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Musculoskeletal Disorders

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Musculoskeletal System | Nurse Practitioner (NP) School Study Aid

Musculoskeletal Disorders
30 Picmonics to Learn | 58 mins
Osteoarthritis
Mechanism
Articular Cartilage Destruction
Biomechanical Stress
Aging
Signs and Symptoms
Asymmetric
Pain Decreases with Rest
Morning Stiffness Under 30 Minutes
Crepitus
DIP and PIP Joints
Treatment
Lifestyle Changes
Acetaminophen or NSAIDs
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2 mins
Rheumatoid Arthritis Assessment
Mechanism
Destruction of Connective Tissue and Synovial Membrane
Signs and Symptoms
Inflammation of Joints
Morning Stiffness
Nodules
Joint Deformities
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1 min
Rheumatoid Arthritis Interventions
Lifestyle Modifications
Heat and Cold Applications
Therapeutic Exercise
Balance Rest and Activity
Drug Therapy
NSAIDs
DMARDs
Glucocorticoids
Considerations
PT/OT
Reconstructive Joint Surgery
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2 mins
Osteoporosis Assessment
Highest Risk
Postmenopausal Women
Long Term Corticosteroids
Assessment
Kyphosis
Dowager's Hump
Loss of Height
Back Pain
Pathologic Fractures
Spinal Compression Fracture
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1 min
Osteoporosis Interventions
Increased Calcium Intake
Vitamin D Supplements
Bisphosphonates
Raloxifene
Denosumab
Calcitonin
Teriparatide
Bone Densitometry (DEXA) Scan
Weight Bearing Exercises
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2 mins
Osteomyelitis
Cause/Mechanism
Bone Infection
Assessment
Warmth
Edema
Constant Bone Pain
Fever
Interventions
IV Antibiotics
Implanted Beads
Hyperbaric Oxygen
Surgical Removal of Ischemic Tissue
Considerations
Elevated ESR
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3 mins
Scoliosis
Assessment
S Shaped Lateral Spinal Rotation
Unequal Shoulder and Scapula Height
Uneven Gait
Impaired Oxygenation
Hump when Bending Forward
Interventions
Body Braces
Worn 23 Hours/Day
Surgery
Considerations
Adolescent Screening
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3 mins
Muscular Dystrophy
Mechanism
X-linked Recessive
Signs and Symptoms
Muscle Weakness
Motor Problems
Gower Sign
Large Calves
Waddling Gait
Loss of Ambulation
Consideration
Cardiac and Respiratory Failure
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2 mins
Herniated Disc (Nucleus Pulposus)
Cause/Mechanism
Spine Trauma
Natural Degeneration
Spinal Stenosis
Assessment
Pain
Weakness
Urinary and Fecal Incontinence
Interventions
Brace
Medications
Outpatient Procedures
Surgery
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2 mins
Gout Disease
Acute Inflammatory Monoarthritis
Epidemiology
Primarily in Males
Pathophysiology
Precipitation of Monosodium Urate Crystals
Underexcretion of Uric Acid
Overproduction of Uric Acid
Negatively Birefringent, Needle-Shaped
Symptoms
Swollen, Red, Painful Joint
Asymmetric Joint Distribution
Podagra
Tophus
After Large Meal or Alcohol
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2 mins
Gout Treatment
Acute (Acute-angle)
NSAIDs
Glucocorticoids
Colchicine
Impairs Leukocyte Chemotaxis
Chronic Gout (Crone Goat)
Inhibit Xanthine Oxidase
Allopurinol
Febuxostat
Inhibit Reabsorption of Uric Acid
Probenecid
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1 min
Pseudogout
Pathophysiology
> 50 Years Old
Arthritis of Large Joints (Classically the Knee)
Calcium Pyrophosphate Crystals
Diagnosis
Positively Birefringent
Chondrocalcinosis (On X-ray)
Treatment
NSAIDs
Colchicine
Steroids
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1 min
Osteogenesis Imperfecta
Pathophysiology
Autosomal Dominant
Decreased Type I Collagen Production
Symptoms
Phenotypically Diverse
Brittle Bone Disease
Fractures from Minimal Trauma
Confused with Child Abuse
Hearing Loss
Dental Imperfections
Blue Sclera
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1 min
Ehlers-Danlos Syndrome Disease
Pathophysiology
Faulty Collagen Synthesis
Autosomal Dominant or Recessive
Various Severities
Signs and Symptoms
Hypermobile Joints
Hyperextensible Skin
Easy Bruising/Bleeding
Berry (Saccular) Aneurysm
Considerations
Brighton Criteria
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2 mins
Ehlers-Danlos Syndrome Types
Types
Types 1 and 2 - Classical
Type V Collagen Mutation
Joints and Skin
Type 3 - Hypermobility
Most Common
Tenascin X Deficiency
Joint Instability
Type 4 - Vascular
Type III Collagen Mutation
Vascular and Organ Rupture
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2 mins
