MS: Musculoskeletal Lesson

Module 6:
Disorders of the Musculoskeletal System

Skeletal Tissues and Function

Movement
Protection
Stores Calcium

Functions

Bone
Cartilage
Ligaments

Tissues

Muscular Tissues and Function

Movement
Heat production
Promotes blood return from legs

Functions

Skeletal muscle
Tendons
Fasciae

Tissues

Multiple Choice

Which of the following is NOT a function of the skeletal system?

• Movement

• Protection

• Stores calcium

• Produces calcium

Open Ended

Why is the skeletal system important for the human body?

Multiple Choice

Which of the following is NOT a tissue found in the muscular system?

• Skeletal muscle

• Fibrous connective tissue (tendons)

• Fasciae

• Epithelial tissue

Open Ended

Describe two main functions of the muscular system and explain their importance for the human body.

Multiple Choice

Which is NOT a function of synovial fluid?

• Lubricates the articulating cartilage.

• Acts as a shock absorber.

• Nourishes the chondrocytes.

• Keeps the bones from being pulled apart.

Multiple Choice

What are the possible consequences of bone calcium loss and muscle strength decline as shown in the diagram?

• Fractures and falls

• Joint pain and fever

• Increased flexibility and energy

• Improved posture and balance

Open Ended

Discuss how age-related changes in the musculoskeletal system can impact daily life and mobility.

Multiple Choice

Which of the following is considered subjective data in musculoskeletal system data collection?

• Physical examination

• Inspection

• History

• Palpation

Assessing the Musculoskeletal System

Inspection
Palpation
Range of Motion (ROM)

Objective

History: Injury, occupation, family history, Nutritional history

Psychosocial: affect on body image, psychological stress

Subjective

Multiple Choice

What are the three main components of a physical examination in musculoskeletal system data collection?

• Inspection, Palpation, Range of motion (ROM)

• History, Inspection, Palpation

• Inspection, History, Psychosocial

• Palpation, ROM, Family history

Diagnostic Tests

Diagnostic Tests

• Serum Lab Tests

  • Alkaline phosphatase (ALP)

  • Calcium

  • Phosphorus

  • Myoglobin

  • Uric acid

Match

Match the following serum lab test result to the indicated disease process

• Elevated ALP

• Decreased Calcium

• Elevated myoglobin

• Uric acid crystals in joint fluid

Bone Cancer

Osteoporosis

Rhabdomyolysis

Gout

• Bone Cancer

• Osteoporosis

• Rhabdomyolysis

• Gout

​Diagnostic Tests

• Arthrocentesis

• Arthroscopy

• Bone or muscle biopsy

• Bone density scan

• Myelography

• Nuclear medicine scans

• Arthrogram

Open Ended

Describe patient teaching when preparing for an arthrogram?

Multiple Choice

Procedure where synovial fluid is aspirated from the joint?

• Arthroscopy

• Arthrocentesis

• Biopsy

• Orthocentesis

Open Ended

How would the nurse explain the purpose of Arthrocentesis?

Open Ended

What are expected findings and treatment after arthroscopy procedure?

Multiple Choice

Used to diagnose Osteoporosis

• Blood test
• DEXA scan
• X-ray
• MRI scan

Multiple Choice

Nurse evaluation post bone or muscle biopsy

• Prescribe antibiotics immediately after the procedure
• Schedule a follow-up appointment in one month
• Perform a full blood count before the biopsy
• Monitor biopsy site for complications and educate patient on care.

Open Ended

Describe neurovascular data collection

​Nuclear Medicine

Multiple Select

Radioisotopes used to identify bone cancer?

• Gallium

• Phosphorus 32

• Thallium

• Iodine 131

Fractures

Fractures-Break in Bone

Open-Infection risk, delayed healing
Closed

Open vs Closed

Trauma
Pathological

Cause

Signs and Symptoms of Fractures

• Pain

• Decreased ROM

• Limb rotation

• Deformity, shortening of limb

• Swelling

• Bruising

Fractures: Dx Tx and Goals

• X-ray or CT

• 911- Splint it as it lies

• Immobilization

• Realignment

Internal vs External Fixation

External fixation

Open reduction w/internal fixation

• Metal plates, screws

• Prosthesis

• Pins, metal frame

• Allows care of wounds

Open Ended

What should the nurse monitor when caring for a patient with external fixation for femur fracture

Fracture Complications

• Neurovascular compromise

• Hemorrhage

• Infection

• Thromboembolic complications

  • DVT, PE, etc

• Acute compartment syndrome

• Fat embolism syndrome

Multiple Choice

What is compartment syndrome

• A type of muscle injury caused by overexertion.
• Compartment syndrome is a condition characterized by increased pressure within a muscle compartment, leading to potential tissue damage.
• A condition where blood flow is increased to the muscles.
• A surgical procedure to relieve muscle tension.

