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musculoskeletal exam 2

1.

rotator cuff tear

pain might improve but weakness remains

-encourage patient to stretch, rest, follow up with any physical therapy

2.

ACL tear

anterior cruciate ligament

-pivot, sudden stop, landing injury

-management brace, pain/swelling control, rehabilitation plan.

-safety: preventing falls, clear on safety, and getting around

3.

isometric exercise

quadriceps bent knee exercises and foot exercises

4.

meniscal injury

twisting with knee flexed and weight bearing.

-joint like pain, catching/locking, clicking, swelling.

5.

achilles tendon rupture

sudden push off, jumping, pivoting.

  • sudden posterior ankle/calf pain, cannot stand on toes
  • high risk of falls, limited mobility
  • side effect- can cause tendonitis
6.

bursitis

inflammation of a bursa (the saclike structures that line freely moveable joints) from overuse or pressure

-rest, ice, activity modification

7.

bunion

the most common foot problem. it is a painful swelling of the bursa that occurs in the great toe, at the metatarsal joint

8.

carpal tunnel syndrome

compression of the median nerve as it passes through the carpal tunnel in the wrist.

-pain, numbness, and tingling

9.

fracture= break

think circulation!!!!

10.

internal fixation

  • pins, nails, or metal plates to stabilize the portion of the two broke ends
11.

external fixation

massive open fractures with extensive soft-tissue damage infected fractures that do not heal properly

-multiple trauma such as burns, chest injury, or head injury

12.

external fixation nursing care

  • neuromuscular checks and pain control
  • pain-site care per facility protocol
  • mobility assistance and fall prevention
  • physical therapy and occupational therapy plan
13.

foot drop

  • caused by peroneal damage
  • unable to dorsiflex foot- foot drags when walking
14.

osteoarthritis asymmetrical

  • degenerative joint disease (cartilage breakdown in joints)
  • pain worse with use; brief stiffness after inactivity, joint deformity
  • management: pacing, strengthening, low impact exercise
15.

rheumatoid arthritis

  • autoimmune joint disease with systemic effects
  • symmetric joint swelling and warmth
  • prolonged morning stiffness and fatigue
  • goal: reduce inflammation and preserve function
16.

gout

  • inflammation from high levels of rate crystal deposition
  • sudden severe pain, swelling, redness (often great toe)
17.

signs and symptoms of gout

tight reddened skin over an inflamed, edematous joint accompanied by elevated temperature snd extreme pain in the joint,

elevated serum uric acid

18.

osteoporosis

decreased bone density- increased fracture risk

-often silent until fracture or height loss

19.

bisphosphonate teaching

take with water and remain upright

20.

Lyme disease

  • causes: spirochete, transmitted by the bite of a deer tick
21.

Paget disease

abnormal bone remodeling (weak bones)

; pain and fracture risk

  • bone tumors: pain , swelling and warmth
22.

osteosarcoma

cancer in the bones

23.

total joint replacement

  • preoperative teaching: mobility plam, pain plan, breathing
  • postoperative teaching: neurovacqlar checks and pain control
24.

any ortho surgeries

neurovascular checks

25.

pillows should always be applied to to your patient when moving them post op hip surgery to avoid :

hip dislocation

26.

amputation common causes

lower-limb amputations are related to peripheral vascular disease, diabetes mellitus and resultant gangrene, severe trauma, malignancy, congenital defects and military injuries from shrapnel and land mines

27.

amputation upp extremities

brought on by crushing blows, thermal, and electrical burns, severe lacerations, vasospastic disease, malignancy, and infection

28.

amputation post op care

  • monitor dressing and drainage, vital signs and perfusion
  • protect skin and incision; follow dressing orders
  • prevent contractures with correct positioning
  • encourage mobility plan and strengthening as ordered
  • phantom limb sensations
29.

amupatation think

hemmorage / bleeding , number one priority

30.

prosthetics and rehabilitation

  • requires proper stump healing and shaping
  • physical therapy essential for mobility
  • goal: restore indépendence and ADL'S
  • below knee amupations have better outcomes than above knee
  • patient education critical for success
31.

accidental amputation

  • rinse only to remove visible debris
  • wrap in clean damp cloth; seal in waterproof bag/waterproof
  • keep cool in ice-water mixture (do not freeze)
  • label and transport with the patient