Management of Patients with Musculoskeletal Disorders

bursitis and tendonitis

inflammation of fluid filled saces and tendons affecting shoulder, elbow, and wrist.

how is bursitis and tendonitis caused?

repetitive motion, overuse, trauma

what are symptoms of bursitis and tendonitis

pain, swelling, limited range of motion

loose bodies “joint" mice”

small fragments of cartilage or bone that break off and dloat freely within joint space, most commonly in elbow

what are symptoms of loose bodies

sudden locking, catching sensations, intermittent pain

impingement syndrom

when rotator cuff tendons are compressed during shoulder movements, particularly overhead activities

what does impingement syndrome result in

pain, weakness, and difficulty raising arm

impingement syndrom is most common in

athletes and workers with repetitive overhead motions

caral tunnel syndrome

compression of median nerve in the wristw

what does carpal tunnel cause

numbness, thingling, pain in thumb, index, middle, and half of ring finger.w

what can carpal tunnel lead to

weakness and muscle atrophy

ganglion

fuild filled cysts that develop along tendons and joints in the wrist. painless but can cause discomfrt

dupuytren contracture

progresssive thickening and tightening of the palmar fascia, causing fingers to curl toward palm.

what is dupuytren syndrome most common in?

men over 50 of northern european descent. interferes with hand function and grip

what sign is assessment for carpal tunnel syndrome

tinel sign: pins and needles radiating into median nerve

what is nursing management for surgery of the hand

every hour for first 24 hrs assess motor function only as prescribed

callus

thickenedd, hardened skin layers, often caused by friction or pressure on sole of foot

corn

small tender areas of thickened skin, on toes or between them due to pressure

hammer toe

deformity causing a toe to bend in at the middle joint often affecting second toe

bunion

bony bump forming at the base of the big toe, causing it to bend inward medially

morton neuroma

painful condition affecting the ball of the foot, between third and fourth toes caused by thickened nerve tissue around digital nerve

flatfoot (pes planus)

condition where arch on inside of foot collapses causing entire sole to touch the ground

plantar fasciitis

inflammation on plantar fascia, connecting the heel bone to toes, causing heel pain

ingrown toenail (onychocryptosis)

edge of toenail grows into surrounding skin leading to pain, redness, and swelling

clawfoot (pes cavus)

deformity of abnormall high arch that doesnt flatten when weight is applied

osteoarthritis (degenerative joint disease)

noninflammatory degenerative disorder of the joints

what is pathophysiology of osteoarthritis

articular cartilage breaks down leading to progressive damage to underlying bone and eventual formation of osteophytes that protrude into joint space

what is the most prominent modifiable risk factor for osteoarthritis

obesity

osteoporosis

rate of bone resorption is greater than rate of bone formation, resulting in loss of total bone mass

how to prevent osteoporosis

diet hight in calcium and vitamin D, regular weight bearign exercise 20-30 min a day

pharmacological therapy for osteoporosis CVBCEPR

calcium and vitamin D

biphosphonates

calcitonin

estrogen agonists/antagonists

parathyroid hormone analogs

receptor activator of nuclear factor kappa-b ligand inhibitors

what do biphosphonates do?

slow down bone loss and strengthen existing bone, effectively reducing fracture risk

what do estrogen agonists/antagonists do?

mimic estrogen beneficial effects on bone density, helpning to prevent bone loss without significant estrogenic effect

what does parathyroid hormone do?

stimulate new bone formation and significantly increase bone density

what do rankl inhibitors do?

block a protein for bone breakdown leading to reduction in bone absorption

what is osteomalacia

metabolic bone disease c/b inadequate bone mineralization

management of osteomalacia

increase vit d and calcium, supplement calcitrol for underlying kidney, exposure to sunlight

calcitrol is the same thing as

vitamin d

paget disease

bone resorption by osteoclasts and osteoblasts

management of paget disease

nsaids, antineoplastic therapy, biphosphonates,

osteomyelitis

infection of bone by soft tissue infection, direct bone contamination, or another infection spreadwh

at organisms infect osteomyelitis

staph aureus, e.coli

septic (infectious) arthritis

infection from the joints

osteosarcoma

most common and most fatal

metastatic (secondary) bone tumor

can spread to kidney, prostate, lung, breast, ovary, throid

tx for metastatic tumor

palliative

what do we have hypercalcemia in bone tumors

cancer prevents calcium resorption and calcium from bone is released into blood stream from lack of calcium resorption

assessment of pt with total hip arthroplasty

asess for risk of clot, leading to veinous thromboembolism/deep vein

nursing interventions for pt with total hip arthroplasty

begin mobility/ambulation with walker/crutches

nonpharmacologic prophylaxis

compression socks

pharmacologic prophylaxis

warfarin

with chronic myelitis, infection can ltreated by

antibiotics