Musculoskeletal System Disorders: Diagnosis, Symptoms, and Treatment, Exams of Nursing

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HPEX 353 VCU - chapter 9 questions

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Musculoskeletal System - correct answer ✔✔• Bones, joints, ligaments, muscle and tendons

• Skeleton: shape the body, provides physical support and protection for the organs. Responsible for blood cell formation and storage of minerals.
• Muscles hold the skeleton and create physical movement of the body. Two types of bones - correct answer ✔✔• Compact: dense, hard tissue found in the shafts of long bones.
• Spongy: less dense, found at the end of long bones. Three types of muscles - correct answer ✔✔• Skeletal/Voluntary: Movement is consciously controlled.
• Smooth/involuntary: not consciously controlled
• Cardiac: combination of both. Involuntary contract. Lordosis, Kyphosis and Scoliosis - correct answer ✔✔Abnormal inward curvature of the lumbar or lower spine.
  • Lordosis: lower spine or lumbar area
  • Kyphosis: upper thoracic vertebrae
  • Scoliosis: spine, either left or right
  • Associated with congenital spinal defects, posture, discrepancy in leg lengths, growth retardation, generative arthritis or neuromuscular conditions. Lordosis, Kyphosis and Scoliosis symptoms - correct answer ✔✔• Chronic Fatigue
• Backache Lordosis, Kyphosis and Scoliosis medical diagnosis - correct answer ✔✔X-rays of the spine

Lordosis, Kyphosis and Scoliosis - correct answer ✔✔• Physical therapy

• Exercise
• Surgery Osteoporosis - correct answer ✔✔Metabolic bone disease.
• Women over age 50, postmenopausal
• Proportion of bone mineral to bone matrix normal. Bone composition abnormal
• Bones become brittle, porous and vulnerable. Decrease calcium and phosphate in bones
• Hereditary? Possible other factors: Calcium intake, diet, alcohol consumption, Vit D deficiency, estrogen deficiency, etc. Osteoporosis symptoms - correct answer ✔✔*Asymptomatic
• Fractures
• Bone pain (lower back)
• Loss of height
• Kyphosis Osteoporosis medical diagnosis - correct answer ✔✔• DEXA
• Blood test for mineral content Osteoporosis treatment - correct answer ✔✔• Increase intake of Ca, P and multivitamins
• Exercise Osteomyelitis - correct answer ✔✔Acute and chronic infection of the bone forming tissue.
• Edema, inflammation and circulatory congestion of the bone marrow
• Associated with trauma and bacterial infection (Staphylococcus aureus ) Osteomyelitis symptoms - correct answer ✔✔*bone affected and mo
• Sudden onset of fever

• Chills
• Malaise
• Sweating
• Pain
• Swelling over the affected bone
• Fatigue Osteomyelitis medical diagnosis - correct answer ✔✔• Physical examination
• Blood culture for mo
• X-rays and MRI
• Bone biopsy Osteomyelitis treatment - correct answer ✔✔• Antibiotics
• Tissue and bone grafts
• Analgesics Osteoarthritis - correct answer ✔✔Chronic inflammatory process of the joints and bones that results in degeneration of joint cartilage and bones that results in degeneration.
• Idiopathic (autoimmune? environmental?) and trauma related Osteoarthritis symptoms - correct answer ✔✔• Joint pain
• Swelling
• Crepitations Osteoarthritis medical diagnosis - correct answer ✔✔• Physical examination
• X-ray Osteoarthritis treatment - correct answer ✔✔*uncured
• Antiinflammatories

• Physical activity restriction
• Local heat
• Physical therapy Rheumatoid Arthritis - correct answer ✔✔Chronic, systemic, inflammatory disease affecting the synovial membranes of multiple joints.
• Autoimmune disease (genetic predisposition) Rheumatoid Arthritis symptoms - correct answer ✔✔• Joint pain
• Malaise
• low-grade fever
• Fatigue
• Weight loss Rheumatoid Arthritis medical diagnosis - correct answer ✔✔• Rheumatoid factor blood test
• ESR
• CBC
• Synovial fluid analysis
• X-ray Rheumatoid Arthritis treatment - correct answer ✔✔• Antinflammatory drugs
• Corticosteroids
• Surgery Gout / Gout Arthritis - correct answer ✔✔Chronic disorder of uric acid metabolism
• Uric acid (crystals) appear in the synovial fluid of joints (tophi)
• Men (> 30 yo) > Women (menopause)
• Metabolic (genetic) and/or renal (renal problem to clear uric acid)
• Risk factors: obesity, alcohol consumption, aspirin, low thyroid function

Gout / Gout Arthritis symptoms - correct answer ✔✔• Sudden onset of joint pain (*big toes)

