Musculoskeletal Disorders - PowerPoint PPT Presentation

Loading...

PPT – Musculoskeletal Disorders PowerPoint presentation | free to download - id: 6d1196-NDgwM



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Musculoskeletal Disorders

Description:

Musculoskeletal Disorders Part Two – PowerPoint PPT presentation

Number of Views:157
Avg rating:3.0/5.0
Slides: 36
Provided by: dco126
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Musculoskeletal Disorders


1
Musculoskeletal Disorders
  • Part Two

2
Osteoporosis
  • Reduction in bone density change in bone
    structure
  • Bone reabsorption gt bone formation
  • Pathological fractures can occur and collapse of
    vertebrae
  • Postmenopausal women greatest risk due to
    estrogen deficiency
  • Affects 1.4 million Canadians
  • 1 in 4 women over 50
  • 1 in 8 men over 50
  • Silent Dx as bone loss is asymptomatic- 1st sign
  • Estimated cost 1.9 billion

3
Metabolic Bone Disorders
  • Changes in the physical chemical structure of
    the bone due to estrogen deficiency, parathyroid
    disorders, Vitamin deficiency, malabsorption or
    physical inactivity.
  • Types
  • Osteoporosis
  • Pagets Disease
  • Osteomalacia
  • Gout Gouty Arthritis

4
Osteoporosis
  • Fragility fractures occur due to low trauma
    (bending over to pick up a newspaper)
  • Most common fractures hip, vertebrae radius
  • Osteopenia- low bone mineral density compared
    with that expected for age sex risk factor
    for fracture
  • Affects 13-18 of post-menopausal women 30-50
    have osteopenia of the hip
  • 1 of every two women will experience a fracture
    at some point in their life

5
Osteoporosis
  • The World Health Organization defines
    osteoporosis as bone mass that is 2.5 standard
    deviations below the peak normal value for a
    young adult (Dowd, 1999)
  • Normal
    Osteoporotic


6
Osteoporotic Changes
Height 59 53 5 49 46 43

7
Osteoporosis Risk Factors
  • Female
  • Caucasian, non-Hispanic, Asian
  • Increased age
  • Low weight BMI
  • Estrogen deficiency or menopause
  • Family hx
  • Low initial bone mass
  • Long term use of certain medications
    (corticosteroids, anticonvulsives)
  • Coexisting medical conditions (celiac)
  • Insufficient calcium vitamin D
  • Life style factors-smoking, caffeine, alcohol
  • Lack of weight-bearing exercise
  • Lack of sunshine

8
(No Transcript)
9
Osteoporosis Management
  • Adequate intake calcium vitamin D throughout
    life
  • Regular wt bearing exercises
  • Avoid alcohol smoking

10
Discuss Osteoporosis is a pediatric disease
with geriatric consequences.
11
Medications
  • ERT (prevents bone loss) decreased use
  • Bisphosphonates approved for the treatment of
    osteoporosis alendronate (Fosamax), risedronate
    (Actonel), and etidronate (Didrocal). Absorption
    of bisphosphonates by the oral route is poor,
    even when taken on an empty stomach
  • Calcitonin-hormone slows bone reabsorption
  • Evista (raloxifene) selective estrogen receptor
    modulators (do not increase risk breast or
    uterine ca)

12
Nursing Diagnoses
  • Altered health maintenance
  • Acute pain r/t fracture muscle spasm
  • Risk for constipation
  • Risk for injury

13
Pagets Disease
  • An idiopathic bone disorder characterized by
    abnormal accelerated bone reabsorption
    formation in one or more bones
  • Normal bone is replaced by abnormal, structurally
    weaker bone that is prone to fractures
  • Painful deformities are produced in femur, tibia,
    lower spine, pelvis cranium

14
Pagets Disease Humerus
15
Osteomalacia
  • Disease which bone becomes abnormally soft due to
    disturbed calcium phosphorous balance secondary
    to Vit D deficiency
  • Bones bend flatten
  • Deformities wt bearing bones
  • Affects women endemic in Asia
  • Causes
  • Chronic use anticonvulsants, strict vegetarian,
    very low fat diets, fibrous dysplasia,
    hyperthyroid induced osteopenia
  • Treatment- Vit D, adequate Ca, P Protein

