Injury Management and Assessment Quiz
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Questions and Answers

Which injury is characterized by the excessive stretching of a muscle or tendon?

  • Strain (correct)
  • Fracture
  • Dislocation
  • Sprain
  • What is indicative of a moderate strain injury?

  • Minimal inflammation with slight tenderness
  • Complete rupture of muscle or tendon
  • Joint deformity and loss of motion
  • Partial tearing of muscle or tendon fibers (correct)
  • The acronym RICE, used in the initial treatment of strains, stands for:

  • Rest, Ice, Compression, Elevation (correct)
  • Run, Ice, Compression, Elevate
  • Run, Immobilize, Cool, Exercise
  • Rest, Ice, Compress, Exercise
  • A sprain is best described as an injury to which type of soft tissue?

    <p>Ligament (C)</p> Signup and view all the answers

    What distinguishes a severe sprain from a moderate sprain?

    <p>Joint instability (D)</p> Signup and view all the answers

    Which of the following is a primary characteristic of a dislocation?

    <p>Bones moved out of normal joint position (B)</p> Signup and view all the answers

    What is the most critical immediate action when managing a suspected dislocation before medical help arrives?

    <p>Immobilize the joint and apply ice (D)</p> Signup and view all the answers

    Compared to a sprain and a dislocation, a strain uniquely involves injury to which structure?

    <p>Tendon (C)</p> Signup and view all the answers

    What is the primary purpose of bursae in joints?

    <p>To cushion tendons and reduce friction during movement. (D)</p> Signup and view all the answers

    Which of the following is NOT mentioned as a common cause of bursitis?

    <p>Traumatic injury. (A)</p> Signup and view all the answers

    What is the initial recommended treatment for bursitis to reduce inflammation and pain?

    <p>Resting the joint and applying ice. (D)</p> Signup and view all the answers

    Which tendon is most commonly affected in chronic impingement syndrome, a type of rotator cuff injury?

    <p>Supraspinatus tendon. (C)</p> Signup and view all the answers

    What diagnostic imaging technique is typically used to confirm a rotator cuff injury?

    <p>Magnetic Resonance Imaging (MRI). (D)</p> Signup and view all the answers

    Carpal tunnel syndrome is caused by the compression of which nerve?

    <p>Median nerve. (D)</p> Signup and view all the answers

    A positive Phalen test, used in diagnosing carpal tunnel syndrome, involves:

    <p>Flexing the wrist and holding the position. (B)</p> Signup and view all the answers

    What is the first step in bone fracture healing, occurring within 48 to 72 hours after the injury?

    <p>Hematoma formation. (B)</p> Signup and view all the answers

    Which type of bone cell is responsible for resorbing necrotic bone during the remodeling phase of fracture healing?

    <p>Osteoclasts. (B)</p> Signup and view all the answers

    Approximately how long does it take for a complete bone fracture to heal in a young, healthy adult?

    <p>6 weeks. (D)</p> Signup and view all the answers

    What is the term for a fracture that occurs as a result of an underlying disease, such as osteoporosis or bone cancer?

    <p>Pathological fracture. (A)</p> Signup and view all the answers

    In which type of fracture is the bone broken into two or more pieces?

    <p>Complete fracture. (C)</p> Signup and view all the answers

    Which of the following is an example of a preventive measure for carpal tunnel syndrome mentioned in the text?

    <p>Alternating repetitive tasks with nonrepetitive tasks. (D)</p> Signup and view all the answers

    Following carpal tunnel surgery, patients should be instructed to report symptoms of neurovascular compromise. Which of the following is NOT a symptom of neurovascular compromise?

    <p>Warmth in the hand. (C)</p> Signup and view all the answers

    What is the primary reason for using lifting devices like draw sheets when moving patients?

    <p>To prevent injury to both the patient and healthcare provider. (A)</p> Signup and view all the answers

    Which of the following is the primary concern with an open fracture compared to a closed fracture?

    <p>Greater potential for infection (A)</p> Signup and view all the answers

    A patient with a suspected hairline fracture reports tenderness but no visible deformity. What is the MOST likely initial symptom they would present with?

    <p>Pain with movement of the affected area (D)</p> Signup and view all the answers

    A patient experiencing hip fracture pain may report discomfort in which unexpected location due to referred pain?

    <p>Back of the knee (D)</p> Signup and view all the answers

    Limb shortening is a common sign associated with which type of fracture?

    <p>Complete fracture (D)</p> Signup and view all the answers

    What clinical finding is described as a grating sound caused by bone fragments rubbing together?

    <p>Crepitation (A)</p> Signup and view all the answers

    During the emergency care of a patient with a suspected extremity fracture, what is the MOST critical action regarding limb manipulation?

    <p>Immobilize the limb in the position found, without repositioning (A)</p> Signup and view all the answers

    Which type of fracture is characterized by bone splintered into numerous fragments, often associated with crushing injuries?

    <p>Comminuted fracture (B)</p> Signup and view all the answers

    What diagnostic imaging technique is BEST suited for detecting fractures in complex areas such as the hip and pelvis?

    <p>Computed Tomography (CT) scan (A)</p> Signup and view all the answers

    What is the primary goal of closed reduction in fracture management?

    <p>Manual realignment of bone ends without surgical incision (B)</p> Signup and view all the answers

    Splints are often preferred over casts in the initial management of fractures for which primary reason?

    <p>Splints accommodate swelling and allow for wound care (C)</p> Signup and view all the answers

    What immediate intervention is required if a patient in a cast exhibits signs of compartment syndrome?

    <p>Bivalve the cast to relieve pressure (D)</p> Signup and view all the answers

    In fracture management, what is the primary purpose of traction?

    <p>To apply pulling force to align and immobilize bone fragments (B)</p> Signup and view all the answers

    Which type of fracture is caused by bone weakening due to a tumor, either within or pressing on the bone?

    <p>Pathological fracture (A)</p> Signup and view all the answers

    Regular neurovascular checks are crucial for patients in splints or casts. What is the MOST important reason for these assessments?

    <p>To ensure adequate blood flow and nerve function to the extremity (A)</p> Signup and view all the answers

    A 'window' is created in a cast primarily to allow for what?

    <p>Direct visualization and care of a wound under the cast (C)</p> Signup and view all the answers

    What is the maximum weight typically used in Buck traction for an adult patient?

    <p>5 to 10 pounds (2.2 to 4.5 kg) (B)</p> Signup and view all the answers

    Which intervention is most appropriate when moving a patient's limb with an external fixation device?

    <p>Grasp the external fixation device itself to maneuver the limb. (C)</p> Signup and view all the answers

    For extremity skeletal traction, what is the typical range of weight applied to achieve bone alignment?