Osteosarcoma
Pathophysiology
Osteogenic Sarcoma
Peak incidence men 10-20 years old
Metaphysis of Long Bones
Knee Region
Radiation
Familial Retinoblastoma
Paget's Disease
Diagnosis
Codman Triangle
Sunburst Pattern from Elevated Periosteum
Grave Prognosis
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2 mins
Giant Cell Tumor
Pathophysiology
Osteoclastoma
Epiphyseal End of Long Bones
Peak Incidence 20-40 Years
Benign
Knee Region
Diagnosis
Soap Bubble Appearance on X-ray
Spindle-shaped Cells
Multinucleated Giant Cells
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46 secs
Ewing's Sarcoma
Epidemiology
Most Common in Boys < 15 years old
Pathophysiology
11;22 Translocation
Characteristics
Long bones, Pelvis, Ribs
Diaphysis
Small Blue Cells
Malignant
Aggressive
Onion-skin Appearance
TREATMENT
Responsive to Chemotherapy
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2 mins
Chondrosarcoma
Pathophysiology
Cartilaginous tumor
Malignant
Men 30-60 years old
Pelvic and femur bones
Signs & Symptoms
Glistening mass in medullary cavity
Can be primary in origin or from osteochondroma
Metastasize to lungs
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1 min
Marfan Syndrome
Mechanism
Fibrillin-1 Mutation
Symptoms
Autosomal Dominant
Tall
Arachnodactyly
Pectus Excavatum
Hypermobile Joints
Aortic Aneurysm And Dissection
Mitral Valve Prolapse (MVP)
Subluxation of Lens (Superior)
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2 mins
Baker's Cyst
Pathophysiology
Due To Enlargement of Bursa Between Gastrocnemius and Semimembranosus Muscles
Often Related to Rheumatoid Arthritis or Osteoarthritis
Clinical Manifestations
Often Asymptomatic
Mass or Swelling Behind Knee
Acute Pain If Rupture
Crescent Sign
Diagnosis
Ultrasound
Management
Treat Underlying Condition
Arthrocentesis
Glucocorticoid Injection
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4 mins
Polymyalgia Rheumatica
General Characteristics
Proximal Muscle Pain
Normal Muscle Strength
Morning Stiffness
Age Over 50
Associated With Temporal Arteritis
Diagnosis
Elevated ESR, CRP
Normal CK
Management
Corticosteroids
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4 mins
Poliomyelitis
Characteristics
Poliovirus
Picornavirus
Fecal-Oral Transmission
Destruction of Anterior Horn
Clinical Features
Flaccid Paralysis
Hyporeflexia
Fasciculations
Diagnosis
Elevated CSF Lymphocytes and Proteins
Normal CSF Glucose
Viral Culture or PCR
Management
Supportive Care
Vaccination
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3 mins
Osteochondroma
Characteristics
Most Common Benign Bone Tumor
Males Under 25
Cartilage-capped Spurs
Metaphysis of Long Bones
Small Risk of Chondrosarcoma
Clinical Features
Painless Mass near Joint
Painful if Growing or Malignant
Workup
X-Ray
MRI if Concern for Malignancy or Functional Limitation
Management
Monitoring
Surgery
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3 mins
Medial Epicondylitis (Golfer's Elbow)
Characteristics
Overuse Injury of Flexor Tendons
Wrist Flexion
Forearm Pronation
Pain over Medial Epicondyle
Management
Conservative Management
Injections
Surgery
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1 min
Lateral Epicondylitis (Tennis Elbow)
Characteristics
Overuse Injury of Extensor Tendons
Wrist Extension
Forearm Supination
Pain over Lateral Epicondyle
Management
Conservative Management
Surgery
Injections
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1 min
Chorea and Athetosis
Characteristics
Sudden Jerky Movements
Athetosis
Snake-like, Writhing Movements
Basal Ganglia Lesions
Associations
Huntington's Disease
Acute Rheumatic Fever
Management
Treat Underlying Disorder
Tetrabenazine
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1 min
Prepatellar Bursitis
Etiologies
Repetitive Trauma on Flexed Knee
"Housemaid's Knee"
Symptoms
Pain
Erythema
Complications
Septic Bursitis
Staphylococcus aureus
Diagnosis
Aspiration
Management
NSAIDs
Antibiotics
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2 mins
Plantar Fasciitis
Characteristics
Inflammation of Plantar Fascia
Symptoms
Heel Pain
Worse in Morning and with Dorsiflexion
Treatment
Lifestyle Changes
NSAIDs
Glucocorticoids
Surgery as Last Resort
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2 mins
Ganglion Cyst
Characteristics
Benign
Fluid-filled Swelling
Water Balloon on a Straw
pathophysiology
Herniation of Dense Connective Tissue
Location
Dorsal Side of Wrist
Treatment
Observation
Surgery
Considerations
Resolves Spontaneously
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1 min

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