3Test Yourself List the bones of the body. (More pts more bones!) Bone forming cells are called ______.Local stress stimulates bone formation. T or F?The knee is a/an _______joint.
4What 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?AB
5Bone Structure: Orthopaedic Implications PeriosteumDiaphysisEpiphysisEndosteumEpiphyseal plates; bone growth, injury
6What is the significance of the epiphyseal plate?
7Bone Formation and Maintenance TypesBone = cells, protein matrix, mineral depositsTypes of bone cellsFunction of each type bone cellProtein matrix: 98% collagen, 2% otherMineral salts: insoluble Ca/Phos = hydroxyapitite +Process of ossification
8Factors Influencing Bone Growth and Formation ParathyroidWhat effect of low Ca?CalcitoninEffect on Ca?Source?ThyroxinEstrogenGlucocorticoidsWhat effect on bones with long term use of glucocorticoids?Vit C & D
9Types of Joints: Identification AmphiarthrosisSynarthrosisDiarthrosis
13Descriptive Orthopaedic Terms Valgus: part of body distal to joint directed away from midlineVarus: Part of body distal to joint directed toward midlineHallusGenu varusGenu valguspes varusmetatarus valgusmetatarus varus
14Which foot has a valgus deformity? Hallus valgusHow do you describe this foot deformity?
15Stressors of the Musculoskeletal System Trauma Infection Altered Metabolism
16For the person with a musculoskeletal condition: Peripheral neurovascular dysfunctionPain (acute, chronic)Impaired skin integrityInfection, high risk forDisuse syndromeActivity intoleranceTrauma. high risk forKnowledge deficitImpaired adjustmentFear, anxietyList effects on personList “most “ frequent orthopaedic diagnosis
18Components of Assessment Chief ComplaintWhy seeking careAcute and chronic problemHistory taking; its significancePain characteristicslocationcharacterwhat effectsAssociated conditionsPainComplications!
19Principles of Assessment Test your skillsChanges with ageNurtitional statusSkin integrityRashesColor changes, esp with cold; arterial vs. venousCharacter of jointsBruises, swellingNormal firstBilateral comparisionInspect then gentle palpationshape, size , contoursigns inflammation, ecchymosismuscle conditiondeformity
20Assessment of the Knee Fluid in the Knee Bulge sign: medial aspect knee, displace fluid upward, tap lateral patellar margin and note fluid returnBallottment:force fluid into joint space; displace patella
21Ballottment:force fluid into joint space; displace patella
23Knee Support and Stability Anterior and posterior cruciate ligaments connect the inner surfaces of the head of the femur with the head of the tibia. They cross each other, anterior ligament extend from the inside of the lateral condyle of the femur to the medial side of the tibial head, and posterior ligament extend from the inside of the medial condyle of the femur to the lateral side of the tibial head.
25Diagnostic Tests CT Scan Bone Scan MRI Dual-Photon Absorptiometry ArthrographyArthrocenthesisArthroscopy
26Diagnostic Tests Arthrocenthesis Arthrography Aspiration synovial fluid; reduce pain; dx; treatmentAnalysis joint fluid: usual clear, high viscosity, scant fluidTeaching: no restrictions; consent form; slight painPost-op: RICEArthrographyRadiographic exam, use air or contrast medium:; 90-95% accuracyTeachingComplications: infection, allergyPost-op: Rest joint 6-12 hrs, use ice
27Arthroscopy Therapeutic /diagnostic Visual recording; surgical removal of meniscus, foreign bodies, etcRare complications; depends on procedure, operative length, use of tourniquetTeachingPost-op care