    <p>20 to 40 pounds (9 to 18 kg) (A)</p> Signup and view all the answers

    A patient with an external fixation device reports increased pain, redness, and drainage at a pin site. Which complication is MOST indicated by these findings?

    <p>Pin-site infection (B)</p> Signup and view all the answers

    What is the primary rationale for using strict aseptic technique during pin-site care for a patient with external fixation?

    <p>To reduce the risk of microorganisms entering bone tissue and causing osteomyelitis. (A)</p> Signup and view all the answers

    In the immediate management of a suspected fracture, what is the priority action before moving the limb for splinting?

    <p>Immobilize the affected limb. (A)</p> Signup and view all the answers

    Which assessment finding is MOST indicative of a neurovascular problem in a patient with a fractured extremity?

    <p>Cool skin temperature, dusky color, and decreased sensation. (D)</p> Signup and view all the answers

    When applying a splint to a fractured extremity, what is the recommended practice regarding clothing?

    <p>Apply splint and padding directly over the clothing. (B)</p> Signup and view all the answers

    What is a critical early nursing intervention for a patient suspected of acute compartment syndrome?

    <p>Maintaining the extremity at heart level and notifying the healthcare provider immediately. (C)</p> Signup and view all the answers

    During the first 24 hours after cast application, how frequently should neurovascular checks be performed?

    <p>Every 1 to 2 hours (C)</p> Signup and view all the answers

    Which factor is LEAST likely to contribute to delayed bone healing (nonunion)?

    <p>Well-controlled diabetes mellitus. (D)</p> Signup and view all the answers

    Which of the following actions is contraindicated when drying a newly applied plaster cast?

    <p>Covering the cast to retain heat and promote drying. (B)</p> Signup and view all the answers

    What is the primary rationale for elevating a casted extremity above heart level during the first 48 hours?

    <p>To reduce swelling and promote venous drainage. (D)</p> Signup and view all the answers

    A patient with a femur fracture is at highest risk for which complication?

    <p>Fat embolism syndrome (A)</p> Signup and view all the answers

    Which intervention is a priority for preventing thromboembolic complications in a patient following orthopedic surgery?

    <p>Administering prophylactic anticoagulant therapy as prescribed. (C)</p> Signup and view all the answers

    To maintain tissue integrity under a cast, which instruction should be given to a patient regarding foreign objects and itching?

    <p>Avoid inserting any objects inside the cast to prevent tissue damage and infection. (A)</p> Signup and view all the answers

    What is the MOST important action for the Licensed Practical Nurse (LPN) to take immediately after discovering a patient has fallen and is complaining of hip pain?

    <p>Instruct the patient to remain still and notify the Registered Nurse (RN) or healthcare provider. (A)</p> Signup and view all the answers

    Which of the following is a concerning sign of potential infection under a cast that requires immediate attention?

    <p>Foul odor emanating from the cast. (A)</p> Signup and view all the answers

    Open Reduction with Internal Fixation (ORIF) is commonly indicated for which type of fracture?

    <p>Fractured hip involving the proximal femur. (B)</p> Signup and view all the answers

    What is the primary purpose of Buck traction applied to a patient with a hip fracture prior to surgery?

    <p>To reduce muscle spasms and pain, and to slightly immobilize the fracture. (A)</p> Signup and view all the answers

    Which vital sign change would be MOST concerning in a patient being monitored for hemorrhage after a femur fracture?

    <p>Increase in pulse rate from 80 to 100 beats per minute. (A)</p> Signup and view all the answers

    Following an Open Reduction Internal Fixation (ORIF) for a hip fracture, what is a key benefit that promotes faster recovery in older adults?

    <p>Early ambulation to prevent complications of immobility. (B)</p> Signup and view all the answers

    External fixation is most appropriate for managing fractures with which characteristic?

    <p>Severe bone damage, such as crushed or splintered fractures. (A)</p> Signup and view all the answers

    What is malunion of a fracture?

    <p>Healing of a fractured bone in a misaligned position. (C)</p> Signup and view all the answers

    Which treatment modality is used for nonunion fractures to stimulate bone healing?

    <p>Electrical bone stimulation (A)</p> Signup and view all the answers

    When handling a wet plaster cast, why should palms be used instead of fingertips?

    <p>Palms distribute pressure evenly, preventing indentations. (B)</p> Signup and view all the answers

    In the acronym 'EF device', as used in the text, what does 'EF' stand for?

    <p>External Fixation (C)</p> Signup and view all the answers

    For a patient experiencing itching under a cast, what is an appropriate non-invasive intervention to suggest?

    <p>Tapping gently on the cast over the itchy area. (B)</p> Signup and view all the answers

    Which of the following nursing interventions is crucial for a patient with external fixation of the lower extremity?

    <p>Monitoring pin sites for signs of infection. (A)</p> Signup and view all the answers

    What is the definition of 'osteomyelitis'?

    <p>Inflammation of the bone and bone marrow. (D)</p> Signup and view all the answers

    What is the fundamental physiological process underlying acute compartment syndrome?

    <p>Elevated pressure within a confined space compressing neurovascular structures. (C)</p> Signup and view all the answers

    A patient with a tibial fracture reports severe pain that intensifies with active movement and is not relieved by opioid analgesics. This pain is MOST indicative of which condition?

    <p>Acute compartment syndrome (B)</p> Signup and view all the answers

    Which of the following is the MOST ominous and late sign of acute compartment syndrome?

    <p>Pulselessness (B)</p> Signup and view all the answers

    A nurse assesses a patient with a casted forearm and notes increasing pain, pallor, and paresthesia in the fingers. What is the priority nursing action?

    <p>Immediately report these findings to the healthcare provider. (B)</p> Signup and view all the answers

    Which surgical intervention is performed to relieve pressure in acute compartment syndrome?

    <p>Fasciotomy (A)</p> Signup and view all the answers

    Volkmann contracture, a potential complication of untreated compartment syndrome, is characterized by:

    <p>Permanent flexion of the hand at the wrist. (D)</p> Signup and view all the answers

    Fat embolism syndrome (FES) is triggered by the release of fat droplets into the bloodstream primarily from:

    <p>Yellow bone marrow of fractured bones. (D)</p> Signup and view all the answers

    Which patient population is at the HIGHEST risk for developing fat embolism syndrome?

    <p>Older adults with hip fractures. (D)</p> Signup and view all the answers

    Within what timeframe after the initial injury is fat embolism syndrome MOST likely to occur?

    <p>Up to 72 hours. (C)</p> Signup and view all the answers

    Which triad of manifestations is characteristic of fat embolism syndrome?

    <p>Respiratory failure, cerebral involvement, and skin petechiae. (A)</p> Signup and view all the answers

    What is typically the EARLIEST clinical sign of fat embolism syndrome?

    <p>Pulmonary dysfunction. (A)</p> Signup and view all the answers

    Which initial nursing intervention is MOST appropriate for a patient suspected of having fat embolism syndrome?

