NUR 230 – ortho Exam Questions With
Answers Graded A+
what are osteoblasts
bone forming/building cells (Blast, B, Build)
what are osteoclasts
bone destroying cells they 'cut' (Clast, C, Cut)
what is Wolff's law of remodeling
bone will remodel itself over time to become stronger if loading on a particular bone increases - this is
why laying in bed for extended periods of time can be damaging to bones
what is hyaline cartilage
covers bone ends and is the most common form of cartilage
describe isotonic contraction
causes movement - shortens muscle
describe isometric contractions
increased tension in a muscle but does not cause movement; kegels are example of this
describe ligaments
connect bone to bone
describe tendons
connect muscle to bone
why do ligaments and tendons tend to have slower healing than bones
ligaments and tendons have relatively poor blood supply and can prolong the healing process
what are some effects of aging for muscles/bones
-decreased strength, flexibility, metabolism, and muscle mass
-altered balance
-loss of water in vertebral discs
-slowed bone remodeling
when doing an orthopedic assessment what should we always look for
symmetry! compare to other side
as the nurse what is our responsibility when a patient is going to x ray
remove any kind of radiopaque objects like piercings, bra straps, jewelry etc
what is an arthroscopy
visual exam of the interior joint cavity with an endoscope
,what is an arthroscopy used for
to detect or confirm abnormalities of meniscus, articular cartilage, ligaments, or joint capsule
as a nurse what are the responsibilities prior to an arthroscopy
patient is NPO after midnight, need to know med lists/anticoagulant therapy and bleeding times (labs)
what is an arthrogram
injection of dye or air into joint cavity to visualize joint structures in different positions via X ray, CT or
MRI
what needs to be assessed prior to an arthrogram
allergies to contrast or shellfish
what should be taught post op for an arthrogram
ice and elevate, crepitus may be felt for a few days, report any pain/tenderness/crepitus lasting more
than a few days
describe a CT scan
an x ray that gives 3 dimensional pictures of a structure - must stay very still
what are some contraindications for MRI use
history of pacemaker or ANY metal in the body - all metal must be taken off
what is a myelogram
injecting contrast medium into subarachnoid space of spine and an X ray or CT visualizes the spinal
cord or vertebral column
what is a myelogram used for
to detect nerve root compression or impingement, spinal cord lesions, or ruptured discs
who cannot have a myelogram
pregnant patients
what medications must be held if a patient is having a myelogram
anticoagulants - this would risk compression of spinal cord due to excess bleeding if not stopped prior
what needs to be verified before a myelogram
allergies and medication history
After a patient has a myelogram what is the priority for the nurse
keep HOB elevated 30-50 degrees for 6-8 hours and tell patient to inform someone if they get
headache (r/t not wanting dye to reach level of brain)
, what is a DXA (also known as dexa scan)
dual energy x ray absorptiometry (DXA)
what is a DXA or dexa scan used for
measures bone mineral density of spine, femur, forearm and total body
what is a QUS/quantitative ultrasound
evaluates density, elasticity and strength of bone using ultrasound
what is a bone scan
a radioisotope is injected and taken up by bone - looks at how much of the isotope is taken up by the
bone
describe the significance of uptake or decreased uptake of the isotope in a bone scan
-uniform uptake is normal
- increased uptake seen in osteomyelitis, bone cancers, certain fractures
-decreased uptake seen in avascular necrosiswhat is
when is the isotope given prior to the procedure
2 hours prior
what should we ensure is EMPTY before a bone scan
patients bladder
what do we want the patient to do post bone scan
increase and force fluids after the scan
what is arthrocentesis
puncture of a joint capsule to remove fluid or gather samples of synovial fluid from a joint cavity
what can arthrocentesis be used to diagnose
jont inflammation, meniscal tears or subtle fractures - it is done at bedside
what should be done post arthrocentesis
send samples to the lab, apply dressing, and observe for leakage
what is an electromyogram (EMG)
test used to evaluate electrical potential associated with skeletal muscle contraction
what is the electromyogram used for
to provide info related to lower motor neuron dysfunction and primary muscle disease
what should a patient avoid before an electromyogram