16
Gout Gouty Arthritis
  • Gout is a condition in which crystals of uric
    acid rise above normal levels deposit in the
    joints, causing inflammation.
  • Crystals may also form under the skin as well as
    the kidneys or urinary tract.
  • Tophi - with repeated attacks accumulations of
    sodium urate crystals, are deposited in
    peripheral areas of the body, such as the great
    toe, the hands, and the ear

17
Gout is caused by
  • an increase in production of uric acid
    under-elimination of uric acid by the kidneys
  • increased intake of foods containing purines
    which are metabolized to uric acid
  • dietary factors, some drugs toxins

18
Purine in Food
19
Gouty Arthritis
20
Comparison of Normal /Gouty Joint
21
Uric Acid Crystals
  • These spiked rods are uric acid crystals
    photographed under polarized light.
  • Increased uric acid blood levels and formation of
    uric acid crystals in the joints are associated
    with gout.
  • The definitive diagnosis of gout is dependent on
    finding uric acid crystals in the joint fluid
    during an acute attack

22
TREATMENT of GOUT
  • Colchicine (reduces uric acid and phagocytosis
  • NSAIDs (the treatment of choice) indomethacin
    naproxen or steroids if resistant to NSAIDS
  • Allopurinol (blocks production of uric acid)
  • Aspirin and aspirin-containing products should be
    avoided during acute attacks used only on the
    advice of physician

23
Gout Drugs
  • In multiple gout attacks, or those that
    developed kidney stones more aggressive drug
    management is necessary.
  • Drugs that block absorption by the kidney, such
    as probenecid, and drug that block production of
    uric acid by the body, such as allopurinol are
    considered.
  • The choice between these two types of drugs
    depends on the amount of uric acid in the urine.
    With correct treatment, gout should be well
    controlled in almost all cases.

24
Gout Nursing Care
  • Episodes may be triggered by surgery, heart
    attacks, trauma, alcohol use, some meds
  • Pain management essential (acute pain often great
    toe)
  • Teaching
  • Avoid certain diuretics such as thiazide
  • Weight control without wide fluctuations
  • Avoid alcohol, caffeine, chocolate, organ foods,
    gravy, peas

25
Spinal Cord Deformities
  • Scoliosis- lateral curvature of the spine in any
    area
  • Kyphosis-humpback , posterior rounding of
    thoracic spine
  • Lordosis- inward curvature of the lumbar spine
    seen sometimes pregnant, obese or lg. abd. tumors

26
Scoliosis
27
Herrington Rod Scoliosis
28
(No Transcript)
29
Osteomyelitis
  • Severe pyogenic infection of the bone
    surrounding tissue
  • Bacterial mostly, can be viral or fungus
  • Staph most common (E-coli, Pseudomonas,
    Klebsiella, Salmonella, Proteus)
  • Femur tibia males
  • Clinical manifestations
  • Acute, localized pain, reddness or drainage,
    fever, malaise, elevated WBC, ESR, MRI to Dx

30
Septic Arthritis
  • A closed-space infection, caused by invasion of
    the synovial membrane by pus-forming bacteria or
    other pathogens
  • Joints mostly affected knee, hip, shoulder,
    wrist ankle
  • Most common cause neisseria gonorrhoae staph
  • Client has pain, swelling, warmth in joint
    acute systemic reaction

31
Septic Arthritis
  • Antibiotic therapy initiated
  • Pen G administered due to common causal organisms
  • Open synovectomy debridement or repeated joint
    aspirations irrigations maybe needed
  • Exercise rehab. Important
  • ROM CPM successful for some

32
Synovectomy
33
Muscular Dystrophy
  • Designates a group of genetic disorders involving
    gradual degeneration muscle fibers
  • Progressive weakness skeletal muscle wasting,
    disability deformity
  • Duchennes MD most common severe Dx
  • Sex-linked recessive disorder affects males
    exclusively (Xp21 gene)
  • Lab Dx serum creatinine kinase analysis (levels
    elevated in MD due to abn of striated muscle
    function)
  • Treatment symptomatic supportive

34
Read
  • Bone tumors
  • Disorders of the foot

35
  • Berarducci, A. Lengacher, C.A., Keller, R.
    (2002). The impact of osteoporosis continuing
    education on nurses' knowledge and attitudes. The
    Journal of Continuing Education in Nursing,
    33(5), retrieved from proquest http//proquest.umi
    .com/pqdweb?Did000000184306351Fmt4Deli1Mtd1
    Idx14Sid1RQT309
  • The Arthritis Society
  • Canadian Orthopedic Nurses Association
About PowerShow.com