    <p>Administer oxygen and elevate the head of the bed. (D)</p> Signup and view all the answers

    What is the PRIMARY origin of emboli in fat embolism syndrome compared to pulmonary embolism?

    <p>Fat emboli originate from yellow bone marrow, while pulmonary emboli originate from blood clots or fat globules. (D)</p> Signup and view all the answers

    What is a KEY differentiating cause of fat embolism syndrome compared to pulmonary embolism according to the provided table?

    <p>Long-bone fractures. (C)</p> Signup and view all the answers

    Frequent neurovascular status checks distal to a fracture are crucial for early detection of which potential complication?

    <p>Neurovascular compromise. (B)</p> Signup and view all the answers

    What is the most common type of osteoporosis?

    <p>Primary osteoporosis (D)</p> Signup and view all the answers

    Which of the following risk factors for osteoporosis can be modified through lifestyle changes?

    <p>Sedentary lifestyle (C)</p> Signup and view all the answers

    Which diagnostic test is the standard method to measure bone density in osteoporosis patients?

    <p>Dual-energy x-ray absorptiometry (DEXA) (D)</p> Signup and view all the answers

    What physiological effect of osteoporosis can lead to an increased risk of pneumonia?

    <p>Decreased respiratory capacity (A)</p> Signup and view all the answers

    Which symptom is likely to indicate that a person has developed osteoporosis?

    <p>Loss of height (A)</p> Signup and view all the answers

    Which of the following is a non-modifiable risk factor for primary osteoporosis?

    <p>Postmenopausal status (A)</p> Signup and view all the answers

    Why are women at a greater risk of developing osteoporosis than men?

    <p>Their bones are generally smaller (A)</p> Signup and view all the answers

    Which group is primarily targeted by the Healthy People 2030 osteoporosis objectives?

    <p>Older adults (B)</p> Signup and view all the answers

    What dietary component is essential in protecting against osteoporosis, especially for those over 50 years of age?

    <p>Calcium (A)</p> Signup and view all the answers

    What is the role of osteoclast cells in the bone remodeling process?

    <p>Break down old bone tissue (D)</p> Signup and view all the answers

    Which of the following is a symptom or sign that might not be immediately noticeable in a person with osteoporosis?

    <p>Pain (C)</p> Signup and view all the answers

    What is the primary consequence of postmenopausal status that leads to increased bone loss?

    <p>Decreased estrogen levels (A)</p> Signup and view all the answers

    Why is vitamin D important for individuals at risk of osteoporosis?

    <p>It enhances calcium absorption (B)</p> Signup and view all the answers

    Which bone areas are most at risk of fractures due to osteoporosis?

    <p>Spine, wrist, and hip (B)</p> Signup and view all the answers

    How does osteoporosis potentially impact a person's emotional well-being?

    <p>Causing depression and fear of injury (A)</p> Signup and view all the answers

    Which therapeutic measure is essential to prevent complications associated with suspected compartment syndrome?

    <p>Immediate reporting of abnormalities (B)</p> Signup and view all the answers

    What is the primary goal of providing pain management prior to promoting patient mobility?

    <p>To improve the patient's ability to move (C)</p> Signup and view all the answers

    What is a common risk factor for developing osteoarthritis?

    <p>Obesity (C)</p> Signup and view all the answers

    What dietary components are emphasized for promoting healing in patients with osteomyelitis?

    <p>High protein, calories, vitamins, and minerals (A)</p> Signup and view all the answers

    What is the primary indication of an effective outcome for interventions in patients at risk for peripheral neurovascular dysfunction?

    <p>Maintenance of peripheral pulses and warm skin (A)</p> Signup and view all the answers

    Which of the following characterizes early symptoms of rheumatoid arthritis?

    <p>Morning stiffness and bilateral joint inflammation (B)</p> Signup and view all the answers

    Which of the following is a crucial component in educating a patient about care after cast removal?

    <p>Cleansing skin gently to remove dry scales (B)</p> Signup and view all the answers

    Which therapeutic measure is commonly used in treating both osteoarthritis and rheumatoid arthritis?

    <p>Heat and cold application (A)</p> Signup and view all the answers

    Which type of exercise is most effective for relieving chronic low back pain?

    <p>Resistance training (B)</p> Signup and view all the answers

    What is a key nursing intervention to address potential pain in cognitively impaired patients?

    <p>Using the PAINAD scale for assessment (B)</p> Signup and view all the answers

    What is a common symptom of osteoarthritis in the hands?

    <p>Heberden nodes (C)</p> Signup and view all the answers

    Which pathogen is most commonly associated with osteomyelitis?

    <p>Staphylococcus aureus (D)</p> Signup and view all the answers

    Why is cold therapy applied to a fracture site as part of the treatment plan?

    <p>To reduce swelling and pain (D)</p> Signup and view all the answers

    Why might a patient with osteoarthritis be advised to lose weight?

    <p>To reduce stress on weight-bearing joints (D)</p> Signup and view all the answers

    What is a distinguishing feature of rheumatoid arthritis' pathophysiology?

    <p>Autoimmune synovial inflammation (C)</p> Signup and view all the answers

    Which is NOT a sign of chronic osteomyelitis?

    <p>Persistent fever (B)</p> Signup and view all the answers

    What diagnostic test result is typically elevated in patients with osteomyelitis?

    <p>Elevated white blood cell count (A)</p> Signup and view all the answers

    Which diagnostic test is helpful in diagnosing osteoarthritis by showing joint structure abnormalities?

    <p>MRI (A)</p> Signup and view all the answers

    Which intervention should a nurse avoid when caring for a patient in a cast to prevent neurovascular complications?

    <p>Applying tight bandages over the cast (B)</p> Signup and view all the answers

    Which factor does not directly increase the risk of osteoarthritis?

    <p>Excessive daily exercise (C)</p> Signup and view all the answers

    Which outcome indicates that a patient with neurovascular compromise has maintained adequate function?

    <p>Ability to move extremity freely (A)</p> Signup and view all the answers

    What common intervention can help maintain joint function in osteoarthritis?

    <p>Balanced rest and exercise (B)</p> Signup and view all the answers

    What is the role of administering anti-inflammatory medication to a patient with a fracture?

    <p>To reduce pain and swelling (A)</p> Signup and view all the answers

    Which of the following medications is typically NOT used for treating osteoarthritis?

    <p>Prednisone (B)</p> Signup and view all the answers

    What is the initial inflammatory response in osteomyelitis related to?

    <p>Decreased blood flow and ischemia (D)</p> Signup and view all the answers

    What main therapeutic focus exists for managing osteoarthritis?

    <p>Controlling symptoms (D)</p> Signup and view all the answers

    What characterizes primary malignant tumors that occur in the prostate, breast, lung, and thyroid gland?

