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MS Nursing I Chapter 66


Cancellous or spongy bone found in the epiphyses or rounded, irregular ends of long bones. Cortical or compact bone found in the diaphyses or long shafts of arm ... – PowerPoint PPT presentation

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Title: MS Nursing I Chapter 66

M/S Nursing I Chapter 66
  • Introduction to the Musculoskeletal System

A P Review
  • Bones, 206 in body
  • short bones, fingers toes
  • long bones, femur
  • flat bones, sternum
  • irregular bones, vertebrae
  • Cancellous or spongy bone found in the epiphyses
    or rounded, irregular ends of long bones
  • Cortical or compact bone found in the diaphyses
    or long shafts of arm leg bones

  • Types of bone cells
  • osteoblasts cells that build bone cells
  • osteocytes mature bone cells
  • osteoclasts involved in the destruction,
    resorption, remodeling of bone
  • Periosteum a layer of tissue that covers the
  • Red bone marrow found in the sternum, ileum,
    vertebrae, ribs make blood cells hgb
  • Yellow bone marrow in long bone consisting
    mostly of fat connective tissue

Muscles Joints
  • Skeletal
  • voluntary
  • found in the arms, legs, etc
  • Smooth
  • involuntary
  • found in the walls of the stomach, intestine,
    blood vessels, etc
  • Cardiac
  • involuntary
  • found only in the heart
  • Joints
  • junction between 2 or more bones
  • see table 66-2 for types of joints
  • types of diarthrodial movements - box 66-1

  • Tendons cordlike structures that attach muscles
    to the periosteum of the bone
  • origin, more fixed
  • insertion, more movable
  • Ligaments connect 2 adjacent freely movable bones
  • provide stability alignment

  • Cartilage
  • a type of connective tissue
  • functions to reduce friction between articular
    surfaces, absorb shocks reduce stress on the
    joint surfaces
  • examples elbow, knee
  • Bursae
  • a small sac filled with synovial fluid
  • functions to reduce friction between a tendon
    bone bursitis

  • History
  • chronic problem
  • new injury
  • Physical exam table 66-3
  • mobility
  • inspection
  • compare 2 sides
  • strength
  • ROM
  • pulses
  • Be gentle with assessment especially with recent
  • pain assessment
  • wounds?

  • Imaging procedures
  • CT scans, MRI
  • Arthrogram xray of joint MD aspirates
    synovial fluid sends to lab contrast medium
    injected xrays are taken client may hear
    clicking or crackling noises in joint for up to 2
  • Arthroscopy internal inspection of a joint
    Nursing Guidelines 66-1
  • Arthrocentesis aspiration of synovial fluid for
    s/s of traumatic arthritis, septic arthritis,
    gout, rheumatic fever, or SLE

  • Synovial fluid analysis sent to lab to assess
    for traumatic or septic arthritis gout
    rheumatic, SLE
  • Bone density radiography of the wrist, hip or
    spine to determine bone mineral density
  • Bone scans involves the IV injection of
    radioactive substance to assess for metastatic
    bone cancer or fractures
  • Biopsy
  • needle
  • surgical excision

  • CBC infection, inflammation or anemia
  • increased Alk phos bone tumors, healing
  • increased acid phos Pagets dz and metastatic
  • decreased serum calcium osteomalacia,
    osteoporosis, bone tumors
  • increased serum phosphorus bone tumors
    healing fractures
  • increased uric acid - gout
  • elevated antinuclear antibody level (ANA) SLE

Nursing Management nursing process
  • Prepare for tests with instructions
  • Answer any questions
  • Check any surgical sites for bleeding,
    inflammation, serous drainage
  • Pain assessment
  • If a new, traumatic injury keep client calm,
    application of cold, slings, etc
  • Explain all procedures prior to performing them
    as much as situation will allow
  • Client family teaching musculoskeletal care,