Multiple Choice

Which of the following is an early sign of acute compartment syndrome

• Increased range of motion
• Mild swelling
• Numbness in the limb
• Severe pain

6 Ps of Acute Compartment Syndrome

• Pain

• Paresthesia

• Pallor

• Paralysis

• Pulselessness

• Poikilothermia

​Fat Embolism

Multiple Choice

Early sign of fat embolism syndrome?

• Dyspnea (shortness of breath)
• Rash
• Headache
• Fever

Open Ended

Priority care for the patient showing signs of fat embolism syndrome

Musculoskeletal
Diseases

• Osteomyelitis

• Osteoporosis

• Osteoarthritis

• Rheumatoid Arthritis

Match

Match the following

• Osteomyelitis

• Osteoporosis

• Osteoarthritis

• Rheumatoid Arthritis

Bone infection

Bone density loss

Joint inflammation

Autoimmune disorder

• Bone infection

• Bone density loss

• Joint inflammation

• Autoimmune disorder

Osteomyelitis

• Data: Redness, swelling, pain, drainage, fever, ↑ WBC/ESR

• Plan: Prevent infection spread, promote healing

• Implement: Sterile dressing changes, antibiotics, pain meds

• Evaluate: Wound healing, labs normal, afebrile

• Teach: Hand hygiene, full antibiotics, report ↑ pain/fever

Word Cloud

Implementation Phase: Osteomyelitis

Osteoporosis

• Data: Fractures, kyphosis, ↓ calcium/vit D intake

• Plan: Prevent fractures, strengthen bone

• Implement: Weight-bearing exercise, calcium/vit D, fall precautions

• Evaluate: No new fractures, improved diet

• Teach: Increase calcium and Vitamin D, safe home setup

Word Cloud

Teaching : Osteoporosis

​Osteoarthritis

• Data: Pain, stiffness, ↓ ROM, crepitus

• Plan: Reduce pain, keep mobility

• Implement: Heat/cold, assistive devices, meds, gentle ROM

• Evaluate: Less pain, ADLs maintained

• Teach: Joint protection, weight mgmt, exercise (walk, swim)

Word Cloud

Implementation Phase: Osteoarthritis

Rheumatoid Arthritis

• Data: Early fatigue/stiffness → late deformities, nodules

• Plan: Control inflammation, monitor systemic effects

• Implement: DMARDs, NSAIDs, heat/cold, labs (ESR, CRP)

• Evaluate: ↓ pain, stable labs, ADLs preserved

• Teach: Med adherence, report chest pain/SOB/fever, energy conservation

Word Cloud

Data Collection Phase (Early): Rheumatoid Arthritis

Bone Cancer

• Data: Bone pain, swelling, fractures, weight loss, ↑ alkaline phosphatase, ↑ ESR

• Plan: Control pain, monitor spread

• Implement: Pain meds, chemo/radiation, safe handling

• Evaluate: Pain controlled, labs tracked

• Teach: Report new pain, keep follow-ups, support options

Word Cloud

Data Collection Phase: Bone Cancer

​Gout

• Data: Sudden severe joint pain, redness, swelling, ↑ uric acid

• Plan: Relieve pain, prevent attacks

• Implement: NSAIDs/colchicine, fluids, ice to joint

• Evaluate: Pain relief, fewer attacks

• Teach: Avoid purine foods (red meat, shellfish), limit alcohol, hydrate

Word Cloud

Evaluation Phase: Gout

Total Hip Replacement

• Data: Pain, incision site, mobility, DVT risk

• Plan: Prevent complications, restore mobility

• Implement: Abduction pillow, hip precautions, anticoags, early ambulation

• Evaluate: No infection/dislocation, pain managed

• Teach: Don’t cross legs or bend >90°, report swelling/fever, PT follow-up

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Teaching: Hip Replacement

​Amputation

• Data: Upper limb → big ADL impact, phantom pain, wound check

• Plan: Prevent contractures, manage pain

• Implement: Prone 30 min x4/day (if able), wound care, pain meds

• Evaluate: Healing stump, pain managed, mobility gained

• Teach: Phantom pain is real, proper positioning, adaptive devices, PT/OT

Word Cloud

Implementation Phase: Amputation