11/7/25, 8:17 PM Nur 165 - Musculoskeletal
Nur 165 - Musculoskeletal
Intramembranous Ossification Bone develops within membrane; occurs in bones of face and
skull
Cartilage like tissue is formed, reabsorbed, and replaced
Endochondral Ossification
by bone. This is how most fractures heal.
• Local stress
Regulating Factors For Bone • Vitamin D, Parathyroid hormone, Calcitonin
Maintenance • Circulation, Blood supply
• Calcium, phosphorus, calcitonin, parathyroid hormone, growth
hormone
• Vitamin D
Factors Affecting Growth and • Glucocorticoids
Metabolism
• Estrogens, Androgens
• Thyroxine
• Insulin
• Stage 1 - Fracture hematoma (24-72 hrs.)
• Stage 2 - occurs in 3 days to 2 weeks when granulation forms at
tissue
• Stage 3 - 2 weeks to 6 weeks; new vascularization forms (Callus
formation)
5 Stages in Fracture Healing
• Stage 4 - may take 3 weeks to 6 months callus is resorbed and
made to bone
• Stage 5 - 4-5 weeks after fracture up to 1 yr. Consolidation and
reformation of bone
--
Healing:
• Younger - 6 weeks
• Older adult may take 3-6 months
Anteroposterior and lateral projections are initial screening view
Standard Radiography • Observations of bone density, alignment, swelling, and
intactness are made.
• Other determinations: size of joint space, smoothness of
synovial swelling
/ 1/23
,11/7/25, 8:17 PM Nur 165 - Musculoskeletal
Involves injection of contrast medium, or dye into subarachniod
space of the spine.
Myelography * • Vertebral column, intervertebral disks, spinal nerve
roots and blood vessels can be visualized
• CT and MRI- more popular
/ 2/23
, 11/7/25, 8:17 PM Nur 165 - Musculoskeletal
X- ray study after air or contrast injected
• Most common studied joints: knee and shoulder
Arthrography * • Ask patient if they are allergic to shellfish or iodine
• Joint may be swollen for several days after the test;
no strenuous activity for 24 hours.
Allows direct visualization of a joint. Bone needle is
inserted and joint is distended with saline.
Arthroscopy * • Nursing interventions: after procedure cover wound
with compression dressing to control swelling. Monitor
neurovascular function. Keep joint extended and elevate
to reduce swelling. Give analgesics.
Reflects degree to which matrix of bone takes up a bone
seeking radioisotope that is injected into the system.
Bone Scan *
Scan is done after isotope is injected.
• Nursing interventions: no restricted activity for patient.
Encourage patient to drink plenty of fluids after
procedure!
A connective tissue disease that destroys the joints.
• Patho: onset is characterized by synovitis, or
Rheumatoid Arthritis (RA) inflammation of synovial tissue in joints. Synovium
thickens, fluid accumulates in joint space, and a pannus
forms. The pannus destroys cartilage and erodes
bone.
Results: loss of cartilage and bone.
Unknown; an inflammatory disease
• Probably an autoimmune disease
• Some suspect female hormones influence as
Rheumatoid Arthritis (RA) - women are more affected. Some suspect a virus
Etiology cause like Epstein-Barr virus
• Smoking and coffee drinking have been found to increase RA.
• Average age:35-55. More women
• Insidious or acute onset
/ 3/23
Nur 165 - Musculoskeletal
Intramembranous Ossification Bone develops within membrane; occurs in bones of face and
skull
Cartilage like tissue is formed, reabsorbed, and replaced
Endochondral Ossification
by bone. This is how most fractures heal.
• Local stress
Regulating Factors For Bone • Vitamin D, Parathyroid hormone, Calcitonin
Maintenance • Circulation, Blood supply
• Calcium, phosphorus, calcitonin, parathyroid hormone, growth
hormone
• Vitamin D
Factors Affecting Growth and • Glucocorticoids
Metabolism
• Estrogens, Androgens
• Thyroxine
• Insulin
• Stage 1 - Fracture hematoma (24-72 hrs.)
• Stage 2 - occurs in 3 days to 2 weeks when granulation forms at
tissue
• Stage 3 - 2 weeks to 6 weeks; new vascularization forms (Callus
formation)
5 Stages in Fracture Healing
• Stage 4 - may take 3 weeks to 6 months callus is resorbed and
made to bone
• Stage 5 - 4-5 weeks after fracture up to 1 yr. Consolidation and
reformation of bone
--
Healing:
• Younger - 6 weeks
• Older adult may take 3-6 months
Anteroposterior and lateral projections are initial screening view
Standard Radiography • Observations of bone density, alignment, swelling, and
intactness are made.
• Other determinations: size of joint space, smoothness of
synovial swelling
/ 1/23
,11/7/25, 8:17 PM Nur 165 - Musculoskeletal
Involves injection of contrast medium, or dye into subarachniod
space of the spine.
Myelography * • Vertebral column, intervertebral disks, spinal nerve
roots and blood vessels can be visualized
• CT and MRI- more popular
/ 2/23
, 11/7/25, 8:17 PM Nur 165 - Musculoskeletal
X- ray study after air or contrast injected
• Most common studied joints: knee and shoulder
Arthrography * • Ask patient if they are allergic to shellfish or iodine
• Joint may be swollen for several days after the test;
no strenuous activity for 24 hours.
Allows direct visualization of a joint. Bone needle is
inserted and joint is distended with saline.
Arthroscopy * • Nursing interventions: after procedure cover wound
with compression dressing to control swelling. Monitor
neurovascular function. Keep joint extended and elevate
to reduce swelling. Give analgesics.
Reflects degree to which matrix of bone takes up a bone
seeking radioisotope that is injected into the system.
Bone Scan *
Scan is done after isotope is injected.
• Nursing interventions: no restricted activity for patient.
Encourage patient to drink plenty of fluids after
procedure!
A connective tissue disease that destroys the joints.
• Patho: onset is characterized by synovitis, or
Rheumatoid Arthritis (RA) inflammation of synovial tissue in joints. Synovium
thickens, fluid accumulates in joint space, and a pannus
forms. The pannus destroys cartilage and erodes
bone.
Results: loss of cartilage and bone.
Unknown; an inflammatory disease
• Probably an autoimmune disease
• Some suspect female hormones influence as
Rheumatoid Arthritis (RA) - women are more affected. Some suspect a virus
Etiology cause like Epstein-Barr virus
• Smoking and coffee drinking have been found to increase RA.
• Average age:35-55. More women
• Insidious or acute onset
/ 3/23
