Brunner & Suddarth's Textbook of Medical-surgical Nursing: Medical surgical nursing Flashcards

skeleton, joints, ligaments, muscles, and tendons

Support
Protection
Movement
Hematopoeisis
Storage

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

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

Yellow and Red (responsible for hematopoiesis

Stenum, ileum, vertebrae, and ribs

in long bones

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

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

Cells that build bones

Cells involved in destruction reabsorbtion and remodeling of bone

Mature bone cells

Heredity
Nutrition
Exercise
Hormones
Muscle tissue characteristics

to absorb calcium and phosphous

For bone calcification

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

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

immovable joint

slightly immovable

freely movable

tough fibers that bind bones together

secretes synovial fluid a lubricating material

Fluid filled sac that cushions movement of the muscles and tendons

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

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

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

Muscles move skeleton and maintains normal body tmeperature

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

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

cordlike structures that attach muscles to periosteum of the bone

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

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

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

Frontal lobe of the cerebral cortex

Cerebellum

Neuromuscular juntions

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

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)

Lateral curvature of the spine

Exaggerated convex curvature of the thoracic spine (humpback)

Excessive concave curvature of the lumbar spine (Swayback)

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

determine bone density alignment swelling and intactness

Provides cross section of bony soft tissue

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

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

aspiration of synovial fluid or inject corticosteroid

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

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

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

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

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

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

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

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

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

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

skin intactness
type
location
alignment status

no break in the skin simple fracture

bone protrudes thru skin compound fracture

close to the body

Away from the body

Middle portion of the body

bone fragments are aligned at the fracture sight

two edges of fracture moved out of alignment zigzag contour

Edges are postioned but the fragments are out of alignment

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

plaster of paris and synthetic

body cast limit calorie intake

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

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

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

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

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

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

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

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

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

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

Some ligament tearing edematous tenderness moderate pain with movement

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

rest ice compression elevation

involves extension and flexion injuries usually the knee

anterior cruciate ligament tears due to twisting sudden stopping motion

attaches the muscle to the heel

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

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

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

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

occurrence of numbness with wrist flexion

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

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

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

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

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

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

A broken wrist

the bone is broken or shattered into multiple smaller pieces

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

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

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

an angled break

fracture caused by sickness disease

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

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

a complete degree break

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

in the joint

complete break into 2 pieces malaligned

the fracture is parallel with the bone

fracture goes in a slanting direction in the bone

having a segment of the bone fractured and detached

fragments pushed inward and depressed

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

enlargement of the proximal inter-phalangeal joints

grows in the terminal phalengeal joints with DJD

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

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

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

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

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

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

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

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

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

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

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

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

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

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