    <p>They frequently migrate to bones. (B)</p> Signup and view all the answers

    What is an important practice for preventing pain in patients undergoing frequent turning procedures?

    <p>Administering analgesics beforehand (A)</p> Signup and view all the answers

    Which diagnostic test can identify secondary tissue inflammation in patients with metastatic disease?

    <p>Elevated ESR (A)</p> Signup and view all the answers

    In Mr. Finn's case, what lifestyle change is important to manage his knee pain?

    <p>Weight loss (A)</p> Signup and view all the answers

    What is likely to occur in the vertebral column if involved in osteoarthritis?

    <p>Radiating pain and muscle spasms in the extremity (A)</p> Signup and view all the answers

    Which treatment is commonly used for Ewing sarcoma to reduce tumor size and pain?

    <p>External radiation (A)</p> Signup and view all the answers

    What role do ligaments and tendons have in osteoarthritis?

    <p>They may be affected by inflammation (C)</p> Signup and view all the answers

    What is a major concern in managing metastatic bone disease?

    <p>Pathological fractures (B)</p> Signup and view all the answers

    What is the characteristic symptom of acute gout?

    <p>Severe pain and inflammation in one or more small joints (C)</p> Signup and view all the answers

    Which type of gout results from an inherited issue with purine metabolism?

    <p>Primary gout (C)</p> Signup and view all the answers

    Which medication is prescribed to prevent the increase in serum uric acid levels in chronic gout?

    <p>Zyloprim (B)</p> Signup and view all the answers

    Which of these is a common trigger for acute attacks of gout?

    <p>Stress (A)</p> Signup and view all the answers

    Which preventive measure is suggested for managing gout?

    <p>Drinking plenty of fluids (A)</p> Signup and view all the answers

    What is a recommended therapeutic measure for primary bone tumors?

    <p>Surgery with chemotherapy or radiation (B)</p> Signup and view all the answers

    Which of the following statements about connective tissue disorders is true?

    <p>They result from joint involvement. (C)</p> Signup and view all the answers

    How are urate crystals formed in the body?

    <p>Due to excessive uric acid build-up (D)</p> Signup and view all the answers

    Which test is used to confirm the presence of uric acid crystals in synovial fluid?

    <p>Joint fluid aspiration analysis (B)</p> Signup and view all the answers

    Which of the following foods should be avoided to help prevent gout?

    <p>Organ meats (B)</p> Signup and view all the answers

    What characterizes osteosarcoma according to its word building elements?

    <p>Osteo refers to bone, sarc to flesh, oma to tumor. (C)</p> Signup and view all the answers

    What is a common side effect associated with the use of bisphosphonates for osteoporosis?

    <p>Osteonecrosis of the jaw (B)</p> Signup and view all the answers

    Why might vitamin D supplementation be necessary for some patients with osteoporosis?

    <p>Vitamin D aids in calcium absorption (D)</p> Signup and view all the answers

    Which exercise type is particularly recommended to stimulate bone building in osteoporosis patients?

    <p>Walking (B)</p> Signup and view all the answers

    What is the function of SERMs in the treatment of osteoporosis?

    <p>They mimic estrogen to increase bone mass (B)</p> Signup and view all the answers

    Which dietary component is emphasized for individuals seeking to prevent or manage osteoporosis?

    <p>Calcium (B)</p> Signup and view all the answers

    What is the primary action of bisphosphonates in osteoporosis treatment?

    <p>Binding to bone and suppressing osteoclast activity (B)</p> Signup and view all the answers

    In what situation might a health professional recommend staying upright for at least 30 minutes after taking certain osteoporosis medications?

    <p>When taking bisphosphonates (C)</p> Signup and view all the answers

    What is the role of teriparatide (Forteo) in osteoporosis management?

    <p>It increases bone mass by stimulating osteoblasts (D)</p> Signup and view all the answers

    What complication might arise from excess calcium supplement intake without adequate fluid consumption?

    <p>Calcium-based urinary stones (D)</p> Signup and view all the answers

    Which bone condition is characterized by increased bone breakdown and formation leading to weak bones?

    <p>Paget disease (D)</p> Signup and view all the answers

    Which demographic is most affected by Paget disease?

    <p>Older adults and men (B)</p> Signup and view all the answers

    What is the recommended source of dietary calcium for osteoporosis patients aside from supplements?

    <p>Sardines (C)</p> Signup and view all the answers

    What is one complication of bone fractures that could increase fall risk, especially in older adults?

    <p>Pathological fracture (C)</p> Signup and view all the answers

    What role does calcitonin play in the management of osteoporosis?

    <p>Reduces bone loss (B)</p> Signup and view all the answers

    Why is weight-bearing exercise critical for osteoporosis patients?

    <p>It supports bone building (C)</p> Signup and view all the answers

    What is a potential gastrointestinal risk associated with NSAID use?

    <p>Gastrointestinal bleeding (A)</p> Signup and view all the answers

    What is the primary reason for placing joints in a functional position?

    <p>To prevent contractures (A)</p> Signup and view all the answers

    Which medication is classified as a pyrimidine synthesis inhibitor?

    <p>Leflunomide (C)</p> Signup and view all the answers

    What is the effect of tumor necrosis factor inhibitors in treating joint diseases?

    <p>Reduce inflammation by inhibiting TNF (C)</p> Signup and view all the answers

    Why should older patients on NSAIDs be monitored closely?

    <p>For development of hypertension (D)</p> Signup and view all the answers

    What type of diet might be appropriate for someone on corticosteroids?

    <p>Low-sodium diet (A)</p> Signup and view all the answers

    Which therapy would typically be preferred by a patient with osteoarthritis?

    <p>Heat therapy (A)</p> Signup and view all the answers

    What is TRUE about the application of cold packs for joint pain?

    <p>They should be applied for no longer than 20 minutes (C)</p> Signup and view all the answers

    What is the primary use of DMARDs in rheumatologic conditions?

    <p>To prevent joint damage (C)</p> Signup and view all the answers

    What is the function of T-cell modulators in inflammatory processes?

    <p>They reduce activation of T cells (C)</p> Signup and view all the answers

    What is a characteristic of late-stage rheumatoid arthritis?

    <p>Joint deformities (C)</p> Signup and view all the answers

    Which nursing implication is important for patients on gold preparations?

    <p>Give test dose and monitor for allergic reaction (C)</p> Signup and view all the answers

    Which laboratory finding is typically NOT associated with rheumatoid arthritis?

    <p>High red blood cell count (D)</p> Signup and view all the answers

    Which aspect of NSAIDs is responsible for their analgesic effect?

    <p>Block cyclooxygenase enzymes (D)</p> Signup and view all the answers

    Which test is used to measure the rate of inflammation in rheumatoid arthritis?

