Chapter 45 Musculoskeletal Function and Assessment

Answers assessment of the patient’s airway, breathing, circulation, and disability. (E can also be included for exposure). A secondary survey identifies medical problems or injuries that are not immediately life-threatening but require treatment. 2. Pneumothorax from a rib fracture or a cardiac contusion from a blow to the chest. 3. There are six areas for a neurovascular check: (1) movement, (2) sensation, (3) color, (4) temperature, (5) pulses, and (6) capillary refill. CHAPTER 45 MUSCULOSKELETAL FUNCTION AND ASSESSMENT AUDIO CASE STUDY Tony and Fracture Care 1. It is a quick set of assessments using the ABCDs for organization. A primary survey conducts an initial STRUCTURE OF NEUROMUSCULAR JUNCTION AND SARCOMERES Motor neuron Vesicles of acetylcholine Synaptic cleft Sarcolemma T tubule 1 3 2 Sarcoplasmic reticulum Myofilaments ACh receptors Ca+ 4 Sarcomere 1 2 Chapter 45 Answers NEUROMUSCULAR JUNCTION REVIEW QUESTIONS—CONTENT REVIEW 1. (3, 5) 2. (1, 6) 3. (2, 4) The correct answers are in boldface. SYNOVIAL JOINTS 1. (5) 2. (3) 3. (1) 4. (2) 5. (4) VOCABULARY 1. (3) 2. (1) 3. (4) 4. (5) 5. (2) 6. (9) 7. (8) 8. (7) 9. (10) 10. (6) DIAGNOSTIC TESTS 1. (3) 2. (1) 3. (2) 4. (5) 5. (4) 6. (7) 7. (6) 8. (11) 9. (10) 10. (9) 11. (8) CRITICAL THINKING 1. Allergies, medical conditions, medications, surgeries, injury, cause and mechanism of injury (e.g., twisting, crushing, stretching; how the patient is injured will indicate other injuries to look for). 2. Inspection: area of injury, asymmetry, mobility and range of motion, swelling, deformity and limb length, ecchymosis. Palpation: skin temperature, crepitation, tenderness, sensation. 3. X-ray of his leg and other areas of potential injury based on the history. Complete blood count (CBC) to identify loss of blood. Additional tests may be ordered based on findings. 4. Explanation of pain management and procedures and tests to be performed; importance of reporting symptoms; answer questions. 1. (3) is correct. (1, 2, 4) are incorrect. 2. (2) is correct. (1, 3, 4) are incorrect. 3. (1) is correct. (2, 3, 4) are incorrect. 4. (3) is correct. (1, 2, 4) are incorrect. 5. (1, 3, 4) are correct. (2, 5) are incorrect. 6. (2) is correct. (1, 3, 4) are incorrect. REVIEW QUESTIONS—TEST PREPARATION The correct answers are in boldface. 7. (2) is correct. Crepitation is the term used for a grating sound heard in a joint. (1) is incorrect. A friction rub is associated with either pleural or pericardial inflammation or fluid accumulation. (3) is incorrect. An effusion is a collection of fluid in a space. (4) is incorrect. Subcutaneous emphysema is leaking air that is felt under the skin. 8. (3, 5, 6) are correct. Joint movement should immediately be stopped to prevent further joint injury, the joint should be protected from further injury, and immobilization of the joint should be maintained to prevent joint damage. (1, 2, 4) would move the joint, causing possible injury. 9. (1, 3, 4) are correct. Feeding, bathing, and dressing one’s self are activities of daily living, which are parts of a functional assessment. (2, 5, 6) are not items evaluated in a functional assessment. 10. (4) is correct. A hematoma may develop after a biopsy. (1) does not occur from a biopsy. (2) is incorrect. Crepitation is heard in a joint. (3) is incorrect. An infection would not develop immediately. 11. (1, 2, 3, 4, 5) are not elevated, so further teaching would be needed. (6) is incorrect. Uric acid is elevated in gout. 12. The area in which the contraindication to the magnetic resonance imaging is located is at the left cardiac permanent pacemaker implantation site.