Week 9 chapter 37 & 41 PLP transcript Video

Here is the combined master study guide in bullets:

🦴 Musculoskeletal System Trauma — Master Study Guide

Overview of the Musculoskeletal System

• Includes: bones, muscles, cartilage, ligaments, and tendons

• Trauma sources: vehicle accidents, work-related accidents, sports injuries

• Common trauma types:

  • Bone fractures

  • Nerve trauma

  • Muscle, tendon, and ligament injuries (sprains, strains, dislocations)

Bone Fractures

Definition: Any disruption — complete or incomplete — in the continuity of a bone

• Occur when forces exceed the bone's capacity to withstand them

Stress Fractures

• Caused by repetitive, cumulative trauma (overuse injuries)

• Frequently occur in the lower extremities

• Common in: runners, athletes, military recruits

Hip Fractures

• Actually a break in the proximal femur (NOT the hip bone itself)

• Primary risk factor: Osteoporosis

• Osteoporosis weakens bone density, making fractures more likely with minimal force

Femoral Shaft Fractures

• Most commonly caused by trauma (unlike hip fractures which are often from osteoporosis)

• The femur is the strongest bone in the body — requires significant force to fracture

• Common causes:

  • Contact/high-speed sports: skiing, football, hockey

  • Motor vehicle accidents

• 3 Types:

  • Type 1 — Spiral or Transverse Fracture

    • Spiral = twisting injury pattern

    • Transverse = break straight across the bone

  • Type 2 — Comminuted Fracture

    • Bone is shattered into multiple fragments

  • Type 3 — Compound Fracture

    • Bone breaks through the skin (also called open fracture)

Compression Fractures

• Most commonly occur in the vertebrae

• Pathognomonic for osteoporosis — meaning they are a hallmark/defining sign of osteoporosis

• Cause kyphosis — abnormal outward curvature of the thoracic spine ("hunchback" appearance)

Clavicle Fractures

• Most common fracture in childhood

• Clavicle = collarbone

Distal Radius Fractures (Wrist Fractures)

• Common result of a fall on an outstretched hand (FOOSH mechanism)

  • Person extends hand to protect their face and upper body

• Two main types:

  • Colles Fracture — fracture with dorsal displacement (most common FOOSH fracture)

  • Smith Fracture — reverse Colles; fracture with volar/palmar displacement

Nerve Trauma

• Nerves near joint structures can be injured by acute or repetitive trauma

Carpal Tunnel Syndrome

• Affects the median nerve in the wrist

• Results in pain, numbness, and tingling in the hand

Ulnar Nerve Damage

• Causes weakness and tingling

• Often affects the hand and fingers, especially grip strength and sensation

Brachial Plexus Injury

• Involves more than one nerve simultaneously

• Caused by a violent pull of the entire arm or shoulder

• Common in: football and wrestling

• The brachial plexus is a network of nerves supplying the shoulder, arm, and hand

Muscle, Tendon & Ligament Injuries

Knee Injuries

• Traumatic forces to the knee commonly tear:

  • Menisci — cartilage cushions that stabilize and protect the knee joint

  • Supporting ligaments (e.g., ACL, MCL, PCL, LCL)

Shoulder Injuries

Rotator Cuff Injury

• A strain of one or more of the four rotator cuff muscles

• These muscles provide stability and rotation to the glenohumeral joint (the main shoulder joint)

• Results from overuse or acute trauma

Shoulder Dislocation

• The shoulder is the most commonly dislocated joint in the body

• Occurs when a strong force causes the humeral head to separate from the scapula's glenoid cavity

• Anatomy key points:

  • Humeral head = top of the upper arm bone

  • Scapula = shoulder blade

  • Glenoid cavity = the socket of the shoulder joint

High-Yield Associations (Must Know)

• Osteoporosis → hip fractures + vertebral compression fractures + kyphosis

• Pathognomonic for osteoporosis → vertebral compression fractures

• Most common childhood fracture → clavicle

• Strongest bone in the body → femur

• Most commonly dislocated joint → shoulder

• Carpal tunnel syndrome → median nerve

• Ulnar nerve damage → weakness + tingling

• Brachial plexus injury → violent pull of arm/shoulder; involves multiple nerves