    <p>ESR test (A)</p> Signup and view all the answers

    Why is a Synvisc injection used in osteoarthritic knees?

    <p>To replace the cushioning synovial fluid (B)</p> Signup and view all the answers

    What is the expected outcome for a patient with decreased activity intolerance related to pain?

    <p>The patient will participate in ADLs as tolerated. (A)</p> Signup and view all the answers

    Which of these therapies is considered a complementary and alternative modality?

    <p>Hydrotherapy (A)</p> Signup and view all the answers

    What is the primary purpose of disease-modifying antirheumatic drugs (DMARDs) in rheumatoid arthritis treatment?

    <p>To prevent joint destruction (D)</p> Signup and view all the answers

    Which interdisciplinary team member is NOT typically involved in managing disturbed body image related to degenerative joint disease?

    <p>Pain clinic member (D)</p> Signup and view all the answers

    When may total joint replacement be indicated in a patient?

    <p>If pain cannot be managed successfully (B)</p> Signup and view all the answers

    To prevent hyperflexion while sitting after a total hip replacement, what is recommended for patients?

    <p>Sitting in a straight-back chair with armrests (D)</p> Signup and view all the answers

    Which symptom might indicate systemic involvement in rheumatoid arthritis?

    <p>Malaise (A)</p> Signup and view all the answers

    Which therapy is advisable for joints that are acutely inflamed in rheumatoid arthritis?

    <p>Cold applications (B)</p> Signup and view all the answers

    What is the pathophysiological feature of rheumatoid arthritis that leads to joint destruction?

    <p>Growth of a destructive pannus (D)</p> Signup and view all the answers

    What is a primary prevention measure for skin breakdown in older patients post-surgery?

    <p>Early ambulation (A)</p> Signup and view all the answers

    What is the role of ESR in the management of rheumatoid arthritis?

    <p>It evaluates the effectiveness of treatment. (B)</p> Signup and view all the answers

    Which statement best describes the autoimmune response in rheumatoid arthritis?

    <p>Formation of immune complexes in synovium (A)</p> Signup and view all the answers

    Which of the following is a sign of infection to observe during dressing changes?

    <p>Presence of purulent discharge (D)</p> Signup and view all the answers

    Which of the following is NOT typically a sign of rheumatoid arthritis?

    <p>Weight gain (C)</p> Signup and view all the answers

    Which organ is NOT typically affected in late-stage rheumatoid arthritis?

    <p>Liver (C)</p> Signup and view all the answers

    How should cefaclor suspension be administered if 500 mg is ordered and the suspension is 375 mg/5 mL?

    <p>8 mL (D)</p> Signup and view all the answers

    How does rheumatoid arthritis typically affect physical mobility over time?

    <p>Decreases physical mobility (D)</p> Signup and view all the answers

    How can rheumatoid arthritis be characterized in terms of joint involvement?

    <p>Bilateral and symmetrical (B)</p> Signup and view all the answers

    What technique is recommended for reducing the risk of bruising after administering low molecular weight heparin?

    <p>Avoiding rubbing the injection site (C)</p> Signup and view all the answers

    What measure is suggested to prevent hip dislocation after a posterior total hip replacement?

    <p>Using pillows to keep legs abducted (C)</p> Signup and view all the answers

    Which of these vitamins may help in decreasing inflammation in rheumatoid arthritis?

    <p>Vitamin C (D)</p> Signup and view all the answers

    What is a common early sign of rheumatoid arthritis?

    <p>Morning stiffness lasting up to an hour (B)</p> Signup and view all the answers

    For patients who have had hip surgery, what can reduce the risk of venous thromboembolism?

    <p>Thigh-high compression stockings and anticoagulant medication (A)</p> Signup and view all the answers

    Which factor is NOT a direct contributor to chronic sorrow in patients with rheumatoid arthritis?

    <p>Random dietary changes (B)</p> Signup and view all the answers

    What can secondary osteoporosis lead to in rheumatoid arthritis patients?

    <p>Fractures (C)</p> Signup and view all the answers

    Which diagnostic imaging technique is useful for detecting joint damage specifically in the vertebral column?

    <p>X-ray examination (A)</p> Signup and view all the answers

    Which intervention is encouraged to help manage disturbances in body image among patients with joint deformities?

    <p>Encouraging active socialization (C)</p> Signup and view all the answers

    How can patients minimize risk during home rehabilitation after a total hip replacement?

    <p>Avoiding throw rugs and using safety measures in the shower (A)</p> Signup and view all the answers

    Which test result can indicate the aggressiveness of rheumatoid arthritis?

    <p>Presence of RF in serum (B)</p> Signup and view all the answers

    Which activity limitation is typically given after anterior hip replacement surgery?

    <p>No muscles are cut; generally no activity limitations (D)</p> Signup and view all the answers

    What is a recommended educational resource for patients looking to improve joint protection and energy conservation in osteoarthritis?

    <p>Arthritis Foundation (C)</p> Signup and view all the answers

    What should be monitored to detect neurovascular compromise post-surgery?

    <p>Color, warmth, pulses, sensation, and movement of the limb (B)</p> Signup and view all the answers

    What type of professional support is suggested for a patient experiencing chronic sorrow due to body image changes?

    <p>Spiritual adviser (D)</p> Signup and view all the answers

    Which occupational aid is helpful for individuals unable to perform their usual job due to rheumatoid arthritis?

    <p>Occupational therapy (A)</p> Signup and view all the answers

    Why is a patient discharged with instructions to keep their surgical leg abducted after hip replacement?

    <p>To prevent hip dislocation (C)</p> Signup and view all the answers

    Which type of activity is recommended to observe the patient's self-care abilities to gather baseline data for planning care?

    <p>Assisted ADLs (D)</p> Signup and view all the answers

    What therapeutic measure is often needed if nonsurgical approaches fail to relieve arthritic pain?

    <p>Total joint replacement (C)</p> Signup and view all the answers

    Which is a frequent inclusion in the interdisciplinary team for a patient with self-care deficits due to joint disease?

    <p>Occupational therapist (C)</p> Signup and view all the answers

    What is a common symptom in older patients that may indicate infection, aside from fever?

    <p>Confusion (C)</p> Signup and view all the answers

    Which type of connective tissue is primarily affected during the autoimmune response in rheumatoid arthritis?

    <p>Synovial membrane (D)</p> Signup and view all the answers

    What should be done with a prefilled syringe of enoxaparin before administration to ensure proper dosing?

    <p>Leave the air bubble to ensure the complete dose is given (D)</p> Signup and view all the answers

    How does rheumatoid arthritis primarily progress?

    <p>From upper extremities and progresses to other joints over years (A)</p> Signup and view all the answers

    Which precaution is recommended to prevent falls after discharge from hip surgery?

