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Unit 41

Unit 41. Musculoskeletal System. Objectives. Spell and define terms. Describe the location and functions of the musculoskeletal system. Describe some common conditions of the musculoskeletal system. Objectives.

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Unit 41

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  1. Unit 41 Musculoskeletal System

  2. Objectives • Spell and define terms. • Describe the location and functions of the musculoskeletal system. • Describe some common conditions of the musculoskeletal system.

  3. Objectives • Describe the nursing assistant actions related to the care of patients with conditions and diseases of the musculoskeletal system. • List seven specific diagnostic tests for musculoskeletal conditions.

  4. The Musculoskeletal System • Skeleton • Bony frame of the body • Muscles • Tissues made up of contractile fibers or cells that produce movement • Together, the skeleton and muscles are termed the musculoskeletal system

  5. Structure and Function • Review the parts of the human skeleton

  6. Structure and Function • Review the major muscles of the body

  7. Common Conditions • Many conditions can affect the bones, muscles, tendons, ligaments, and joints • Often, when one of these structures is diseased or injured: • Surrounding tissues are also involved

  8. Range of Motion • Patients who have been ill or confined to bed are not as active as usual • Their joints may not move through the normal range of motion daily • Atrophy • Weakness and muscle wasting from lack of use

  9. Range of Motion • Over time • Muscles become rigid • Joints do not move as freely as they once did • Joint movement may be painful because the muscles have shortened from lack of use

  10. Range of Motion • When the joint moves • Muscles stretch • This causes discomfort or pain • As a result the patient may move even less

  11. Abduction – Moving away from midline • Adduction – Moving toward the midline • Flexion- Decreasing the angle between two bones • Extension – Increasing the angle between two bones

  12. Bursitis – Inflammation of the bursae (small sacs of fluid around joints) • Treatment – use heat to promote healing

  13. Arthritis • Rheumatoid – autoimmune response can occur with any age • Osteoarthritis – affects the cartilage covering the ends of the bones that form a joint . Most common symptom is Pain

  14. Gout – The great toe is usually first affected. Caused by uric acid not metabolized correctly. It may go into remission

  15. osteoporosis • Metabolic disorder of the bones • Most common in women • The first sign is a fracture • Treatment is to prevent fractures and control pain

  16. Fibromyalgia • Chronic pain syndrome. Not sure of cause • Affects more women than men • Criteria for dx: • Pain on both sides of the body, pain above and below the waist, and pain upon palpatation in at least 11 of 18 body sites

  17. Fractures • See pg 709

  18. Signs/Sx of fracture • Edema, Pain, Limited movement, ecchymosis – Bruising • Treatment – Keep immobile , in most cases will not exercise the fractured extremity

  19. Cast • Elevated the casted extremity on a pillow • Turn the patient frequently using the palms of your hands • Observe the uncasted area of the extremity for signs off decreased circulation. Report coldness, cyanosis, swelling, increased pain, numbnessor tingling

  20. Signs of infection under cast • Odor and drainage

  21. Traction • It is designed to pull two body areas slightly apart. Do Not disturb the weights • Check under straps for pressure areas • Keep bed covers off of ropes and pulleys

  22. Hip fractures • most common with elderly • The leg on the affected side may be shortened and in a position of external rotation • At risk of pressure ulcers on the heels therefore a pressure relieving mattress may be ordered

  23. THA total hp arthroplasty • (Insertion of a hip prosthesis) • Care: Anti embolism stockings • trapeze bar • Use an abduction pillow to keep legs apart • Avoid flexion of the hip and legs • Bed is not elevated more than 45 degrees (see pg 715)

  24. Total Joint Replacement • Goal is to relieve pain. • Most common is hip and knee

  25. CPM (Continuous Passive Motion) • CPM therapy prevents stiffness by delivering a form of passive ROM so the joint is moved without the patient’s muscles being used. CPM therapy is effortless for the patients

  26. Compartment syndrome • Painful condition that occurs when pressure within the muscles builds up, preventing blood and oxygen from reaching muscles and nerves, This is a serious complication that may develop following an injury or surgical procedure • Report to nurse immediately this is surgical emergency.

  27. Amputation • Phantom pain - this is a real pain • Avoid abduction • Avoid flexion of the knee • Avoid placing pillow under the amputated extremity • Avoid elevating HOB • Keep legs in adduction

  28. Range of Motion • Prevents contractures (disfigurement caused by muscle shortening) • Easier to prevent than reverse

  29. EMG – measure the effectiveness of muscle/nerve interaction

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