MS system diseases and disorders ch. 31,32

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joint

articulation or connection point between 2 bones

ligaments

hold bones of a joint together

cartilage

type of connective tissue that acts as a cushion for joints

bursa

fluid filled sac that provides friction free movement

fascia

connective tissue that surrounds and separates muscles

tendons

attaches muscle to bone

osteocyte

bone cells

osteoblast

immature bone cells that build bone

diaphysis

shafts of long bones and contain yellow marrow

epiphysis

the ends of long bones and have red marrow

periosteum

fibrous connective tissue that covers or lines the bones

hematopoesis

blood cell formation and takes place in the red marrow

erythropoetin

makes red blood cells

vit a, c, d, calcium, phosphorous

essential nutrients needed for bone growth

estrogen, growth hormone, testosterone

hormones that are influintial in the retention of calcium

where is red bone marrow made?

flat, spongy bone

axial, appendicular

2 divisions of the skeleton

suture

joints in the skull

functions of bone

structure, protection, blood cell formation, movement, posture, shape

functions of muscle

heat, strength, protection

changes in the ms system with age

bone loss, muscle atrophy, brittle, fracture easily, kyphosis, decrease in flexibility, weaken, bone density decreases

flexion

bending of joint

extension

straightening of a joint

abduction

away from the body

adduction

toward the body

rotation

movement around an axis of a joint

supination

rotation of the forearm with palms facing up

pronation

rotation of the forearm with palms facing down

dorsiflexion

hands and toes pointing toward the body

plantar flexion

hands and toes pointing away from the body

kyphosis

convex curvature of the thoracic spine

lordosis

concave curvature of the lumbar spine

scoliosis

lateral curvature of the spine

7 P's

pulselessness, paresthesia, paralysis, polar temp, paleness, puffiness, pain

parasthesia

numbness or tingling

CBC

checks for infection, inflammation, anemia

ESR

erythrocyte sed rate, increases with inflammatory conditions

uric acid

checked for gout

calcium and phosphorous

inverse relationship, secreted by the thyroid and para thyroid

calcium

increases with bone cancer, decreases with osteoporosis

ALP

(liver) increases with bone or tissue damage

CK

creatinine kinase, serum muscle enzymes, increases with muscle damage

rheumatoid factor

identifies antibodies present in conditions such as lupus, sceleroderma, rheumatoid arthritis

x-ray, CT, MRI

uses radiographic techniques to assess for fracture or bone disease

arthography

x-ray exam of the synovial joint

myelogram

use of contrast media injected into the subarachnoid space to visualize spinal cord, head down for prep and up for post op

head ache

major side effect of a myelogram

arthroscopy

internal inspection of a joint with a scope

arthrocentesis

aspiration of synovial fluid or used to instill meds

arthrogram

radiographic exam of a joint using contrast media, pt may experience a popping or clicking noise in joints for a few days

synovial fluid analysis

aspirate synovial fluid for infection, protein and glucose, joint is elevated for 12 hrs after apply ice 24-48 hrs

bone density

x-ray that estimates bone thickness (usually taken from the spine, hip, or waist)

bone scan

injection of a radio neucleide used to diagnose bone cancer and inflammatory disorders

gallium, thallium scan

scans bones but also picks up brain tissue and breast tissue

biopsy

a piece of bone or muscle is removed to diagnose malignancy, very painful, observe for swelling and bleeding after and apply ice

dexascan

same as a bone density scan

sprains

injuries to ligaments and usually affect the areas such as ankles, wrists, and knees

whip lash

a sprain of the cervical spine

strain

an injury caused by pulling or stretching a muscle beyond its capacity

contusion

soft tissue injury resulting from a blow or blunt trauma and does not usually affect ms structures but leaves a bruised area

hematoma

collection of blood in soft tissue that usually resolves in 2 weeks

avulsion

a tramatic sprain in which bones are chipped at the point of ligament attachment causing ligaments to become detached

RICE

rest, ice, compression, elevate, standard treatment for tramatic injuries

dislocation

occurs when articular surfaces of a joint are no longer in contact

subluxation

a partial dislocation caused by trauma or disease of a joint usually the spine

foot drop

caused by pressure on the perineal nerve

volkmanns contracture

claw like deformity of the hand caused by the obstruction of arterial blood flow to the forearm and hand

fracture

a break in the continuity of a bone resulting from a blow, twisting, or crushing injury

spontaneous fracture

results from injury

pathologic fracture

results from disease such as osteo, arthritis, bone cancer

open or compound fracture

results in the bone protruding through the skin

closed or simple fracture

seen when the bone doesn't protrude through the skin

greenstick

incomplete fracture, remains secure on one side

complete

fracture line extends all the way through the bone

comminuted

bone is splintered int fragments

impacted or telescope

fracture where one part is impacted into the other, you would see a shorter body part

oblique

break that runs along th slant of the length of the bone (diagonal)

spiral

break coils around the bone results from a twisting force

depressed

fragments are driven down inward (such as a head injury)

transverse

fracture across the bone

longitudinal

fracture up and down the bone along the length

12 months

time it takes to regain total strength of a fractured body part

extracapsular fracture

fracture occurs outside of the joint capsule

intracapsular fracture

occurs within the joint capsule

cast window

window cut out of a cast for an incision, needs to be replaced after care of the incision to prevent swelling