    <p>No use of throw rugs and keeping walkways clear (C)</p> Signup and view all the answers

    What is an important part of post-operative care to ensure a patient's recovery after orthopedic surgery?

    <p>Encouraging early ambulation (C)</p> Signup and view all the answers

    What is the main purpose of 'joint camp' following surgery?

    <p>To receive occupational therapy and physical therapy instructions (C)</p> Signup and view all the answers

    Which type of medication was prescribed for pain relief after hip surgery?

    <p>Acetaminophen/hydrocodone (Norco) (D)</p> Signup and view all the answers

    What is the primary goal of a total joint replacement procedure?

    <p>To relieve severe chronic pain and improve ADLs (C)</p> Signup and view all the answers

    What action is most crucial for nurses following hip surgery to promote healing?

    <p>Monitoring the patient's pain level and encouraging movement (A)</p> Signup and view all the answers

    Which condition is a common indication for total joint replacement?

    <p>Severe connective tissue disease (D)</p> Signup and view all the answers

    In a total hip replacement, which surgical factor is critical to prevent postoperative hip dislocation?

    <p>Correct positioning of the surgical leg (B)</p> Signup and view all the answers

    Following a total knee replacement, what is not a major concern compared to a total hip replacement?

    <p>Preventive positioning (D)</p> Signup and view all the answers

    How does a cementless prosthesis secure itself within the patient’s bone?

    <p>The patient's bone grafts to the porous prosthesis (A)</p> Signup and view all the answers

    What is the primary difference regarding dislocation between total hip replacement (THR) and total knee replacement (TKR)?

    <p>Dislocation concerns are more relevant to THR (C)</p> Signup and view all the answers

    What is a potential complication of long-term steroid use related to bone health?

    <p>Avascular necrosis (A)</p> Signup and view all the answers

    Which factor is most critical in the initial recovery phase after a hip surgery?

    <p>Early mobilization and walking (A)</p> Signup and view all the answers

    What is the typical weight-bearing limitation initially after hip surgery?

    <p>Partial weight-bearing (C)</p> Signup and view all the answers

    What common postoperative complication is associated with posterior or anterior-lateral THR?

    <p>Total or partial hip dislocation (B)</p> Signup and view all the answers

    Which surgery-related condition might necessitate higher-level amputations?

    <p>Peripheral vascular disease (A)</p> Signup and view all the answers

    What purpose does tranexamic acid serve when used during joint replacement surgeries?

    <p>To reduce blood loss (B)</p> Signup and view all the answers

    Which of the following is crucial for preoperative care before a total hip replacement?

    <p>Allergy history and neurovascular status assessment (C)</p> Signup and view all the answers

    What is a common site for elective surgical amputation related to peripheral vascular disease?

    <p>The lower extremity (B)</p> Signup and view all the answers

    Why might a cemented prosthesis be used instead of a cementless one in joint replacements?

    <p>When bone health is poor, such as in osteoporosis (C)</p> Signup and view all the answers

    During the recovery process from hip surgery, which aid was used for approximately one month?

    <p>Cane (C)</p> Signup and view all the answers

    What immediate action should be taken if a postoperative hip dislocation is suspected?

    <p>Notify the surgeon and keep the patient in bed (C)</p> Signup and view all the answers

    How long after surgery did the patient begin driving again?

    <p>Four weeks (C)</p> Signup and view all the answers

    Which surgical procedure often involves the removal of part of the pelvis?

    <p>Hemipelvectomy (B)</p> Signup and view all the answers

    During postoperative care for THR, how is pain generally managed?

    <p>With a combination of analgesics, including Tylenol and NSAIDs (C)</p> Signup and view all the answers

    What is the primary benefit of preoperative exercises prescribed by a physical therapist?

    <p>They help strengthen the operative leg (C)</p> Signup and view all the answers

    What was a significant benefit for the patient having a former ortho nurse as a spouse?

    <p>Enhanced understanding of postoperative care (C)</p> Signup and view all the answers

    What does the term 'replantation' imply in surgical terminology?

    <p>Re-attaching a severed body part (A)</p> Signup and view all the answers

    What are the prosthetic components of a total hip replacement typically made of?

    <p>Ceramic, polyethylene, or metal (D)</p> Signup and view all the answers

    Why is it advised not to shave the skin before THR surgery?

    <p>To avoid microabrasions that could harbor bacteria (D)</p> Signup and view all the answers

    What risk is significantly higher in patients with diabetes regarding amputations?

    <p>Lower extremity amputation (B)</p> Signup and view all the answers

    What should be avoided to minimize the risk of hip dislocation after surgery?

    <p>Hip adduction and hyperflexion (D)</p> Signup and view all the answers

    Study Notes

    Soft Tissue Injuries

    • Strains: Excessive stretching of muscle or tendons. Causes include falls, overexertion, and heavy lifting.
    • Mild Strain: Minimal inflammation, with swelling and tenderness.
    • Moderate Strain: Partial tearing of muscle/tendon fibers, causing pain and limited movement.
    • Severe Strain: Complete rupture of muscle/tendon, separating muscle from muscle, tendon from muscle, or tendon from bone. Causes severe pain and disability.
    • RICE Therapy: Rest, Ice, Compression, Elevation. Crucial for strain and sprain injuries immediately after injury.
      • Rest: Protects the injured area.
      • Ice: Applied 15-20 minutes, four times daily, to reduce swelling and pain.
      • Compression: Elastic bandage applied to support and reduce swelling.
      • Elevation: Raises the injured area (if possible) to reduce swelling.
    • Post-Swelling Treatment: Apply heat (15-30 minutes, four times daily), increasing blood flow for healing.
    • Medication: NSAIDs and muscle relaxants may be prescribed to manage pain and inflammation. Surgical repair may be needed for severe cases.

    Sprains

    • Sprains: Excessive stretching of ligaments from twisting movements (sports, exercise, falls).
    • Mild Sprain: Few ligament fibers torn, causing tenderness. Treated with RICE and NSAIDs.
    • Moderate Sprain: More ligament fibers torn, but the joint remains stable. May need braces or casts for immobilization. Uncomfortable, especially during activity.
    • Severe Sprain: Instability of the joint, usually requiring surgical repair or grafting. Pain and swelling limit movement.

    Dislocations

    • Dislocations: Injury where bones of a joint are moved out of normal position, often due to trauma or disease (e.g., rheumatoid arthritis).
    • Symptoms: Severe pain, reduced range of motion, and deformity of the joint.
    • Treatment: Immobilize the joint, apply ice, and seek immediate medical attention to preserve function. Avoid moving the affected joint.

