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muscular skeletal system
updated 6 years ago by pbrobsst
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1

Muscular Skeleton system includes

skeleton, joints, ligaments, muscles, and tendons

2

Functions of the skeleton

Support
Protection
Movement
Hematopoeisis
Storage

3

Compact Bone

Hard and dense composes the shaft of the long bones and outer layer of bones

4

Spongy Bone

Composed of small bony plates contains more spaces than compact bone Filled with soft substance: Marrow

5

What are the 2 types of Bone Marrow

Yellow and Red (responsible for hematopoiesis

6

Where is red marrow found

Stenum, ileum, vertebrae, and ribs

7

Where is yellow marrow found

in long bones

8

Cancellous (spongy bone)

light contains may spaces found mostly at rounded, irregular ends or epiphyses of long bones

9

Cortical (Compact)Bone

Dense and Hard found mostly in the long shafts or diaphyses of bones in arms and legs

10

Osteoblasts

Cells that build bones

11

Osteoclasts

Cells involved in destruction reabsorbtion and remodeling of bone

12

Osteocytes

Mature bone cells

13

What factors affect bone growth

Heredity
Nutrition
Exercise
Hormones
Muscle tissue characteristics

14

What is vitamin D needed for

to absorb calcium and phosphous

15

What is vitamin A and C needed for

For bone calcification

16

Hormones affecting Bone growth

Growth Hormone( in the pituitary)
Thyroxine (increases protein synthesis)
Glucose ( provides energy)
Parathyroid Hormone ( increases the removal of calcium and reduces serum calcium) Phosphate from bone and calcitonin promotes retention in bone and reduces serum calcium
Sex Hormone estrogen and testosterone(important for the retention of calcium in adult bones

17

What can happen in children with damage to the epiphyseal growth plate

The younger the child is when injury occurs the greater the final deficit in length between the injured limb and uninjured limb will be

18

Synathroses

immovable joint

19

Amphiarthroses

slightly immovable

20

Diarthroses

freely movable

21

Ligaments

tough fibers that bind bones together

22

Synovial membrane

secretes synovial fluid a lubricating material

23

Bursae

Fluid filled sac that cushions movement of the muscles and tendons

24

What do synovial joints have?

Smooth white articular hyaline cartilage to decrease friction
Joint capsule lined with a synovial membrane
Cavity filled with synovial fluid clean and nearly colorless lubricates joint to decrease friction
Bones in these joints have bursae small sacs of synoval fluid between joint and tendon permits tendons to slide as joint moves

25

Synovitis

joint is swollen tender painful with restricted motion May result from strain or sprain

26

What are the muscle classification

Skeletal Controls movement of skeleton
Smooth/Visceral Controls involuntary motion inside body organs
Cardiac Automatic responsible for propelling blood through blood vessels

27

Functions of muscles

Muscles move skeleton and maintains normal body tmeperature

28

Purpose of ligaments

Connect bones to muscles or cartilage
Support internal organs or structures
Allows great flexibility stretching movement

29

Accessory ligaments

Don not move or stretch but strengthen or support other ligaments to produce stability of joints

30

Tendons

cordlike structures that attach muscles to periosteum of the bone

31

Ligaments

Fibrous tissue connecting two adjacent freely movable bone Help to stabilize the joint and keep in proper alignment

32

Cartilage

Firm Dense type of connective tissue Reduces friction between articular surfaces absorb shocks and reduce stress on joint surfaces

33

Bursae

Small sac filled with synovial fluid reduces friction between areas such as tendon and bone and tendon and ligament

34

In order for muscles to contract Nerve impulses originates from where to initiate muscle contraction

Frontal lobe of the cerebral cortex

35

What coordinates and regulates voluntary movement muscle contraction

Cerebellum

36

Where do nerve fiber and muscle fiber make contact

Neuromuscular juntions

37

What happens with muscular skeletal system with aging

Women after menopause lose more calcium than is replace
Weight bearing joints wear down
Muscle strength decreases

38

What does PQRST stand for when assessing for pain

P= provoking incident
Q= quality of pain(burning, throbbing, stabbing)
R= Region radiation relief
S= Severity of pain(pain rating scale)
T= Time (how long does it last, when does it occur when is it worse)

39

Scoliosis

Lateral curvature of the spine

40

Kyphosis

Exaggerated convex curvature of the thoracic spine (humpback)

41

Lordosis

Excessive concave curvature of the lumbar spine (Swayback)

42

Physical Assessment

Inspection check joints and muscles of hands arms legs and feet palpate

43

What does an x-ray determine in muscular skeletal system

determine bone density alignment swelling and intactness

44

Why use CT scan for muscular skeleton

Provides cross section of bony soft tissue

45

MRI is used for what

More accurate than CT the only dx modality that can demonstrate for demelinated cord lesions found in MS also detects tumors, degenerated discs, osteomyelitis