• FOOSH mechanism → distal radius fractures (Colles or Smith)

• Kyphosis → caused by vertebral compression fractures

Quick NCLEX Memory Tricks

• Sprain = ligament (ligament = bone to bone)

• Strain = muscle or tendon

• Stress fracture = repetitive/overuse trauma

• Compound fracture = open fracture (bone through skin)

• Comminuted fracture = multiple fragments/shattered

• Median nerve = carpal tunnel

• Ulnar nerve = weakness + tingling

• Shoulder = most commonly dislocated joint

• Osteoporosis = hip fractures + compression fractures + kyphosis

• Proximal femur = what breaks in a "hip fracture"

Combined transcripts

🏥 Musculoskeletal & Skin Disorders — Master Nursing Study Guide

PART 1: MUSCULOSKELETAL SYSTEM

Overview

• The musculoskeletal system includes: bones, muscles, cartilage, ligaments, and tendons

• Trauma sources: vehicle accidents, work-related accidents, sports injuries

• Common trauma types:

  • Bone fractures

  • Nerve trauma

  • Muscle, tendon, and ligament injuries (sprains, strains, dislocations)

Bone Fractures

Definition: Any disruption — complete or incomplete — in the continuity of a bone

• Occur when forces exceed the bone's capacity to withstand them

• Can be complete (bone fully broken through) or incomplete (partial break)

Stress Fractures

• Caused by repetitive, cumulative trauma — also called overuse injuries

• Frequently occur in the lower extremities (feet, shins, lower leg)

• Common in: runners, military recruits, dancers, athletes

• Often develop gradually — pain worsens with activity and improves with rest

• Not caused by a single traumatic event — this is what distinguishes them from other fractures

Hip Fractures

• Actually a break in the proximal femur — NOT the hip bone (ilium) itself

• Primary risk factor: Osteoporosis — weakens bone density, increasing fracture risk with minimal force

• Also common in older adults due to falls

• Symptoms: severe pain in the hip/groin, inability to bear weight, leg may appear shortened and externally rotated

• Serious complication risk — immobility after hip fracture can lead to DVT, pneumonia, and pressure ulcers

Femoral Shaft Fractures

• Most commonly caused by high-energy trauma

• The femur is the strongest bone in the body — requires a large force to break

• Common causes:

  • Contact/high-speed sports: skiing, football, hockey

  • Motor vehicle accidents

• Because of the large force needed, there is often significant blood loss into the thigh — can be life-threatening

• 3 Types:

  • Type 1 — Spiral or Transverse Fracture

    • Spiral = caused by a twisting/rotational force

    • Transverse = break goes straight across the bone, usually from direct force

  • Type 2 — Comminuted Fracture

    • Bone is shattered into multiple fragments

    • More complex to treat; often requires surgical fixation

  • Type 3 — Compound Fracture (Open Fracture)

    • Bone breaks through the skin

    • High risk of infection due to open wound

    • Requires immediate medical attention

Compression Fractures

• Most commonly occur in the vertebrae (spinal bones)

• Pathognomonic for osteoporosis — meaning they are a hallmark/defining sign strongly associated with osteoporosis

• The vertebral body collapses under pressure, causing the spine to compress

• Cause kyphosis — abnormal outward curvature of the thoracic spine ("hunchback" appearance)

• Symptoms: sudden onset back pain, loss of height over time, limited spinal mobility

• Can occur with minimal or no trauma in patients with severe osteoporosis

Clavicle Fractures

• Most common fracture in childhood

• Clavicle = collarbone — connects the sternum to the shoulder

• Often caused by a fall on an outstretched hand or direct blow to the shoulder

• Symptoms: pain, swelling, and a visible bump or deformity over the clavicle

Distal Radius Fractures (Wrist Fractures)

• Common result of a FOOSH injury — Fall On an OutStretched Hand

• Person extends hand to protect their face and upper body during a fall

• Two main types:

  • Colles Fracture

    • Most common wrist fracture

    • Fracture with dorsal (backward) displacement — wrist looks like a "dinner fork"