    Bursitis

    • Bursae: Fluid-filled sacs cushioning tendons during movement. Common in shoulder, elbow, hip, knee, ankle, and heel.
    • Bursitis: Inflammation of a bursa.
    • Causes: Arthritis, gout, repetitive movements, infections, or sleeping positions (e.g., shoulder compression).
    • Prevention: Strategic stretching, frequent movement, avoiding repetitive motions, cushioned seating, and avoiding leaning on elbows can help.
    • Symptoms: Achy pain, stiffness, swelling, redness, or burning pain over the joint area. Worsens with activity; usually subsides in a week.
    • Treatment: Rest, ice (until warmth decreases), then heat. Elevation, ultrasound, massage, NSAIDs, antibiotics (if infection), physical therapy are possible.

    Rotator Cuff Injury

    • Rotator Cuff: Short tendons connected to muscles around the shoulder, covering its top, front, and back. Muscle contraction moves or rotates the shoulder.
    • Chronic Impingement Syndrome: Top tendon (supraspinatus) and bursae become impinged under the acromion bone. Causes inflammation with repeated arm movements, leading to pain, and potential tendon tears.
    • Symptoms: Shoulder ache, increased pain with lifting, night pain, weakness, limited range of motion.
    • Diagnosis: MRI.
    • Treatment: (Minor): Rest, ice, NSAIDs, physical therapy. (Severe): Arthroscopic surgery to relieve impingement or repair tears.

    Carpal Tunnel Syndrome

    • Cause: Median nerve compression within the carpal tunnel, due to swelling from edema, trauma, rheumatoid arthritis, or repetitive hand movements.
    • Symptoms: Slow-onset finger, hand, and arm pain/numbness, painful tingling, paresthesia, and eventual fine motor deficits and then muscle weakness.
    • Diagnosis: Signs and symptoms, patient history, positive Phalen test (numbness with wrist flexion), electromyography (EMG).
    • Treatment: Initially, wrist splinting, rest. NSAIDs or cortisone injection to reduce inflammation, followed by endoscopic or open surgery (nerve release) if needed.
    • Post-Surgery Care: Elevate hand, follow splinting instructions, limit lifting for several weeks, monitor for neurovascular compromise (numbness, tingling, coolness, lack of pulse, pale skin/nails, limited movement). Physical therapy for recovery.

    Fractures

    • Fracture: Break in a bone (can be minor or complex).
    • Causes: Falls, accidents, crushing injuries, bone diseases (like osteoporosis or metastatic cancer), malnutrition, or medication side effects.
    • Types: Various types exist (i.e., complete, incomplete, displaced, closed, open, spiral, oblique, transverse, etc). See table for descriptions.
    • Symptoms: Pain (especially with movement), limb shortening (complete fracture), limb rotation/deformity, crepitation (bone grating sound).
    • Skin Inspection: Check for intactness. Open fractures expose bone – wounds are a concern. Closed fractures may have bruising (ecchymosis) and swelling. Swelling impairs blood flow.
    • Diagnostic Tests: X-rays, CT scans, MRIs. Serum calcium level, hemoglobin/hematocrit (with significant bleeding).
    • Emergency Treatment: Immobilize the limb as found. Do not attempt to reposition. Splint above and below the fracture site, keep patient warm. Transport to hospital as soon as possible.

    Fracture Management

    • Goals: Reduce bone ends to correct alignment, immobilize the bone, preserve/restore soft tissue structures, prevent deformity, restore function, promote early healing and pain relief.
    • Closed Reduction: Most common for simple fractures. Bone ends are manually realigned, x-rayed for confirmation, then immobilized with a splint or cast.
    • Splints: Provide support during the healing phase, used for wound care or to accommodate possible swelling. Neurovascular checks are crucial hourly.
    • Casts: More supporting than splints, made of plaster or fiberglass. Plaster takes 24-72 hours to dry; fiberglass hardens quickly. Monitor closely for tightness (compartment syndrome risk.) If cast becomes too tight, it needs bivalving/windowing under medical order.
    • Traction: Applying pulling force to align bone. Primarily temporary with advances in orthopaedic surgery. Buck traction (skin) or skeletal traction (pins/wires).
    • Open Reduction with Internal Fixation: Bone ends are surgically realigned & fixed with plates/screws (or prosthesis) for fracture healing in the hip, ankle, or long bones.
    • External Fixation: Used for severe bone damage (crushed, splintered fractures). Pins inserted & held by an external frame to stabilize bone during healing.

    Complications of Fractures

    • Neurovascular Status: Monitor pulses, skin temperature, sensation, and movement—report immediately any abnormalities.
    • Hemorrhage: Monitor for significant bleeding and vital signs; report any issues.
    • Infection: Monitor for signs (e.g., odor, warmth, redness, pain).
    • Thromboembolic Complications: Deep vein thrombosis (DVT) or pulmonary embolism (PE) is possible; preventative measures are critical.
    • Compartment Syndrome: Increased pressure in limb compartments, reducing circulation; life-threatening. Report increasing pain, not relieved by pain meds, especially with movement. Early signs are critical to report. Possible (late) signs: Pain (severe, & increased with passive stretching), paresthesia (tingling/burning), pallor (with some potential warmth/redness), Paralysis, Pulselessness, Poikilothermia. Immediate treatment by HCP is critical to save the limb.
    • Fat Embolism Syndrome: Associated with long-bone fractures (especially femoral shaft); small fat droplets in blood stream travel to lungs, leading to respiratory insufficiency and possible respiratory failure. Monitor for these signs immediately: tachypnea, dyspnea, cyanosis, confusion/drowsiness, rash (red, measles-like), tachycardia, fever, retinal changes.

    Osteomyelitis

    • Osteomyelitis: Bone infection (acute or chronic).
    • Causes: Bacteria enter bone tissue (open fractures, infections spreading from other body sites). Staphylococcus aureus is a common causative agent.
    • Symptoms: (Acute): Pain, redness, warmth, swelling, fever. (Chronic): Ulceration, drainage, localized pain.
    • Diagnosis: Elevated white blood cell count, elevated ESR, positive bone biopsy. X-rays, CT scans, MRIs. Blood cultures.

