Pathophysiology - NURS 351A
Objectives Exam 4 (Final)FULLY
SOLVED
Obj. #1 Describe the pathophysiology of musculoskeletal injuries including bone, ligament, tendon, and
soft tissue - correct answer ✔✔Bone
- fracture (a break in the continuity of bone)
- patho-- commonly osteoporosis
Strain (muscles and tendons)
- overstretching or tearing of muscles/tendons
Sprain (ligaments)
- overstretching or tearing of ligaments
Obj. #2 Discuss factors that can delay healing and potential complications of musculoskeletal trauma -
correct answer ✔✔Fractures
- delayed union (fracture healing taking longer than expected)
- nonunion (fracture with no chance of healing)
- malunion (healing of bone in an unacceptable position)
Obj. #3 Recognize laboratory tests and imaging studies commonly used to diagnose musculoskeletal
trauma - correct answer ✔✔X-Rays-- fractures, osteoarthritis, and post-traumatic arthritis
DEXA (bone density)-- compression fractures and osteoporosis
Elevated CK-- rhabdomyolysis
WBCs-- systemic infection
MRI-- avascular necrosis (AVN)
CT-- post-traumatic arthritis
Phalen's maneuver with hyperflexion-- Carpal Tunnel Syndrome
,Obj, #4 Discuss treatment modalities used in the management of musculoskeletal trauma - correct
answer ✔✔Fractures
- most injuries are self-limiting, RICE therapy (rest, ice, compression, elevation), realign bones (reduction,
open or closed), physical therapy, massage, acupuncture, transcutaneous electrical nerve stimulation
(TENS), chiropractic care/DO OMM
Sprains and Strains
- cold therapy initially for a short period up to 48 hours
low level of activity (not NO level of activity), lifting activities involving affecting muscles, anti-
inflammatory agents (NSAIDs), muscle relaxants (cyclobenzaprine), weight loss (abdominal obesity can
strain back), PRICES- protection, rest, ice, compression, elevation, supports (splint), physical therapy
important to decrease loss of ROM
Osteoporosis
- lifestyle changes-- appropriate weight-bearing exercise/fall prevention, diet- fiber, calcium, and vitamin
D, UV light, anti-resorption-- bisphosphonates, medications-- teriparatide, clacitonin, vertebroplasty /
kyphoplasty-- cement injections
Osteoarthritis
- maintain mobility, dietary supplements, reduce stress on joints, relieve pain and inflammation, surgical
options osteotomy, osteoplasty, arthrodesis, partial or total joint arthroplasty
Obj. #5, 6, 7, & 8 Identify etiologies, pathological mechanisms, signs and symptoms, clinical
manifestations, assessment techniques, and treatment modalities of degenerative disorders within the
musculoskeletal system - correct answer ✔✔Osteoporosis and Osteoarthritis
Osteoporosis (etiology, pathological mechanism, clinical manifestations, assessment techniques, and
treatment modalities) - correct answer ✔✔Risk Factors-- female, post-menopausal, family history,
Caucasian/Asian, lack of calcium, vitamin D, and weight-bearing exercises, hyperthyroidism, and
hyperparathyroidism
Etiology-- hormones play a role in BMD (low estrogen)
Patho-- osteoclast activity is higher than osteoblast activity
Clinical-- easily fractures bone
Diagnosis-- DEXA (bone density), blood tests (PTH, estradiol, osteocalcin), urine (telopeptides), FRAX risk
assessment
Treatment-- lifestyle changes to incorporate more calcium, vitamin D, fiber, UV light; possible meds like
bisphosphonates, teriparatide, and calcitonin; cement injections into bone
, Osteoarthritis (etiology, pathological mechanism, signs and symptoms, clinical manifestations,
assessment techniques, and treatment modalities) - correct answer ✔✔Risk Factors-- aging, obesity,
history of participation in team sports, history of trauma or overuse of a joint, heavy occupational work,
misalignment of the pelvis, hip, knee, ankle, or foot
Etiology-- individuals older than age 40 years, associated with trauma to joints over course of life
Patho-- slowly progressive, degenerative, and inflammatory condition; changes in cartilage lead to
inflammation and changes in joint surfaces
S/S-- deep aching joint pain, pain relieved with rest, joint pain during cold weather, stiffness when arising
in the morning, crepitus of the joint during motion, joint swelling, altered gait, limited range of motion
Clinical/Assessment-- joint deformity, joint tenderness, decreased range of motion, fingers are often
involved; swellings- heberden's nodes (distral interphalangeal joint), bouchard's nodes (proximal
interphalangeal joint)
Treatment-- maintain mobility, dietary supplements, reduce stress on joints, relieve pain and
inflammation
Surgical-- osteotomy, osteoplasty, arthrodesis, partial or total joint arthroplasty
Obj. #9, 10, 11, & 12 Identify etiology, pathological mechanisms, signs and symptoms, clinical
manifestations, assessment techniques for diagnosis, and treatment modalities of inflammation,
infection, and degenerative disorders within the musculoskeletal system - correct answer ✔✔Rickets
(children), Osteomalacia, Degenerative Disc Disease (DDD), Spinal Stenosis, Cauda Equina Syndrome,
Osteomyelitis, Septic Arthritis, Mycobacterium Tuberculosis, Lyme Disease, Gout
Rickets (children) (etiology, risk factors, S/S, clinical manifestations, diagnosis, treatment) - correct
answer ✔✔risk factors
- lack of sunlight in mom and baby (breast fed)
- genetic abnormalities
etiology
- lack of vitamin D, calcium, phosphorus
- reduced vitamin D decreases calcium absorption
clinical manifestations
- generally begins between 4 and 12 months of age
- bone tenderness, malformation of bones develop, varus
