NR511 Final Exam Study Guide 3

1. Signs and symptoms and management of musculoskeletal sprains/strains/dislocations Kara Irvin Signs and symptoms and management of musculoskeletal sprains/strains/dislocations Sprains: stretching or tearing of ligaments that occurs when a joint is forced beyond its normal anatomical range First degree- stretching of ligamentous fibers Second degree- tear of part of the ligament with pain and swelling Third degree- complete ligamentous separation Sprain- sudden injury or fall that caused acute pain and swelling that got worse over a few hours, redness and bruising, active and passive ROM decreased. Radiography to rule out fx. Strain: muscle injury caused by excessive tensile stress placed on a muscle that results in stiffness and decreased function -effects muscle or tendon that connects a muscle to a bone, complain of “pulled muscle,” severe cases cause inflammation, swelling, weakness and loss of function-surgery may be needed Management: PRICE (protect, rest, ice, compression, elevation), limitation of activity, physical therapy, NSAIDS, referral to ortho Dislocation- complete separation of 2 bones that form a joint Very painful and cause immobility, need immediate medical attention Referral to orthopedics for possible surgery or reduction with application of cast or splint. 2. Signs and symptoms and management of spinal disorders (spondylosis, stenosis, etc.) Sandra Okonkwo Thank you Ashley L for completing!!! Cervical Spondylosis- neck stiffness, mild aching discomfort with activity. Pain and limited ROM occur with lateral rotation and lateral flexion of the neck toward the affected side. Weakness shoulder abduction- C5. Bicep weakness- C6. Tricep weakness-C7.Myelopathy- leg weakness, gait disturbance, balance problems, difficulty performing fine motor tasks, loss of bowel and bladder. Treatment- cervical traction, PT, pain relievers. Surgery for Myelopathy. Low back pain-Tenderness and decreased range of motion. Positive straight leg test. Treatment-NSAIDS, muscle relaxants, opioids, surgical, self-care, spinal manipulation Stenosis-pseudoclaudication causing radicular pain in the calves, buttocks, and upper thighs of one or both legs. Symptoms progress from a proximal to distal direction. Walking or prolonged standing causes pain and weakness in buttocks and legs. Stooping over helps relieve pain. Positive Romberg. Reflexes diminished. Management- surgical decompression. NSAIDS, folic acid, vitamin b12. PT-flexing the spine.Bicycling. 3. Recognition and immediate management of cauda equina syndrome Danie Molly Immediate management of cauda equina syndrome. (P. 829) Cauda equina syndrome is a medical EMERGENCY and requires immediate decompression. If Cauda equina is confirmed, surgical lumbar decompression is necessary to halt neurological deterioration unless surgery is contraindicated for other medical reasons. *Rational on Davis Edge question: Low back pain accompanied by acute onset of urinary retention or overflow incontinence, loss of anal sphincter tone or fecal incontinence, loss of sensation in the buttocks and perineum, and motor weakness in the lower extremities is a red flag for cauda equina syndrome or severe neurologic compromise