46

Arthroscopy

Internal inspection of a joint by means of an instrument called an arthroscope

47

Arthrocentesis

aspiration of synovial fluid or inject corticosteroid

48

Arthrogram

radiographic exam of a joint fluroscopy synovial fluid is aspirated contrast medium injected
Crackling of clicking noise for up to 2 days

49

what is a bone scan

IV injection of a radionuclide to detect uptake of radioactive substance by the bone. Can detect bone lesions, fracture, some inflammatory disorders
Bladder needs emptied before exam increase fluids after procedure

50

Bone biopsy

Identifies bone composition muscle or synovium
do not more for 8 to 12 hours

51

Myoglobin

protein found in striated skeletal or cardiac muscle released in blood when skeletal or cardiac muscle is damaged

52

creatine kinase aldolase AST and LDH

enzymes elevated with disease such as Muscular Dystrophy, Polyositis, and dermatomyositis

53

Ultrasonography

visualization of bone or soft tissue ,noninvasive, uses sound waves
Use to detect osteomyelitis soft tissue disorders joint injuries and surgical hardware placement

54

EMG

Nerve conduction study Electrical shocks to nerves and muscles any alteration in the electrical waves indicates a problem with the nerves or the muscles

55

Myelogram

Visualization of the spine and spinal cord after injection of a contrast medium injected in the subarachnoid space
Postop assess for headache and nausea HOB should be raised no more than 45 degrees for 3 hours

56

Gallium thallium scan

injected with radioactive substance which migrates to bone, brain ,breast and inflammatory tissue

57

Fractures

exceeds maximum resistance begins to repair itself immediately heals in approx 6 weeks

58

Fx identification

skin intactness
type
location
alignment status

59

Close fracture

no break in the skin simple fracture

60

open fracture

bone protrudes thru skin compound fracture

61

Proximal

close to the body

62

Distal

Away from the body

63

Midshaft

Middle portion of the body

64

Nondisplaced

bone fragments are aligned at the fracture sight

65

Displace

two edges of fracture moved out of alignment zigzag contour

66

Angulation

Edges are postioned but the fragments are out of alignment

67

Stages of healing

hematoma formation
cellular proliferation
New capillaries and vessels
callus forms
excess callus

68

Types of cast

plaster of paris and synthetic

69

Spica cast

body cast limit calorie intake

70

window cast

when a wound is under cast portion of cast may be removed ( window)

71

Bivalved cast

with signs and sysptoms of neurovascular compromise the cast is bivalved by cutting it length wise and elastic bandage used to secure

72

Petal Cast

moleskin or adhesive tape lines cut 2 inch strips of adhesive tape or moleskin in the shape of petals line the edge of the cast

73

Cast syndrome

commonly occurs with spica cast claustrophobia signs are increase VS diaphoretic nausea abdominal pressure and pain pressure on the mesentary artery against the duodenum causing nausea

74

Contusion

capillaries small vessels rupture and bleed into the surrounding area causes skin color to change as blood is absorbed color changes bruising and color changes Pain swelling and discoloration

75

strains

injury to muscle or tendon related to overstretching overuse or excessive stress

76

three classes of strains

Mild overstretching of muscle and connective tissue
Moderate tearing of muscle and connective tissue
Severe extensive tearing of muscle and fascia

77

Symptoms of severe stains

muscle soreness swelling local tenderness with use sudden pain with pain on movement discoloration with contusions or soft tissue injury

78

Sprain

caused by tearing twisting stretching injury involves the ligament surrounding the joint
acute trauma activities with overhead movements deterioration with aging

79

Mild sprain

ligament stretched or microscopic tear local tenderness swelling can move the affected part

80

Moderate sprain

Some ligament tearing edematous tenderness moderate pain with movement

81

Severe sprain

ligament is disrupted with stress joint instability unable to flex joint or bear weight

82

RICE

rest ice compression elevation

83

Meniscus tear

involves extension and flexion injuries usually the knee

84

ACL

anterior cruciate ligament tears due to twisting sudden stopping motion

85

Achilles tendon

attaches the muscle to the heel

86

Rotator cuff tear

tears of the shoulder due to damage to the rotator cuff muscles or tendons due to the repetitve injury or sudden trauma Pain weakness loss of shoulder movement

87

Bursitis

inflammation of the bursa small sac between the muscles and joint due to mechanical irritation bacterial infection trauma gout

88

Epicondylitis

Tennis elbow damage to the tendons of the medial or lateral radial and ulnar epicondyles

