Intro to Musculoskeletal System
What are the three bone cells and what do they do? DJ
Osteoblasts-build new bone
Osteocytes are mature bone cells
Osteoclasts break down and remodel bone
What test would detect a fracture, dislocation, joint deformities, bone tumors, osteoporosis?
What is an X-ray, CT, MRI?
What is compartment syndrome?
Pressure buildup from internal bleeding or swelling of tissues. Pressure decreases blood flow.
Differentiate a strain from a sprain.
A strain is a stretched or torn muscle or tendon. A sprain is a stretched or torn ligament.
RA is an autoimmune disease, causing inflammation. You will find elevated inflammatory markers such as ESR and CRP.
OA is a non-inflammatory, progressive joint disease, no systemic symptoms. Normal inflammatory markers.
Where are the red and yellow marrow located?
Red marrow is located in the flat bones (sternum, pelvis, vertebrae, ribs). Yellow marrow is located in the long bones.
What is a normal sound heard following an arthrogram for up to two days?
A post-test clicking is normal from the air injected.
What is the concern of using our fingers when applying our cast? DJ-What should the client do following cast removal?
Can create indentations and cause pressure injuries.
Wash softly with warm water
What is the treatment of a Sprain or Strain?
PRICE
Arthritis in the jaw joint, Teeth grinding, jaw misalignment, injury or overuse.
What are the three types of muscles and where are they located at?
Skeletal muscles, controlled by the CNS, located in biceps. Smooth muscles, controlled by the ANS, found in organs. Cardiac muscle, found only in heart, controlled by intrinsic mechanisms
Differentiate between an Arthrocentesis and an Electromyography (EMG).
An arthrocentesis removes synovial fluid via a needle to relieve pressure or inject medications. An EMG is done to test muscle and nerve electrical activity for weakness or nerve damage.
What is involved in a neurovascular assessment before and after a cast application?
CSM-Circulation, Sensation, Mobility.
Pain, Temperature, Skin Color, Swelling, Paresthesia, cap refill, ROM, pulses
What is epicondylitis?
Tennis elbow, painful elbow inflammation from repeated movements
What labs and medications are specific to GOUT?
Increased Uric Acid. Meds: Colchicine, and Allopurinol
What is the difference between a tendon and a ligament?
Tendons connect muscle to bone, Ligaments connect bone to bone.
What is a DEXA scan?
A bone densitometry (DEXA) measures bone mineral density for osteoporosis.
What is the current best practice for pin care site?
Assess for infection risk, use sterile water, saline, or chlorhexidine with 1 cotton tipped applicator per pin.
What are the stages of bone healing?
Stage 1-Hematoma Formation
Stage 2 Procallus Formation
Stage 3 Callus Formation
Stage 4 Bone Remodeling
How can a person with SLE (lupus) prevent flare-ups?
Avoid sun exposure, use sunscreen, Avoid infections and crowds, balance rest with activity, maintain nutrition and hydration, avoid OTC meds unless approved.
What are 10 aspects of a musculoskeletal assessment?
Ask about recent injury, pain, impact on ADLs, numbness, tingling, nutrition, oberseve the client's gait, balance, posture, ROM, muscle strength, Neurovascular checks, CMS.
List 3 different labs ordered for a musculoskeletal assessment and why?
CBC (looking for elevated WBC indicating an infections)
Alkaline Phosphatase (elevated if a bone tumor or healing fracture)
Acid Phosphatase (Elevated in Paget's disease or metastatic cancer)
Serum Calcium (Low for osteomalacia and osteoporosis.)
Serum Phosphorus (high would indicate bone tumors, healing fractures)
Uric Acid (Increase for Gout)
ANA (Increase for Lupus)
Describe 3 ways to prevent hip dislocation following a hip replacement.
Use abductor pillow, do not exceed 30 degrees of flexion, sit in elevated chairs, don't cross legs, don't flex at your hip.
What is an ORIF
Open Reduction, Internal Fixation
How do you treat Osteomalacia?
Vitamin D supplements.