• Hyperuricemia (high urea in the blood)
• Tophi
• Renal dysfunction Gout / Gout Arthritis medical diagnosis - correct answer ✔✔• Identification of urate crystals in joint fluids
• Urinalysis (*hyperuricemia)
• ESR
• X-rays (damage joints) and physical examination Gout / Gout Arthritis treatment - correct answer ✔✔• Bed rest
• Local heat or cold
• Analgesics
• Corticosteroids (oral or IM)
• Diet + fluids Gout / Gout Arthritis prognosis - correct answer ✔✔• Good
• Complications:
  • Kidney stones
  • Renal damage
  • Hypertension Plantar Fasciitis - correct answer ✔✔Irritation of the plantar fascia ligament (on the bottom of the foot).
• Inflammation, swelling and pain when standing or walking
• Associated with straining and tearing of the fascia (due to high arches, obesity, pregnancy, standing/walking/running for long periods of time, excessive pronation.

Plantar Fasciitis symptoms - correct answer ✔✔Pain and stiffness of the feet Plantar Fasciitis medical diagnosis - correct answer ✔✔• Physical examination

• Tenderness and swelling
• X-rays to rule out other injuries Plantar Fasciitis treatment - correct answer ✔✔• Anti-inflammatories
• Corticosteroids
• Ice
• Rest
• Physical therapy
• Surgery Myasthenia Gravis - correct answer ✔✔Chronic, progressive, neuromuscular disease that produces increasingly sporadic weakness and exhaustion of skeletal muscles.
• Autoimmune response resulting in the disappearance of receptors for the neurotransmitter acetylcholine
• More common un women (age 20-40)
• Tumors of thymus glands also present in 15% cases
• Aggravated by menses, emotional stress and infections Myasthenia Gravis symptoms - correct answer ✔✔• Skeletal muscle weakness
• Fatigue
• Blepharoptosis (drooping eyelids)
• Double vision
• Dysphagia
• Dysphasia
• Myasthenia crisis (respiratory distress)

Myasthenia Gravis medical diagnosis - correct answer ✔✔• Neurological examination

• Electromyography
• IV of edrophonium (muscle function improvement) • MRI or CT scan to verify the presence of thymus abnormalities Myasthenia Gravis treatments - correct answer ✔✔Symptomatic
• Anticholinesterase drugs
• Thymectomy
• Corticosteroids Myasthenia Gravis prognosis - correct answer ✔✔• Unexplained, spontaneous remissions
• Lifelong condition with exacerbations
• No known cure Systemic Lupus Erythematosus (SLE) - correct answer ✔✔chronic, inflammatory connective-tissue disorder (auto-immune).
• Women & 15-
• Unknown (genetic? Environmental? Hormonal?) Systemic Lupus Erythematosus (SLE) symptoms - correct answer ✔✔• Weight loss
• Fatigue
• Fever
• Butterfly rash
• Photosensitivity
• Muscle problems
• Arthralgia
• Arthritis
• Joint deformities
• Nausea

• Vomiting
• Diarrhea
• Raynaud phenomenon
• Oral ulcerations
• Patchy alopecia
• Pericarditis Systemic Lupus Erythematosus (SLE) medical diagnosis - correct answer ✔✔• CBC
• ESR
• Anti-Nuclear Antibody (ANA) Test
• Polymorph nuclear leukocytes in brown marrow Systemic Lupus Erythematosus (SLE) treatment - correct answer ✔✔• Anti-inflammatories
• Corticosteroids Systemic Lupus Erythematosus (SLE) prognosis - correct answer ✔✔• Complications:
  • Cardiovascular
  • Renal
  • Neurological
  • Infectious Fibromyalgia - correct answer ✔✔ Fibromyalgia - correct answer ✔✔ Fibromyalgia - correct answer ✔✔ Fibromyalgia - correct answer ✔✔Chronic condition characterized by pain the muscles, ligaments and tendons.

• Women (>80%) middle age
• Unknown etiology (genetic, emotional distress, trauma, illness)
• Neurotransmitters imbalance that facilitates pain Fibromyalgia symptoms - correct answer ✔✔• Constant Pain
  • Dull muscle ache
• Tender points
  • Head
  • Shoulders
  • Elbows
  • Hips
  • Knees
• Fatigue (*Chronic fatigue syndrome)
• Cognitive difficulties (fibro fog)
• PTSD
• Depression Fibromyalgia medical diagnosis - correct answer ✔✔*Difficult to diagnose
• Widespread pain (>3 mo) Fibromyalgia treatment - correct answer ✔✔• Analgesics
• Antidepressants
  • *Savella
• Physical therapy