traction

application of a pulling force to reduce and realign a fracture, can be used for pain relief, maintain immobilization, and relieve muscle spasms

skin traction

apply a device to the skin that indirectly affects the bones and muscles, bucks and russel

skeletal traction

devices are applied directly to the bone using wires and pins, pin care is very important, sterile procedure always and tell pt not to touch the pins

rules for traction

ensure continuous traction, maintain counter traction positioning is very important, ropes must move freely, prescribed amount of weights on, weights hang freely

avascular necrosis

decreased blood supply that causes bone death

acute compartment syndrome

causes swelling under a cast, painful, usually needs a fasciotomy

fasciotomy

cutting into the fascia to relieve the pressure

intertrochanteric fracture of the hip

through the greater and lesser trocanter of the femur

femoral neck fracture of the hip

through the femoral wall or neck of the femur

ORIF

open reduction internal fixation, go inside to fix the fracture with nails, screws, etc

external fixation

pins inserted into the bone from the skin surface higher risk of infection

pin care

sterile, asses for drainage, examine condition of pins, clean from in to out, no ointment around the pins

swan neck

deformity in rheumatoid arthritis, joints ar hyper flexed and fixed

trophi

hard calculi that develops in the joint tissue caused from gout

rheumatoid arthritis

most serious form of arthritis, leads to crippling affects females more than males, symptoms can appear as early as 20, autoimmune disease, affects the heart and blood vessels also, ESR increases

gout

metabolic disorder that causes an accumulation of uric acid in the blood and urine caused by ineffective metabolism of purines

purines

protein seen in organ meats, yeast, alcohol, and scallops

SLE

systemic lupus erythematosis, a butterfly rash that spans over the nose and cheeks, painful, no cure, immunosuppresants to treat or steroids

AKS

alkylosis spondylitis, chronic progressive disorder affecting the sacroiliac joint, hip joint, and synovial joints, affects men more than women, no cure

lyme disease

ms problems caused by a deer tick, first sign is a bulls eye rash, 4 wks after bite you will see arthritic symptoms, antibiotics to cure

ankylosis

abnormal immobility and consolidation and obliteration of a joint

contracture

shortening of skeletal muscle tissue that is not subjected to normal stretching and contraction

crepitation

a sound like that of hair rubbed between the fingers occurs when bone fragments rub together

ossification

formation of or conversion into bone or a bony substance

arthroplasty

surgery of a joint to increase mobility or decrease pain

subluxation

a partial or incomplete dislocation of a bone from its place in a joint usually the spine

hemiparesis

weakness affecting only 1 side of the body

atrophy

wasting or a decrease in size from lack of use

palsy

decreased sensation and movement

thrombus

blood clot that obstructs a blood vessel

sceleroderma

autoimmune, calcinosis, raynauds, esophageal dysfunction, sclerodactyly, telangiectasis, hardening of the skin

fibromyalgia

a chronic pain syndrome, no known cause, often mistaken for pain med seekers, rule out everything else

pagets disease

a metabolic bone disease causes a bowing of the long bones and abnormal spinal curvature, bone loss

calcitonin

used to treat pagets disease

primary malignant tumors

originate in the bone

osteosarcoma

most common, usually seen in the distal femur more common in men than women

metastatic bone disease

cancer originates somewhere else and metastisizes to the bone

calcinosis

calcium deposits on the skin

raynauds

affects peripheral circulation, severe pain

esophageal dysfunction

acid reflux,

sclerodactyly

thickening and tightening of the skin of fingers and hands

telangiectasis

dilation of capillaries causing red marks on surface of skin

port

post op respiratory therapy

ischemia

decreased blood flow

stump care

assess dressing, keep a tourniquet at bed side in case of hemorrhage, prepare stump for prosthesis, elevate for 24-48 hrs to prevent edema

stump shrinker

compression stocking put on to help shape the amputated area and keep edema out

salicylates

aspirin, used to treat mild pain, anit inflammatory, anti platelet, decreases temp

non salicylates

tylenol, same as salicylates but not an anti platelet, can cause liver failure

opioid analgesics

morphine, demorall, dilaudid, blocks pain receptors for moderate or severe pain

narcan

antagonist, blocks the opiates, used for overdoses

nonopioid analgesics, NSAIDS

clebrex, ibuprofin, naprosyn, blocks an enzyme called cox-2, used for inflammation and mild pain

bisphosphonates

fosamax, boneva, actonel, promotes calcium reabsorption, decreases calcium destruction, used to reverse osteoporosis

antirheumatic drugs

plaquenil, suppresses the immune system, immunosuppressant, not given to patients with renal or liver disease

uric acid inhibitors

allopurinol, anti gout, decreases the amount of uric acid in the blood

skeletal muscle relaxants

soma, flexeril, baclofen, to relax skeletal muscles, no driving

osteomylitis

localized or generalized bone infection

muscular dystrophy

genetic disorder results in a loss of muscle tissue, weakness, and atrophy, no cure

duchennes

MD in children

myotonic

MD in adults

osteoporosis

decreased bone mass primarily seen in women 55-65 yrs, bone looks spongy

osteoarthritis

a non systemic condition it only affects the joints, causes bones to degenerate, pain is relieved by rest, NSAIDS

what increases risk of osteoporosis?

smoking, post menopause, poor calcium intake, small frame, caffiene, chronic steroid use

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