89

Carpal Tunnel Syndrome

repetitive wrist motion swelling involves the median nerve against transverse carpal ligament pain burning mostly at night and early am decrease sensation lost or reduced in the thumb index middle and portion of the ring finger

90

Phalen's sign

occurrence of numbness with wrist flexion

91

Tinel's sign

indicates nerve irritability produced by tapping over median nerve of the wrist results in distal tingling sensation on percussion of damage nerve

92

Dislocations

Trauma of great force caused by congential or acquired hip dislocations neuromuscular disorders RA

93

Subluxation

an incomplete dislocation contact between joint surfaces are disrupted stuctures become trapped and may result in ishchemic

94

Internal fixation

prosthesis causes many pathological fractures in elderly Austin More or Thompson prosthesis referred to as hemiarthroplasty

95

External fixation

metal pins inserted into bone from the outside skin surface and attached to pins through a compression device

96

Types of fractures

Direct blow to bone indirect twisting motion or severe muscle spasm crushing injuries fatigue or stress fracture Disease such as cancer or osteoporosis

97

Collies Fracture

A broken wrist

98

Comminuted fracture

the bone is broken or shattered into multiple smaller pieces

99

Compound fracture

frequently caused by degenerating bone conditons such as osteoporosis this is when the vertebrae seem to shrink

100

Greenstick fracture

Primarily seen in kids this is when the bone is not totally broken like a young twig this is when part of the bone is splintered but not completely broken

101

Impacted fracture

denotes when a piece of the bone is shoved into a different part of the bone

102

oblique fractue

an angled break

103

Pathologic fracture

fracture caused by sickness disease

104

spiral fracture

incredibly slow to heal is when the broken bone is twisted around the axis common to sports or work related injuries

105

Stress fracture

caused by compounded low intensity movements such as running rather than by a lone force

106

transverse fracture

a complete degree break

107

Avulsion

a fracture caused by tearing away of a fragment of bone where strong ligaments or tendons are attached
it forcibly pulls the fragment away from the bone tissue

108

Intra-articular

in the joint

109

displaced fracture

complete break into 2 pieces malaligned

110

longitudinal fracture

the fracture is parallel with the bone

111

oblique

fracture goes in a slanting direction in the bone

112

segmental fracture

having a segment of the bone fractured and detached

113

depressed fracture

fragments pushed inward and depressed

114

Arthritis symptoms

persistent pain and stiffness
pain and tenderness of the joints
swelling in the joints recurrence of symptoms
obvious redness and warmth in the joint

115

Bouchards nodes

enlargement of the proximal inter-phalangeal joints

116

Herberdens nodes

grows in the terminal phalengeal joints with DJD

117

Osteoarthritis

primarily affects weight bearing joints most common cause of disability in the elderly
slow deterioration of the articular cartilage and bone ends of a joint

118

Intervertebral disk

results when a small pad or disk or cartilage nuclues pulposus between the two vertebrae presses against the spinal nerve that radiate out from the spinal cord also knoown as herniated muclleus pulposus and sciatica

119

Osteomyelitis

Infection of the bone bone tissue becomes necrotic often as a bone abcess

120

Osteoporosis

metabolic disorder bone loses density bone resorbtion exceeds bone formation irreversible bone loss with increasing age cancellous bone loss first then compact bone

121

risk factors for osteoporosis

caucasian postmenopausal women
sedentary lifestyle
decrease calcium intake
lack of vitamin d
excessive alcohol intake smoking
petite body build and increase caffient

122

secondary risk factors for osteoporosis

hyperparathyroid
long term drug therapy esp steroids
prolonged immobility esp in the spinal cord

123

blood test for bmd

decrease in serum calcium and vitamin d increase phosporous increas alkaline phospatase with severe bone loss

124

Padget's disease

osteitis deformans metabolic disease of bone excessive bone destruction increase in number of osteoclast excess bone resorption the increase in osteoblast that leads to enlarged bones poor mieralization

125

signs of padgets

bone and joint pain low back pain bowing of long bones loss of normal spine curvature enlarged thick skull pathologic fractures osteogenic scarcoma

126

Primary malignant bone tumors

osteosarcoma mets to the lungs
ewings sarcoma most malignant
chrondosarcomas better prog

127

multiple myeloma

most common primary bone cancer it is malignant tumor of the bone marrow affects apprx people per million each yeary between ages -

128

Osteosarcoma

second most common bone cancer it mostly affects teens develops in growing bone mets to the lungs

129

Ewings sarcoma

ages - begins in the nerve tissue in bone marrow most malignant

130

Chondrosarcoma

affects mostly ages- 40-70 starts in the cartilage has better prog