Objectives Exam 4 (Final)FULLY
SOLVED
Obj. #1 Describe the pathophysiology of musculoskeletal injuries including bone, ligament, tendon, and
soft tissue - correct answer ✔✔Bone
- fracture (a break in the continuity of bone)
- patho-- commonly osteoporosis
Strain (muscles and tendons)
- overstretching or tearing of muscles/tendons
Sprain (ligaments)
- overstretching or tearing of ligaments
Obj. #2 Discuss factors that can delay healing and potential complications of musculoskeletal trauma -
correct answer ✔✔Fractures
- delayed union (fracture healing taking longer than expected)
- nonunion (fracture with no chance of healing)
- malunion (healing of bone in an unacceptable position)
Obj. #3 Recognize laboratory tests and imaging studies commonly used to diagnose musculoskeletal
trauma - correct answer ✔✔X-Rays-- fractures, osteoarthritis, and post-traumatic arthritis
DEXA (bone density)-- compression fractures and osteoporosis
Elevated CK-- rhabdomyolysis
WBCs-- systemic infection
MRI-- avascular necrosis (AVN)
CT-- post-traumatic arthritis
Phalen's maneuver with hyperflexion-- Carpal Tunnel Syndrome
,Obj, #4 Discuss treatment modalities used in the management of musculoskeletal trauma - correct
answer ✔✔Fractures
- most injuries are self-limiting, RICE therapy (rest, ice, compression, elevation), realign bones (reduction,
open or closed), physical therapy, massage, acupuncture, transcutaneous electrical nerve stimulation
(TENS), chiropractic care/DO OMM
Sprains and Strains
- cold therapy initially for a short period up to 48 hours
low level of activity (not NO level of activity), lifting activities involving affecting muscles, anti-
inflammatory agents (NSAIDs), muscle relaxants (cyclobenzaprine), weight loss (abdominal obesity can
strain back), PRICES- protection, rest, ice, compression, elevation, supports (splint), physical therapy
important to decrease loss of ROM
Osteoporosis
- lifestyle changes-- appropriate weight-bearing exercise/fall prevention, diet- fiber, calcium, and vitamin
D, UV light, anti-resorption-- bisphosphonates, medications-- teriparatide, clacitonin, vertebroplasty /
kyphoplasty-- cement injections
Osteoarthritis
- maintain mobility, dietary supplements, reduce stress on joints, relieve pain and inflammation, surgical
options osteotomy, osteoplasty, arthrodesis, partial or total joint arthroplasty
Obj. #5, 6, 7, & 8 Identify etiologies, pathological mechanisms, signs and symptoms, clinical
manifestations, assessment techniques, and treatment modalities of degenerative disorders within the
musculoskeletal system - correct answer ✔✔Osteoporosis and Osteoarthritis
Osteoporosis (etiology, pathological mechanism, clinical manifestations, assessment techniques, and
treatment modalities) - correct answer ✔✔Risk Factors-- female, post-menopausal, family history,
Caucasian/Asian, lack of calcium, vitamin D, and weight-bearing exercises, hyperthyroidism, and
hyperparathyroidism
Etiology-- hormones play a role in BMD (low estrogen)
Patho-- osteoclast activity is higher than osteoblast activity
Clinical-- easily fractures bone
Diagnosis-- DEXA (bone density), blood tests (PTH, estradiol, osteocalcin), urine (telopeptides), FRAX risk
assessment
Treatment-- lifestyle changes to incorporate more calcium, vitamin D, fiber, UV light; possible meds like
bisphosphonates, teriparatide, and calcitonin; cement injections into bone
, Osteoarthritis (etiology, pathological mechanism, signs and symptoms, clinical manifestations,
assessment techniques, and treatment modalities) - correct answer ✔✔Risk Factors-- aging, obesity,
history of participation in team sports, history of trauma or overuse of a joint, heavy occupational work,
misalignment of the pelvis, hip, knee, ankle, or foot
Etiology-- individuals older than age 40 years, associated with trauma to joints over course of life
Patho-- slowly progressive, degenerative, and inflammatory condition; changes in cartilage lead to
inflammation and changes in joint surfaces
S/S-- deep aching joint pain, pain relieved with rest, joint pain during cold weather, stiffness when arising
in the morning, crepitus of the joint during motion, joint swelling, altered gait, limited range of motion
Clinical/Assessment-- joint deformity, joint tenderness, decreased range of motion, fingers are often
involved; swellings- heberden's nodes (distral interphalangeal joint), bouchard's nodes (proximal
interphalangeal joint)
Treatment-- maintain mobility, dietary supplements, reduce stress on joints, relieve pain and
inflammation
Surgical-- osteotomy, osteoplasty, arthrodesis, partial or total joint arthroplasty
Obj. #9, 10, 11, & 12 Identify etiology, pathological mechanisms, signs and symptoms, clinical
manifestations, assessment techniques for diagnosis, and treatment modalities of inflammation,
infection, and degenerative disorders within the musculoskeletal system - correct answer ✔✔Rickets
(children), Osteomalacia, Degenerative Disc Disease (DDD), Spinal Stenosis, Cauda Equina Syndrome,
Osteomyelitis, Septic Arthritis, Mycobacterium Tuberculosis, Lyme Disease, Gout
Rickets (children) (etiology, risk factors, S/S, clinical manifestations, diagnosis, treatment) - correct
answer ✔✔risk factors
- lack of sunlight in mom and baby (breast fed)
- genetic abnormalities
etiology
- lack of vitamin D, calcium, phosphorus
- reduced vitamin D decreases calcium absorption
clinical manifestations
- generally begins between 4 and 12 months of age
- bone tenderness, malformation of bones develop, varus