    • Usually from falling forward onto an outstretched hand

  • Smith Fracture

    • Reverse of Colles

    • Fracture with volar/palmar (forward) displacement

    • Usually from falling backward onto a flexed wrist

Nerve Trauma

• Nerves near joint structures can be injured by acute or repetitive trauma

• Nerve injuries can cause pain, weakness, numbness, and tingling

Carpal Tunnel Syndrome

• Affects the median nerve in the wrist

• Caused by compression of the median nerve within the carpal tunnel

• Symptoms: pain, numbness, tingling in the thumb, index, middle, and part of the ring finger

• Risk factors: repetitive hand/wrist movements, pregnancy, obesity, diabetes

• More common in people who type frequently or perform repetitive hand motions

Ulnar Nerve Damage

• Causes weakness and tingling

• Affects the hand and fingers, especially the pinky and ring finger

• Can be caused by prolonged pressure on the elbow or wrist

• May result in "claw hand" deformity in severe cases

Brachial Plexus Injury

• Involves more than one nerve simultaneously

• The brachial plexus is a network of nerves supplying the shoulder, arm, and hand

• Caused by a violent pull of the entire arm or shoulder

• Common in: football and wrestling (also seen in motorcycle accidents and difficult childbirths)

• Symptoms can range from temporary numbness to complete loss of arm function depending on severity

• Severe injuries may result in a flail arm (complete loss of movement and sensation)

Muscle, Tendon & Ligament Injuries

• Tendons connect muscle to bone

• Ligaments connect bone to bone

• Strains are graded 1–3 based on severity (Grade 1 = mild, Grade 3 = complete tear)

• Sprains are also graded 1–3 (Grade 3 = complete ligament rupture)

Knee Injuries

• Traumatic forces to the knee commonly tear:

  • Menisci — C-shaped cartilage cushions that stabilize and protect the knee joint

    • Medial and lateral meniscus

    • Commonly torn with twisting injuries

  • Supporting ligaments:

    • ACL (Anterior Cruciate Ligament) — most commonly injured; controls forward movement

    • PCL (Posterior Cruciate Ligament) — controls backward movement

    • MCL (Medial Collateral Ligament) — stabilizes inner knee

    • LCL (Lateral Collateral Ligament) — stabilizes outer knee

• Classic ACL injury sign: "pop" sound at the time of injury followed by rapid swelling

Shoulder Injuries

Rotator Cuff Injury

• A strain of one or more of the four rotator cuff muscles

• The 4 rotator cuff muscles (memory trick: SITS):

  • Supraspinatus

  • Infraspinatus

  • Teres minor

  • Subscapularis

• These muscles provide stability and rotation to the glenohumeral joint

• Symptoms: pain with overhead movements, weakness, difficulty raising the arm

• Common in: athletes, overhead workers, older adults

• Can result from acute injury or gradual degeneration

Shoulder Dislocation

• The shoulder is the most commonly dislocated joint in the body

• Occurs when a strong force causes the humeral head to separate from the scapula's glenoid cavity

• Anatomy key points:

  • Humeral head = rounded top of the upper arm bone (humerus)

  • Scapula = shoulder blade

  • Glenoid cavity = the shallow socket of the shoulder joint

• Most dislocations are anterior (forward) — caused by a force on an outstretched arm

• Symptoms: visible deformity, severe pain, arm held away from body, loss of normal shoulder contour

High-Yield Musculoskeletal Associations

• Osteoporosis → hip fractures + vertebral compression fractures + kyphosis

• Pathognomonic for osteoporosis → vertebral compression fractures

• Most common childhood fracture → clavicle

• Strongest bone in the body → femur

• Most commonly dislocated joint → shoulder

• Carpal tunnel syndrome → median nerve

• Ulnar nerve damage → weakness + tingling in pinky/ring finger

• Brachial plexus injury → violent arm/shoulder pull; involves multiple nerves

• FOOSH mechanism → Colles or Smith distal radius fracture

• Compound fracture → high infection risk (bone through skin)

