystals composed of calcium and phosphorus are bound to the colagen fibers |
| What happens with Vitamin D deficiency? | Bone minerazation deficit, deformity, and fracture |
| What is a bone forming cell? | Osteoblast functions in bone formation by secreting bone matrix |
| What is bone remodeling? | Necrotic bone is removed by osteoclasts. Compact bone replaces spongy bone around the fracture periphery. |
| What does muscle action produce? | Movement |
| What is a muscle that is limp without tone? | Flaccid |
| What is an important aspect of the musculoskeletal assessment? | History of present illness (HPI) |
| What sensory disturbances are frequently associated with musculoskeletal problems? | Burning, tingling, numbness, pain |
| What is the Fracture Risk Assessment tool FRAX) | Tool used to predict a patient's 10 year risk of fracturing a hip or other major bone |
| When assessing the musculoskeletal system, what pertinent data should be involved in the health history? | Occupation, exercise patterns, alcohol consumption, tobacco use, dietary intake. Concurrent health conditions including diabetes, heart disease, COPD, infection, preexisting disability, genetic abnormalities) |
| The nursing assessment includes what in relationship to musculoskeletal function? | Functional evaluation focusing on the patients ability to perform ADL's |
| Increased forward curvature of the thoracic spine that causes a bowing or rounding of the back, leading to a hunchback or slouching posture. | Kyphosis |
| Exaggerated curvature of the lumbar spine | Lordosis |
| Lateral curving deviation of the spine | Scoliosis |
| How do you assess gait? | Have the patient walk away from the examination er for a short distance |
| What are common causes of lordosis? | Tight low back muscles, excessive visceral fat, pregnancy |
| Painful weight bearing results in what? | Limping motion |
| How do you assess muscle strength? | Have the patient perform certain maneuvers with and without added resistance |
| What are the two key elements to assess peripheral nerve function? | Evaluation of sensation and evaluation of motion |
| What are the indicators of peripheral neurovascular dysfunction? | Circulation: Color: pale, cyanotic, mottled; cool temperature, capillary refill more than 3 seconds. Motion: weakness and paralysis, Sensation: parasthesia, unrelenting pain, pain on passive stretch, absence of feeling |
| What are recommendations to maintain bone health for older adults? | Weight bearing exercises, consume a diet with adequate calcium and vitamin D, exercise to improve balance and reduce fall risk, avoid smoking, alcohol, caffeine, Carbonated beverages |
| Joint deformity with ulnar deviation of fingers and "swan neck" deformity of fingers is what? | Rheumatoid Arthritis |
| What is the procedure that allows direct visualization of a joint through the use of a fiberoptic endoscope? | Arthroscopy |
| What does the nurse assess after a bone biopsy? | The site is monitored for edema, bleeding, pain, hematoma formation, and infection |
| What diagnostic evaluation is completed to evaluate muscle weakness, pain and disability? | Electromyography |
| Age related changes of the musculoskeletal system include what structural changes? | Gradual and progressive loss of bone mass after 30 Vertebral collapse of bones Increase in collagen and resultant fibrosis Muscle atrophy and wasting Tendons less elastic Cartilage progressively deteriorates and there is thinning of vertebral discs Less than normal strength and weakness (Lax ligaments) |
| What are the age related functional changes of the musculoskeletal system? | Bones fragile and prone to fracture from the vertebrae, hip and wrists Loss of strength and flexibility of muscles Weakness Fatigue Stumbling Falls Stiffness with reduced flexibility and pain that interferes with ADL's Postural joint abnormalities |
| Identify the history and physical findings related to age changes of the musculoskeletal system | Loss of height Postural Changes Kyphosis Loss of flexibility Flexion of hips and knees Back pain Osteoporosis and fracture Loss of strength Diminished agility Decreased endurance and diminished reaction time Diminished tone Broad base of support History of falls Diminished ROM Stiffness Joint pain on motion that resolves with rest Crepitus Joint swelling/enlargement Osteoarthritis (degenerative joint disease |
| What are the indicators of peripheral neurovascular dysfunction? | Circulation: pale cyanotic or mottled; cool temperature and capillary refill more than 3 seconds Motion: weakness; paralysis Sensation: Paresthesia; unrelenting pain; pain on passive stretch and absence of feeling |
| Computerized Tomography | Can be done with or without oral or IV contrast. Shows a detailed cross sectional image of the body. Used to visualize and assess tumors, injury to soft tissues, ligaments, or tendons, and severe trauma to chest, abdomen, pelvis, head, or spinal cord. Also used to locate and identify the extent of fractures in areas difficult to evaluate. |
| MRI | Noninvasive imaging technique that uses magnetic fields and radio waves to create high resolution of bone and soft tissues. Used to visualize torn muscles, ligaments, cartilage, herniated discs and hip or pelvic conditions |
| Patient education for MRI use should include | Scanner is noisy Exam may take 30-90 minutes Patients with metal implants or clips are not candidates for MRI testing Potential allergy to IV contrast used May cause claustrophobia |
Created by:
PRO Teacher
lygervase
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