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chapter 63 Lewis Musculoskeletal
What is a sprain?
Injury to ligamentous structures surrounding a joint, usually caused by wrenching or twisting motion.
What is a strain?
Excessive stretching of a muscle and its fascial sheath, often involving the tendon.
How are strains and sprains classified?
First, second or third degree depending on the amount of damage.
What are the symptoms of a sprain and strain?
Pain, edema, and decrease in function.
What are the effects of a mild sprain?
Self limiting, with full functioning returning within 3 - 6 weeks.
What can severe strains require?
Surgical repair of a muscle and surrounding fascia or tendons.
What is RICE?
Rest, ice, compression and elevation.
What is the point of RICE?
Decrease inflammation and pain for most soft tissue injuries.
What can reduce the risk of sprains and strains?
Warming up prior to exercising and before vigorous activity followed by stretching.
What is Dislocation?
Severe injury of the ligamentous structure that surrounds a joint.
What is the most obvious sign of Dislocation?
What are other manifestations of dislocation?
Local pain, tenderness, loss of function of injured part, and swelling of soft tissues in joint region.
What does dislocation require?
Prompt attention. Realignment and then immobilization by bracing, taping or using a sling to allow time for ligaments and tissue to heal.
What is Subluxation?
Partial or incomplete displacement of the joint surface.
What are the manifestations of a Subluxation?
Similar to dislocation, but may require less time to heal.
What is nursing care for a disolcation or subluxation?
Directed toward pain relief and support and protection of the injured joint.
What is a repetitive strain injury?
RSI - cumulative traumatic disorder resulting from repetitive movements, awkward postures or sustained force.
How can RSI be prevented?
Through education and ergonomics.
What is treatment for a RSI?
Identifying the precipitating activity, modification of activity, pain management with heat/cold application, rest, physical therapy, for strengthening and conditioning, and lifestyle changes.
What is Carpal tunnel Syndrome?
CTS - caused by compression of the median nerve, which enters the hand through carpal tunnel.
How is Carpal Tunnel Syndrome caused?
Pressure from trauma or edema caused by inflammation of tendon (tenosynovitis), rheumatoid arthritis or soft tissue masses.
What are signs of CTS?
Signs are weakness, especially in thumb, burning pain, tingling, numbness, and a positive Phalen's test.
How do you prevent CTS?
Prevention involves educating employees and employers to identify risk factors.
• Rotator cuff injury may occur _
_gradually from aging, repetitive stress, or injury to the shoulder while falling.
• Manifestations of rotator cuff include _
_shoulder weakness, pain, and decreased range of motion (ROM).
• ACL injuries usually occur _
_from noncontact when the athlete pivots, lands from a jump, or slows down when running.
• Bursitis results from _
_repeated or excessive trauma or friction, rheumatoid arthritis, or infection.
• Rest is often the only treatment needed _
• Fracture is a _
_disruption or break in the continuity of the bone structure.
• Traumatic injuries account for _
_the majority of fractures
• Fractures can be classified as _
_displaced (open) or nondisplaced (closed) depending on communication or noncommunication with the external environment.
• Signs of fracture include _
_immediate localized pain, decreased function, and inability to bear weight or use affected part. Obvious bone deformity may be present.
• Bone goes through_
_eight stages of self-healing (union).
• A Colles' fracture is a _
_fracture of the distal radius. Manifestations are pain, swelling, and obvious deformity of the wrist.