• Comminuted fracture → multiple bone fragments

PART 2: SKIN DISORDERS

Overview

• The skin is the body's largest organ

• Its exterior location makes symptoms easily observable during assessment

• Almost 50% of all primary care visits are related to skin concerns

• Skin changes are often early indicators of: disease, infection, immune responses, and environmental damage

Color Change Disorders

Vitiligo

• Appears as depigmented (loss of color/white) patches on the skin

• Caused by abnormal melanin production

• Melanin is the pigment responsible for normal skin color — in vitiligo it is absent in affected areas

• Can occur anywhere on the body; often appears on the face, hands, and areas around body openings

• Has no cure but can be managed; more noticeable in people with darker skin tones

• Can be psychologically distressing for patients — important to address emotional wellbeing

Melasma

• Appears as dark, hyperpigmented patches on the skin

• Triggers include:

  • Sun damage/UV exposure

  • Hormonal changes:

    • Pregnancy (sometimes called the "mask of pregnancy")

    • Use of oral contraceptives

• Most commonly appears on the face (cheeks, forehead, upper lip)

• More common in women and people with darker skin tones

• Often improves after pregnancy or stopping oral contraceptives

Lentigos

• Also known as age spots or liver spots

• Dark, flat spots that appear in response to chronic sun exposure

• Common in older adults and those with significant sun exposure history

• Generally benign but should be monitored for changes using the ABCDE criteria

Dryness & Itching

Xerosis (Dry Skin)

• Definition: dryness of the skin associated with a lack of moisture

• Skin appearance:

  • Wrinkly

  • Dry

  • Scaly

• Makes skin more susceptible to irritation and breakdown

• More common in: older adults, cold/dry climates, people who bathe frequently

• Can lead to skin fissures (cracks) which increase infection risk

Pruritus (Itching)

• Main symptom associated with xerosis

• Not a visible symptom — subjective complaint reported by the patient

• Can significantly impact quality of life and sleep

• Other causes:

  • Insect bites

  • Rashes

  • Discontinuation of certain medications

  • Liver disease, kidney disease, thyroid disorders (systemic causes)

• Pruritus is a symptom, not a disease — always look for the underlying cause

Sweat Response Alterations

• The skin's sweating response can be altered by:

  • Tumors

  • Head or brain injury

  • Illness or injury

  • Certain drugs/medications

Environmental & UV Radiation Disorders

Nevi (Moles)

• Benign skin tumors formed in response to UV radiation

• Commonly known as moles

• Generally harmless but must be routinely assessed using the ABCDE criteria

• Changes in a nevus may indicate malignant transformation

Actinic Keratosis

• Caused by chronic sun/UV exposure

• Described as rough, red, scaly skin patches

• Classified as a premalignant lesion — not yet cancer but has potential to become squamous cell carcinoma if untreated

• Treatment is important to prevent progression to cancer

• Most common in fair-skinned, older adults with significant sun exposure history

Skin Cancer

Basal Cell Carcinoma

• Most common type of skin cancer

• Caused by UV radiation/sun exposure

• Arises from the basal cells of the epidermis

• Rarely metastasizes beyond the original lesion — generally curable if caught early

• Appearance: pearly or waxy bump, flat flesh-colored lesion, or bleeding/scabbing sore

• Grows slowly and is usually found on sun-exposed areas (face, neck, hands)

Malignant Melanoma

• Less common than basal cell carcinoma but far more dangerous

• Arises from melanocytes (pigment-producing cells)

• Lethal — frequently metastasizes to lymph nodes, lungs, liver, and brain

• Early detection is critical — survival rates drop significantly once it spreads

• Risk factors: UV exposure, fair skin, family history, many moles, history of sunburns

• Use the ABCDE criteria to identify suspicious lesions

⭐ ABCDE Assessment Tool for Moles & Growths

Infectious Skin Disorders

Fungal Infections — Tinea (Ringworm)

• A superficial fungal infection — despite the name, it is NOT caused by a worm

• Caused by dermatophytes (fungi that infect the outer layer of skin)

• Symptoms include: scaling, itching, rash

• Different types based on location:

  • Tinea pedis = athlete's foot (feet)

  • Tinea capitis = scalp ringworm

  • Tinea corporis = body ringworm (classic ring-shaped rash)

