Prologue to Orthopedics

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Test Yourself. List the bones of the body. (More pts more bones!)Bone shaping cells are called ______.Local anxiety invigorates bone arrangement. T or F?The knee is an/a _______joint.. What do you know from the slides?. . Which is the hand of the elderly adult?How old do you think the individual is on slide A?.

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Slide 1

´╗┐Prologue to Orthopedics

Slide 2

Test Yourself List the bones of the body. (More pts more bones!) Bone framing cells are called ______. Neighborhood stretch empowers bone arrangement. T or F? The knee is an/a _______joint.

Slide 3

What do you know from the slides? Which is the hand of the elderly grown-up? How old do you think the individual is on slide A? A B

Slide 4

Bone Structure: Nursing Implications Periosteum Diaphysis Epiphysis Periosteum Endosteum Epiphyseal plates; bone development, damage

Slide 5

What is the importance of the epiphyseal plate?

Slide 6

Bone Formation and Maintenance Types Bone = cells, protein framework, mineral stores Types of bone cells Function of each sort bone cell Protein grid: 98% collagen, 2% other Mineral salts: insoluble Ca/Phos = hydroxyapitite + Process of hardening

Slide 7

Factors Influencing Bone Growth and Formation PTH What impact of low Ca? Calcitonin Effect on Ca? Source? Thyroxin Estrogen Glucocorticoids What impact on bones with long haul utilization of glucocorticoids? Vit C & D

Slide 8

Types of Joints: Identification Amphiarthrosis Synarthrosis Diarthrosis

Slide 9

Diarthroidal Joint

Slide 10

Significance of Diarthrotic Joint Capsule encompassed by tendons Synovial Membrane: secretes synovial liquid; lines ligament and muscle sheaths Bursea: agonizing, yet defensive!

Slide 11

Othropaedic Terminology

Slide 12

Descriptive Orthopedic Terms Hallus Genu varus Genu valgus pes varus metatarus valgus metatarus varus Valgus: some portion of body distal to joint coordinated far from midline Varus: Part of body distal to joint coordinated toward midline

Slide 13

Which foot has a valgus distortion? Hallus valgus How would you depict this foot distortion?

Slide 14

Stressors of the Musculoskeletal System Trauma Infection Altered Metabolism

Slide 15

For the individual with a musculoskeletal condition: List consequences for PERSON List "most " regular nursing finding Peripheral neurovascular brokenness Pain (intense, interminable) Impaired skin trustworthiness Infection, high hazard for Disuse disorder Activity narrow mindedness Trauma. high hazard for Knowledge deficiency Impaired conformity Fear, tension

Slide 16

How has orthopedic damage influenced this PERSON?

Slide 17

Components of Assessment Pain Chief Complaint Why looking for care Acute and endless issue History taking; its centrality Pain qualities area character what impacts Associated conditions Complications!

Slide 18

How will you deal with this circumstance? Mr J. reports to the medical attendant at the lealth facility that he can no longer walk since "it justs harms excessively!" What inquiries will you inquires? In what capacity will you lead the physical evaluation?

Slide 19

Principles of Assessment Test your abilities Changes with age Nurtitional status Skin trustworthiness Rashes Color changes, esp with icy; blood vessel versus venous Character of joints Bruises, swelling Normal first Bilateral comparision Inspect then delicate palpation shape, estimate , form signs irritation, ecchymosis muscle condition distortion

Slide 20

Specific Sites....... Hand, limits Herberden' hubs, Bouchard's hubs Subcutaneous knobs Bursal swelling Synovial blisters Tophaceous sores

Slide 21

Deformities Ulnar floats valgus and varus disfigurements decay hypertrophy general cleanliness

Slide 22

Subcutaneous knobs (Rheumatoid joint inflammation) Urate cystals in kidney (gout) Tophaceous pimples (gout)

Slide 23

Structural changes with osteoarthritis Herberden's hubs

Slide 24

Describe this distortion. What ailment does this individual no doubt have?

Slide 25

Assessment of the Knee Fluid in the Knee Bulge sign : average perspective knee, dislodge liquid upward, tap horizontal patellar edge and note liquid return Ballottment : constrain liquid into joint space; uproot patella

Slide 26

Ballottment : compel liquid into joint space; uproot patella

Slide 27

Knee Stability Anterior cruciate tendon : limits front movement Posterior cruciate tendon : limits back movement Lateral security tendon : limits adduction Medial insurance tendon : limits snatching Meniscal harm : McMurray's sign

Slide 28

Knee Support and Stability Anterior and back cruciate tendons associate the inward surfaces of the leader of the femur with the leader of the tibia. They cross each other, front tendon reach out from within the sidelong condyle of the femur to the average side of the tibial head , and back tendon stretch out from within the average condyle of the femur to the parallel side of the tibial head.

Slide 29

Anterior Drawer test McMurray's sign

Slide 30

Diagnostic Tests CT Scan Bone Scan MRI Dual-Photon Absorptiometry Arthrography Arthrocenthesis Arthroscopy

Slide 32

Arthrocenthesis Aspiration synovial liquid; lessen torment; dx; treatment Analysis joint liquid: regular clear, high thickness, insufficient liquid Teaching: no confinements; assent frame; slight torment Post-operation: RICE Diagnostic Tests Arthrography Radiographic exam, utilize air or difference medium:; 90-95% exactness Teaching Complications: contamination, sensitivity Post-operation: Rest joint 6-12 hrs, utilize ice

Slide 33

Arthroscopy Therapeutic/indicative Visual recording; surgical evacuation of meniscus, remote bodies, and so on Rare intricacies; relies on upon methodology, agent length, utilization of tourniquet Teaching Post-operation mind

Slide 36

Orthopedic Interventions! Footing Casts External Fixators Pin, plates and screws CPM Crutch-strolling

Slide 37

Assistive Devices Crutch-strolling Two-point Three-point Four-guide Swing-through swing-toward Safety in prop strolling Cane Traction Definition Uses Types Counter footing is given by: a. body weight b. pulleys c. footing weight d. props

Slide 39

CPM Purpose Guidelines for Use Teaching

Slide 40

Bone Stimulators Indications Electronegativity Bone Remodeling Internal Percutaneous External

Slide 42

External Bone Stimulator

Slide 43

Autologous Blood Transfusions Indications for Criteria for Use Ortho Cell Savers

Slide 44

Cell Savers Autologous Blood

Slide 45

Surgical/Medical Interventions Tissue Allographs Abductor Pillow, Carter Pillow Hot Ice Machines that Aren't! Bone Paste!

Slide 46

Tissue allografts, manufactured unions

Slide 47

Pins, plates, screws ORIF (open lessening, inside obsession)

Slide 48

For more data on throws, footing and outside fixators, come back to C Morse's Home Page Casts, Casting! Purposes Casting Material Plaster Fiberglass Casts External Fixator

Slide 49

Application of Cast Principles Skin Assessment Skin Protection Heat Generated Time to Dry

Slide 50

Cast Types Sugar Tong/Splint Spica Type Body Cast Hip spica Gauntlet Cast-Brace Body Cast Care Cast Syndrome Hip Spica Turning Cast Drying

Slide 51

Nursing Interventions Amy, a 24 yr old is released from the ER with a long arm cast. What INITIAL care? What release educating would it be a good idea for you to do? Can you designate this?

Slide 52

External Fixators How They Work Principles of Care The Iliazarov

Slide 53

External Fixator