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Timby /Smith : Introductory Medical-Surgical Nursing, 10/e

Timby /Smith : Introductory Medical-Surgical Nursing, 10/e. Chapter 60: Introduction to the Musculoskeletal System By: P.K. Williams, RN 01/20 Pg 959. 04 Objectives: 02/20 Pg 959. On completion of this chapter, you will be able to:

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Timby /Smith : Introductory Medical-Surgical Nursing, 10/e

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  1. Timby/Smith:Introductory Medical-Surgical Nursing, 10/e Chapter 60: Introduction to the Musculoskeletal System By: P.K. Williams, RN 01/20 Pg 959

  2. 04 Objectives: 02/20 Pg 959 • On completion of this chapter, you will be able to: • Describe major structures and functions of the musculoskeletal system. • 2. Discuss elements of the nursing assessment of the musculoskeletal system. • 3. Identify common diagnostic and laboratory tests used in the evaluation of musculoskeletal disorders. • 4. Discuss the nursing management of clients undergoing tests for musculoskeletal disorders

  3. 20 Words to know: 03/20 Pg 959 Arthrocentisis Arthrogram Arthroscopy Bone scan Cancellous bone Bursa Cartilage Cortical bone Diaphyses Epiphyses Joint Ligament Osteclasts Osteocytes Periosteum Red bone marrow Yellow bone marrow Skeletal Muscles Tendon [Box 60-2 Pg 961] Adduction; Abduction; Dorsiflexion, Flexion/extension Hyperextension; Supination/Pronation; Rotation -- outward/inward

  4. Anatomy, Physiology *** 04/20 Pg 959

  5. Anatomy, Physiology 05/20 Pg 959 • Bones*** 206 bones in the human body • Classification: Short bones; Long bones; Flat bones; Irregular bones • Two types of bony tissue*** • Cancellous [Spongy- light – Many spaces- Ends of bones- epiphyses] • Cortical[compact-dense-hard-bone shafts- diaphyses ] • Composition of bones • Types of bone cells • Bone marrow

  6. Question 06/20 Pg 959 Is the following statement true or false? There are two types of bones in the body.

  7. Answer 07/20 Pg 959 False. Bones are classified as short bones, long bones, flat bones, and irregular bones. There are two types of bony tissue in the body.

  8. Anatomy, Physiology 08/20 Pg 960 • Muscles: Skeletal[voluntary] ; Smooth[involuntary] walls of organs, controlled by neurotransmitters/ mechanisms i ; Cardiac[involuntary] • Joints [articulations] • The junction between two or more bones • Free-moving or diarthrodial joints • Tendons • Cord-like structures that attach muscles to the periosteum of the bone • Attachments of the muscle • Origin and insertion

  9. Question 09/20 Pg 961 Is the following statement true or false? Tendons attach bone-to-bone.

  10. Answer 10/20 Pg 959 False. Tendons are cord-like structures that attach muscles to the periosteum of the bone. Tendons connect muscles to their corresponding bone.

  11. Anatomy, Physiology***11/20 Pg 961 • Ligaments: Fibrous tissue connecting two adjacent, freely movable bones [keep them in proper alignment] • Cartilage • Firm, dense type of connective tissue • Types: Hyaline or articular; Costal; Semilunar [knee]; Fibrous [vertebrae]; Elastic {larynx, epiglottis, outer ear} [Reduce friction between articular surfaces] • Bursae • Small sac filled with synovial fluid • Reduces friction between areas [inflamation= bursitis]

  12. Question 12/20 Pg 961 Is the following statement true or false? Ligaments attach bone-to-bone.

  13. Answer 12/20 Pg 961 True. Ligaments attach bone-to-bone. The connection is of two adjacent, freely movable bones.

  14. Assessment 13/20 Pg 961 • History • Chronic disorder: Medical, drug, allergy; Familial; Occupational • Recent injury: Occurrence of trauma • Open injury • Date of last tetanus immunization • Compilation of list of symptoms • Determining the effect of activity on symptoms

  15. Assessment***13/20 Pg 962 • Physical Examination • Assessment: Musculoskeletal • Motor skills; Muscle strength, wasting • Symmetry; Size; ROM; Alignment • Pain, tenderness; Swelling; Redness • Spinal inspection [Fig 60-1] : Kyphosis [upper back “hump]; Lordosis [lower back “sway”]; Scoliosis [upper/lower curve left/right] • Neurovascular: Spasms; Tremors

  16. Assessment***16/20 Pg 964 • Physical Examination (Cont’d) • Assessment: Traumatic injury • Vital signs; Swelling; External bleeding, bruising; Open wounds, debris, protrusion of bone or tissue • Peripheral circulation, sensation; Malalignment of the injured limb • Injury beyond the original area • Pain: Type and location

  17. Assessment***17/20 Pg 964-965

  18. Nursing Management***18/20 Pg 964 • Diagnostic Tests • Diagnostic examination protocols • Send specimens to the laboratory • Ensure safe recovery after procedure • Chronic Disorder • General medical history • Current symptoms • Compile drug [Rx, Herbal, OTC ]; allergy [iodine/ seafood] histories

  19. Nursing Management***19/20 Pg 966 • Invasive Joint Examination • Inspect: Swelling, bleeding, or drainage • Change or reinforce dressings • Traumatic Injury • Information regarding injury [mechanism of injury] • Monitor: Vital signs; Neurovascular status • Provide comfort and support

  20. End of Presentation NOW ENCLEX By: P.K. Williams, RN 20/20 Pg 967 pkwilliams@DNI.edu

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