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SPECIFIC DISORDERS OF MUSKULO SKELETAL SYSTEM (CARPAL TUNNEL SYNDROME…
SPECIFIC DISORDERS OF MUSKULO SKELETAL SYSTEM
CARPAL TUNNEL SYNDROME
Definition
Refers to the compression of the median nerve as it passes into the hand.
Pathophysiology
The median nerve is located on the palm side of the hand and it provides sensation to the thumb, index finger, longer finger and it supplies the impulses to the muscle going to the thumb. so when there is carpal tunnel syndrome it means there is swelling inside the wrist causes compression , these leads to the numbness, weakness and tangling on the side of the hand near thumb.
Risk factors
High salt intake
sedentary lifestyle
athritis
Diabetes
High body mass index
causes
Medical conditions that causes swelling in the wrist
Obstructed blood flow
Fractures or trauma to the wrist
Fluid retention due to pregnancy or menopause
Symptoms
Pain due to excess pressure in the wrist
Swelling
Nursing management
Patient should avoid position that over extend the wrist
Wrist splints should be used to hold hand in a neutral position, especially at night
Steroids injections into the carpal tunnel area to reduce inflammation
Treat of any underlying conditions that a patient may have such as DM or athritis
Administer analgesics to reduce pain
surgical management
No surgical options for carpal tunnel syndrome
Health education
Encourage patients to change lifestyles that will reduce the mentioned risk factors.
Encourage regular physical exercise
Always pay attention to hand posture and avoid activities that over extend wrist
OSTEOGENESIS IMPERFECTA
Definition
Refers to a condition that result in fragile bones that break easily, it is typically present at birth,but only
Pathophysiology
TYPE 1: this the mildest form of brittle bone where the body produces quality collagen but not enough of it. this leads to mildly fragile bones
TYPE 2: this is the most severe form of brittle bone where the body doesn't produces enough collagen or produces collagen that is poor quality, and this leads to bone deformities.
TYPE 3:this is also a severe form, here the body produces enough collagen but its poor quality. these leads to bones that break easily.
Surgical management
Surgery to place rods in bones
Reconstructive surgery to correct bone derformities
Mental health counseling to help treat issues with body image
Risk factors
Family history
Connective tissue disorder resulting from the defective syntheollagen
causes
It is caused by defect or flaw in the gene that produces type 1 collagen, a protein used to create bone.
Genetic mutation
Signs and symptoms
Bone derformities
Loose joints
Weak teeth
Bowed legs and arm
Scoliosis, or an abnormal lateral curve spine
Multiple broken bones
Medical management
Physical and occupational therapy to increase mobility and muscle strength
Bisphosphonate medications to strengthen bones
Low impact exercise to help build bones
Medications to relieve pains
Health education
Patients should be encouraged to develop healthy lifestyle habits such as regular strengthening exercises and stretching can help bones, joints and muscles strong.
Always be careful when picking up heavy objects and keep repetitive motions to a minimum.
FIBROMYALGIA
Definition
Refers to the common and complex chronic pain disorders that causes widespread pain and tenderness to touch that may occur body wide or migrate all over the body.
Risk factors
Depression or anxiety
inadequate physical exercise
Athritis
Family history
Causes
Signaling problems in the brain where it processes pain signals that are sent from peripheral nerves.
Pathophysiology
Unkown etiology
Produces vague symptoms that may be associated with diminished blood flow to certain parts of the brain and increased amounts of substance P,
Substance P thought to be a sensory neurotransmitter involved in communicationof pain, touch and temperature from body to brain
Lowers the threshold of synaptic excitability.
Signs and symptoms
Achy all over the body
Sleeping problems
Pain full joints
Low pain threshold
Muscle pain or burning sensation in muscles
Difficulty in concentrating
Medical Management
Medication that can be prescribed include pain relievers, anti-depressants, muscle relaxes and sleeping aids.
Seeing a counselor to help deal with emotional issues
Encourage patients to have enough sleep
Limit noise to promote rest and comfort
Nurse patient in a well comfortable position
Supplements such as st. Johns wort and melatonin may be helpful for encouraging sleep and minimizing depression.
Health education
Engage in regular exercises such as yoga that is low impact and are of moderate impact.
Good nutritional choices may also help to relive symptoms.
Mantain weight to reduce some of pain symptoms
CONGENITAL HIP DISLOCATION
Definition
Refers to a condition that occurs when a child is born with unstable hip caused by abnormal formation of the hip joint during their early stages of fetal development.
Causes
Low levels of amniotic fluid in the womb
Breech presentation
Family history
Confinement in uterus
Prenatal exposure to maternal hormones especially ostrogen
Risk factors
History of family disorders
common in girls
Pathophysiology
Dislocation can happen at birth or after birth
Femoral head is dislocated upwards and laterally, epiphysis is small and ossifies late
Femoral neck is excessively anteverted, acetabulum shallow
Labrum may be folded into the cavity
Capsule is stretched, hip muscles undergo adaptive shortening
Signs and symptoms
Legs that turn outward or appear to differ in length
Folds on their legs and buttocks that are uneven when their legs extend
Delayed gross motor development, which affect how a child sits, crawls and walks
Surgical management
If pavlik harness is unsuccesful or if the baby is too big for harness:
Surgery occurs including maneuvering their hip into socket which is called closed reduction.
The surgeon will lengthen the babys tendon and remove other obstacles before positioning the hip, this is called open reduction.
Femoral or pelvic osteotomies to reconstruct their hip, this means surgeon will divide or reshape the head of femur or acetabulum of pelvis.
Nursing management
If a baby is younger than 6 months of age and they will be fitted for a pavlik harness, this harness presses their hip joints into the socket. The harness abducts the hip by securing their legs in a frog like position.
Baby may wear these for 6 to 12 weeks depending on their age and severity of condition.
Health education
Regular check ups for the baby are important for early diagnosis and get medical attention.
References:
(Mogotlane, 2013) (Smeltzer, 2010)