Professional Documents
Culture Documents
Electrical Excitability Contractility Extensibility Elasticity
Electrical Excitability Contractility Extensibility Elasticity
• Osteoblasts enter the callus and begin to form ■ The clavicle and scapulae constitute the shoulder
a spongy bone - Immobilization of the bone is required
because the delicate new matrix of bone is easily The clavicle
damaged by excessive movement
Articulates with the sternum
The Skull Most commonly fracture bone
- Skeleton of the head The Scapulae
- Made of 21 bones Attached to the ribs and vertebrae by muscles
- Cranial bones only
- Frontal
Has an acromion process, where the clavicle
- Parietal
attaches
- temporal
The Upper extremity
- occipital
- Facial bones
Composed of the following bones
- Maxilla
- Mandible Humerus
- Zygoma Ulna
- Nasal Radius
- Vomer Carpals (wrist bones)
- Palatine Metacarpals
Phalanges
The paranasal sinuses The pelvic girdle
Composed of the 3 fused bones- pubis, ilium and Synarthrosis - immovable joints
ischium - Amphiarthrosis - semi - movable joints
■ Diarthrosis - freely movable joints
Constitute the hip bone
Bursae
The pelvic girdle
- Small synovial fluid sacs located at friction
Female pelvis has the following structure: The points around joints, between tendons, ligaments
pelvic inlet is large/oval, symphysis is shallow. and bones
obturator foramen is oval or triangular, sacrum
is broader - ■ Act as cushions, decrease stress on adjacent
structure
The male pelvis has the following: The pelvic
inlet is small/round to heart-shape, symphysis is
deep. Obturator foramen is round ASSESSMENT
Objective:
The Lower extremity bones
Swelling
Composed of the Fever
Deformity
- Thigh bones- femur
Changes in skin temperature
. The leg bones- Tibia and Fibula Discoloration
Rigidity/spasms Motor deficits
■ The ankle-tarsal bones
ASSESSMENT
■ The foot- metatarsal bones
When assessing the nurse takes into
CARTILAGE consideration:
- A dense connective tissue that consists of fibers History mechanisms of injury. medical/surgical
embedded in a strong, gel-like substance. history, occupation/ activities, presence of risks
like smoking. inactivity, malnutrition, etc.
- . Cartilage supports and shapes various
structures such as the ear pinna, intervertebral Skeletal component
disks, ear canal, larynx, etc. Joint component
Neuro-Muscular component
Types of Cartilage Skin component
Injection of contrast media into the subarachnoid space Canes are artificial support that assist patients
and lumbar space in the spine to determine level of disk who need aid in walking
herniation or site of a tumor
They come in a variety of shapes but majority
An x-ray follows after the contrast is injected have curved handle and rubber tip.
CRUTCH WALKING Open air is helpful to get the cast to dry faster
Goals: Wet cast appears dull and gray while dry cast
appears white, is resonant with percussion,
1. Helps develop power in the shoulder girdle and upper odorless and is firm.
extremities that will bear the patient's weight
CAST - TYPES
CAST-OVERALL CARE
Short arm cast (below elbow-prox. palmar 1. Maintain adequate tissue perfusion
crease) 2. If neurovascular symptoms appear (compartment
Long arm cast (axillary fold-prox. palmar syndrome)- notify doctor stat, bivalve split cast, expose
crease) padding
Short leg cast (below knee-base of toes) 3. Minimize effects of immobility
Long leg cast (upper/mid-thigh-base of toes) 4. Promote nutrition and increase fluids
Cylinder cast 5. Report any crack in the cast
Gauntlet cast (includes the thumb) 6. Health teaching: weight bearing, cast care, gait/
walking, reporting, etc.
CAST-TYPES
TRACTION
Force applied in a specific direction
Body cast/ plaster jacket
To apply the force, materials are needed:
Shoulder Spica Cast (single or double) (trunk.
Ropes
shoulder, elbow)
Pulleys
Hip Spica (single) (unk and lower extremity)
Weight
Hip Spica (double) (Trunk and both Leg)
Cast Brace
TRACTION-PURPOSES
Basket cast
To reduce and immobilize fracture
Others
To regain normal length and alignment of an
injured extremity
CAST CARE
To lessen or eliminate muscle spasms o To
prevent deformity
1. Newly applied Cast
To give patient freedom from in-bed activities
Expose to air
To reduce pain
Allow to cool within 15 minutes
Do not allow ambulation or manipulation; avoid
TRACTION PRINCIPLES
dents
Types of Traction according to direction:
Running traction pull is exerted in one
2. Subsequent days after application
direction. Ex. Buck's Extension Traction
Keep dry and clean
Balanced traction pull is exerted with counter
Cover when showering
balance via the use of additional weights. Ex.
Partial or no weight bearing Thomas Splint with Pearson Attachment
CAST-COMPLICATIONS TRACTION PRINCIPLES
1. Pressure on neurovascular and bony. structures cause Types of Traction according to structures involved:
necrosis, pressure sores and nerve palsies
Skin traction - temporary; light materials are
used on the skin; may be applied by nurses
2 Immobility and confinement increase the risks to
(running traction is applied)
develop multisystem problems
Skeletal traction applied (in the OR) by
orthopedic doctor using pins, tongs placed
Compartment Syndrome - trauma or surgery
through bones: common with fractured femur,
affecting an extremity will produce swelling and
humerus, tibia and cervical spine; running or
vascular insufficiency note: is irreversible
balanced
CAST-COMPLICATIONS
TRACTION CARE
Minimize effects of immobility
Compartment Syndrome pathophysiology
Maintain skin integrity
Compression (of nerves and blood vessels) from
Avoid infection
swelling
Promote tissue perfusion
Recreased blood supple (ischemia)
Provide health education
Decreased oxygen supply to tissues - skin,
muscles, bones
PRINCIPLES OF NURSING CARE:
Tissue death/ necrosis:
The alignment and moving of the patient will
Irreversible damage
only be changed on physician's directive and the
affected extremity will need to be maintained in
CAST-COMPLICATIONS
proper alignment at all times with the ropes and
Complications from immobility
traction straps making sure the mentioned is
unobstructed and weights hanging freely.
1. Cardiovascular thrombo phlebitis/ DVT, possible
pulyembolisma poor circulation, etc
If it is necessary to move the patient while
skeletal traction is in place, the patient should be
2. Respiratory infection like Pneumonia from innefective
moved in the bed with weights hanging freely.
coughing, others
3. GIT constipation from poor peristalsis, anorexia, N/V, In most cases traction will be applied for a
distension, others number of weeks to months and Neurovascular
checks will need to be performed by the nurse
4. Urinary - UTI, retention, stone formation