    Osteoporosis

    • Osteoporosis: Metabolic disorder characterized by low bone mass and deterioration of bone structure, increasing fracture risk. Primary (most common) vs. Secondary. Affects spine, wrist, and hip most commonly.
    • Prevalence: High rates in the aging U.S. population (especially women).
    • Pathophysiology: Imbalance between bone breakdown (osteoclasts) and bone buildup (osteoblasts). Bone density peaks in 30s, breakdown exceeds buildup afterward. Estrogen decrease affects calcium absorption in postmenopausal women.
    • Risk Factors: Age, ethnicity (White/Asian), family history, female gender, history of fractures, low testosterone/estrogen in men, postmenopausal status, small body frame. Modifiable: Anorexia, smoking, excessive alcohol, low calcium/vitamin D, excessive caffeine/protein/sodium intake. Sedentary lifestyle.
    • Secondary: Associated medical conditions (e.g., hyperparathyroidism, renal dialysis), medications (e.g., steroids, some antiseizure meds, sleeping aids).
    • Prevention: Healthy lifestyle (Diet high in calcium & vitamin D, weight-bearing exercise, avoid alcohol/smoking), especially before peak bone density is reached at ~ age 30.
    • Symptoms: Height loss (up to 6 inches), kyphosis (spinal curvature). Often a fracture precedes the osteoporosis being diagnosed.
    • Diagnosis: DEXA (Dual-energy x-ray absorptiometry) scan. Serum calcium and vitamin D levels, serum phosphorus, alkaline phosphatase.
    • Treatment: Medications (supplements, bisphosphonates, calcitonin, denosumab, raloxifene, teriparatide). Maintain healthy diet, exercise, avoid falls.

    Paget's Disease

    • Paget's Disease: Rare metabolic bone disease. Increased bone breakdown and formation, resulting in weak, deformed, painful bones. Increased risk of fractures and osteoarthritis.
    • Signs: Severe bone pain, deformities, fractures.
    • Diagnosis: Bone x-rays, increased serum alkaline phosphatase levels.

    Bone Cancer

    • Bone Tumors: Benign or malignant (primary or metastatic).
    • Types: Osteosarcoma, Ewing sarcoma; metastatic cancers (e.g., prostate, breast, lung, thyroid).
    • Symptoms: Primary tumors: Pain/swelling at site, palpable mass. Metastatic: Diffuse severe pain, disability.
    • Diagnosis: X-rays, CT scans, bone scans, bone biopsy, PET/PET-CT scan, or MRI. Elevated alkaline phosphatase levels.
    • Treatment: Surgery (with chemotherapy/radiation), chemotherapy, radiation, amputation in some cases.

    Connective Tissue Disorders

    Gout

    • Gout: Systemic connective tissue disorder caused by uric acid buildup. Primarily affects middle-aged-to-older men.
    • Pathophysiology: Uric acid is a waste product. Excess uric acid (hyperuricemia) forms urate crystals in joints & connective tissues, causing inflammation (often resolving without treatment). Tophi (urate deposits) may appear under the skin or in kidneys, causing potential stone (calculi) formation.
    • Causes: Primary gout (inherited purine metabolism problem). Secondary gout (caused by other medical issues or medications: renal insufficiency or medications). Acute attacks may be triggered by stress, alcohol, illness, dieting, or certain meds.
    • Symptoms: Severe pain/inflammation in one or more joints; often the great toe. Swollen, red, hot, and tender joints. Chronic gout may have no major obvious signs/symptoms.
    • Diagnosis: Elevated serum uric acid level; joint fluid aspiration analysis for urate crystals.
    • Treatment: NSAIDs, colchicine, steroids (acute). Pegloticase (IV). Uricosuric medications (febuxostat, allopurinol, probenecid) to prevent increased serum uric acid levels. Monitor uric acid levels during treatment.

    Osteoarthritis

    • Osteoarthritis (OA): Most common type of arthritis, affecting weight-bearing joints, hands, and vertebral column. Primarily affects older patients, especially women. Characterized by gradual degeneration of joint cartilage and bone.
    • Pathophysiology: Gradual breakdown of cartilage and bone ends, joint space narrowing, bone spurs, inflamed joint lining.
    • Causes: Primary (unknown cause). Secondary OA (trauma, sepsis, congenital conditions, metabolic problems, other arthritic conditions).
    • Risk Factors: Heredity, obesity, physical activities stressing joints (e.g., prolonged standing, repetitive motions).
    • Symptoms: Joint pain and stiffness, especially upon arising, worsening with activity, and reduced with rest. Heberden and Bouchard nodes (bony nodes affecting finger joints.) Spinal OA results in muscle spasms.
    • Diagnosis: X-rays, MRI, synovial fluid analysis.
    • Treatment: Symptom management. Medications (NSAIDs, acetaminophen). Exercise (balanced rest). Weight control. Heat/cold therapy. Complementary therapies. Surgery (total joint replacement).

    Rheumatoid Arthritis

    • Rheumatoid Arthritis (RA): Chronic, progressive, systemic inflammatory disease damaging synovial joints and other connective tissues.
    • Pathophysiology: Inflammation of synovium (joint lining) caused by inflammatory cells and chemicals. Thickening of synovium, fluid accumulation, destructive pannus formation (eroding cartilage and destroying bone). The disease can affect various systems of the body (blood vessels, nerves, organs etc.) and can be life-threatening.
    • Causes: Autoimmune response (unclear). Risk factors: family history, infection link.
    • Symptoms: Typically bilateral and symmetrical joint inflammation. Often begins in upper extremities. Morning stiffness lasting >1 hr. Fatigue, weakness, anorexia. Late-stage RA involves major organ issues potentially resulting in significant disability.
    • Diagnosis: Elevated white blood cell/platelet counts, presence/absence of rheumatoid factor (RF), decreased red blood cells, etc. ESR, antinuclear antibody test, C-reactive protein. X-rays, MRI, synovial fluid analysis.
    • Treatment: Disease-modifying antirheumatic drugs (DMARDs). NSAIDs, corticosteroids. Heat/cold therapy. Complementary therapies (e.g., capsaicin, vitamin C/E). Joint replacement surgery

    Musculoskeletal Surgery

    Total Joint Replacement

    • Total Joint Replacement (TJR): Often performed for severely deteriorated joints from connective tissue disorders, cancer, trauma, or long-term steroid use. Common: hip and knee.
    • Components: Ceramic, polyethylene, or metal. Most are cementless (bone-grafting). Cemented for those with poor bone health.
    • Procedures: Total hip (acetabular cup, femoral stem/head). Total Knee (femoral, tibial, patellar components.)
    • Post-op Complications: Hip dislocation (posterior/anterior-lateral approach), skin breakdown, infection, bleeding, neurovascular compromise, and thromboembolic complications (e.g., DVT).

    Amputation

    • Amputation: Removal of a body part (finger, lower or upper extremity, significant portion of limb etc.) due to chronic disease (e.g., ischemia in patients with peripheral vascular disease), trauma/injury, bone tumors, infection, or thermal injury).
    • Levels of Amputation: Various levels (great toe, below-knee, above-knee, disarticulation, hemipelvectomy). Higher levels have increased disability.
    • Preoperative Care: Prosthesis fitting, grieving, psychological/emotional support.
    • Postoperative & Rehabilitative Care: Frequent neurovascular checks.

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    Test your knowledge on common injuries, their management, and associated terms. This quiz covers strains, sprains, dislocations, bursitis, and rotator cuff injuries, providing insights into initial treatments and diagnostic techniques. Perfect for students studying sports medicine or healthcare professionals.

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