Answers Graded A+
what are osteoblasts
bone forming/building cells (Blast, B, Build)
what are osteoclasts
bone destroying cells they 'cut' (Clast, C, Cut)
what is Wolff's law of remodeling
bone will remodel itself over time to become stronger if loading on a particular bone increases - this is
why laying in bed for extended periods of time can be damaging to bones
what is hyaline cartilage
covers bone ends and is the most common form of cartilage
describe isotonic contraction
causes movement - shortens muscle
describe isometric contractions
increased tension in a muscle but does not cause movement; kegels are example of this
describe ligaments
connect bone to bone
describe tendons
connect muscle to bone
why do ligaments and tendons tend to have slower healing than bones
ligaments and tendons have relatively poor blood supply and can prolong the healing process
what are some effects of aging for muscles/bones
-decreased strength, flexibility, metabolism, and muscle mass
-altered balance
-loss of water in vertebral discs
-slowed bone remodeling
when doing an orthopedic assessment what should we always look for
symmetry! compare to other side
as the nurse what is our responsibility when a patient is going to x ray
remove any kind of radiopaque objects like piercings, bra straps, jewelry etc
what is an arthroscopy
visual exam of the interior joint cavity with an endoscope
,what is an arthroscopy used for
to detect or confirm abnormalities of meniscus, articular cartilage, ligaments, or joint capsule
as a nurse what are the responsibilities prior to an arthroscopy
patient is NPO after midnight, need to know med lists/anticoagulant therapy and bleeding times (labs)
what is an arthrogram
injection of dye or air into joint cavity to visualize joint structures in different positions via X ray, CT or
MRI
what needs to be assessed prior to an arthrogram
allergies to contrast or shellfish
what should be taught post op for an arthrogram
ice and elevate, crepitus may be felt for a few days, report any pain/tenderness/crepitus lasting more
than a few days
describe a CT scan
an x ray that gives 3 dimensional pictures of a structure - must stay very still
what are some contraindications for MRI use
history of pacemaker or ANY metal in the body - all metal must be taken off
what is a myelogram
injecting contrast medium into subarachnoid space of spine and an X ray or CT visualizes the spinal
cord or vertebral column
what is a myelogram used for
to detect nerve root compression or impingement, spinal cord lesions, or ruptured discs
who cannot have a myelogram
pregnant patients
what medications must be held if a patient is having a myelogram
anticoagulants - this would risk compression of spinal cord due to excess bleeding if not stopped prior
what needs to be verified before a myelogram
allergies and medication history
After a patient has a myelogram what is the priority for the nurse
keep HOB elevated 30-50 degrees for 6-8 hours and tell patient to inform someone if they get
headache (r/t not wanting dye to reach level of brain)
, what is a DXA (also known as dexa scan)
dual energy x ray absorptiometry (DXA)
what is a DXA or dexa scan used for
measures bone mineral density of spine, femur, forearm and total body
what is a QUS/quantitative ultrasound
evaluates density, elasticity and strength of bone using ultrasound
what is a bone scan
a radioisotope is injected and taken up by bone - looks at how much of the isotope is taken up by the
bone
describe the significance of uptake or decreased uptake of the isotope in a bone scan
-uniform uptake is normal
- increased uptake seen in osteomyelitis, bone cancers, certain fractures
-decreased uptake seen in avascular necrosiswhat is
when is the isotope given prior to the procedure
2 hours prior
what should we ensure is EMPTY before a bone scan
patients bladder
what do we want the patient to do post bone scan
increase and force fluids after the scan
what is arthrocentesis
puncture of a joint capsule to remove fluid or gather samples of synovial fluid from a joint cavity
what can arthrocentesis be used to diagnose
jont inflammation, meniscal tears or subtle fractures - it is done at bedside
what should be done post arthrocentesis
send samples to the lab, apply dressing, and observe for leakage
what is an electromyogram (EMG)
test used to evaluate electrical potential associated with skeletal muscle contraction
what is the electromyogram used for
to provide info related to lower motor neuron dysfunction and primary muscle disease
what should a patient avoid before an electromyogram