  • Tinea cruris = jock itch (groin)

• Highly contagious — spreads through direct contact or shared items

Human Papillomavirus (HPV)

• Causes skin warts (verruca)

• Can raise the risk for certain types of cancer (cervical, anal, oropharyngeal)

• Very common virus — spread through direct skin-to-skin contact

• Some strains cause genital warts; others cause common skin warts

• HPV vaccine available for prevention

Insect & Parasite-Related Skin Conditions

• Scabies: caused by the Sarcoptes scabiei mite burrowing into skin — extremely itchy, especially at night

• Lyme disease: if untreated, can progress to joint pain, cardiac, and neurological complications

• Anaphylaxis from bee stings is a medical emergency — requires epinephrine (EpiPen)

Immune & Allergic Skin Responses

Urticaria (Hives)

• An itchy, raised rash representing an immune/allergic response within the skin

• Triggered by:

  • Certain foods (nuts, shellfish, eggs)

  • Medications (penicillin, NSAIDs, aspirin)

  • Allergens such as pollen, latex, animal dander

• Lesions are called wheals — raised, red, itchy welts that can appear anywhere

• Can be acute (resolves within 6 weeks) or chronic (lasts longer than 6 weeks)

• Severe urticaria may be accompanied by angioedema (swelling of deeper tissues) — can be life-threatening if airway is affected

Autoimmune Skin Diseases

• Autoimmune diseases cause the immune system to attack the body's own skin tissue

High-Yield Skin Associations

• Vitiligo → abnormal melanin → depigmented white patches

• Melasma → hormones/sun → dark hyperpigmented patches

• Lentigos → chronic sun exposure → age spots

• Xerosis → lack of moisture → dry, scaly, wrinkly skin → pruritus

• Pruritus → main symptom of xerosis; also bites, rashes, medication changes

• Hyperhidrosis → excessive sweating → risk of heat-related illness, skin breakdown

• Anhidrosis → absent sweating → heat stroke risk

• Actinic keratosis → premalignant → can progress to squamous cell carcinoma

• Basal cell carcinoma → most common skin cancer → rarely metastasizes

• Malignant melanoma → less common but lethal → frequently metastasizes

• Tinea/Ringworm → fungal (NOT a worm) → scaling, itching, rash

• HPV → warts + increased cancer risk

• Tick bite → Lyme disease → bull's-eye rash

• Mite bite → scabies → intense nighttime itching

• Urticaria → hives → immune/allergic response

• Psoriasis, Scleroderma, Lupus → autoimmune skin diseases

• Lupus → butterfly rash across nose and cheeks

COMBINED HIGH-YIELD QUICK REFERENCE

Must-Know Definitions

NCLEX Memory Tricks

• Sprain = ligament | Strain = muScle/tendon

• Tendons = muscle to bone | Ligaments = bone to bone

• Compound fracture = open = infection risk

• Comminuted = crumbled into pieces

• Stress fracture = repetitive overuse, NOT single trauma

• Proximal femur = what breaks in a "hip fracture"

• Shoulder = most commonly dislocated joint

• Median nerve = carpal tunnel

• Ulnar nerve = weakness + tingling (pinky/ring finger)

• SITS muscles = Supraspinatus, Infraspinatus, Teres minor, Subscapularis (rotator cuff)

• Vitiligo = no pigment (white patches)

• Melasma = more pigment (dark patches)

• Xerosis = zero moisture = dry skin

• Pruritus = itching (main symptom of xerosis)

• Hyperhidrosis = too much sweat | Anhidrosis = absent/little sweat

• Actinic keratosis = pre-cancer (watch it closely)

• Basal cell = stays local | Melanoma = moves/metastasizes

• ABCDE = Asymmetry, Borders, Color, Diameter (>6mm), Evolving

• Bull's-eye rash = Lyme disease = tick bite

• Ringworm = fungus NOT a worm

• Hives = urticaria = immune/allergic response

• Lupus = butterfly rash

• Osteoporosis = hip fractures + compression fractures + kyphosis

• Anhidrosis = cannot sweat = heat stroke danger