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osteoporosis, osteomalacia; dec. in older adultsHigh P:bone tumor, acromegaly, healing bone fractureLow P:osteomalacia; dec. in older adultsHigh ALP:metastatic bone cancer, Paget’s disease, osteomalacia; slight inc. in older adultsHigh Ck:muscle trauma, musc. dystrophy, effect of electromyographyHigh LDH:skeletal muscle necrosis, extensive cancer, musc. dystrophyHigh ALD:polymyositis, dermamyositis; musc. dystrophyHigh AST:skeletal muscle trauma, musc. dystrophy; inc. in older adultsDiscuss the correct use and functioning of therapeutic devices that support mobility. (Note: I’m including diagnostic tests here)> Assessment-Goniometer: used by rehabilitation therapists or RNs to provide an exact measurement of flexion/extensionor joint ROM> Imaging-Standard x-ray: most common; shows bone density, alignment, swelling, intactness; joint condition (size of space, smoothness of cartilage, swelling) may also be assessed-Tomography: Produces places/slices for focus and blurs images of other structures-Xeroradiography: highlights contrast between structures; “edge enhancement”* Disadvantages: higher level of radiation, inability to determine tissue densities-Myelography: contrast medium is injected into subarachnoid space of spine; allows visualization of column, intervertebral disks, spinal nerve roots, blood vessels; uncommon, replaced by CT and MRI-Arthrogram: visualization of a jointafter contrast medium (air or solution) is injected-MRI and CT: MRI is most appropriate for joints, soft tissue, bony tumorsinvolving soft tissue; CT is the test of choice for injuries/pathology involving only bone-Ultrasonography: used to view soft-tissue disorders(masses, fluid accumulation), traumatic joint injuries, osteomyelitis, surgical hardware placement> Nuclear imaging scans-Bone scan: radionuclide test in which radioactive material is injected for viewing entire skeleton; primarily used to detect tumors, arthritis, osteomyelitis, osteoporosis, vertebral compression factors, unexplained bone pain (esp. r/t hairline fractures)-Gallium and thallium scans: similar to bone scan but more specific/sensitive in detecting bone problems; thallium preferred for osteosarcoma
> Other diagnostic tests-Biopsy(may be bone or muscle; needle or open)-Electromyography: evaluates diffuse or localized muscle weakness and aids diagnosis of neuromuscular and nerve disorders; multiple small needle electrodes are inserted and pt performs activities to measure muscle potential; nerve/muscle activity is recorded for later interpretation* Contraindicated w/ pts in anticoagulant therapy; skeletal muscle relaxants discontinued several days prior-Arthroscopy: athroscope is inserted into a joint for direct visualization (common for knee, shoulder)> Devices to aid with ADLs- Shower chair or handheld shower; long-handled bathing sponge- Reacher, grabber, or dressing stick- Safety bars> Immobilization devices-Bandage, splint: used to keep bone in placeduring healing; removable-Cast: a rigid devicethat immobilizesthe affected body part; used for more complex fractures* Arm cast: elevate arm above the heart to reduce swelling; ice may be prescribed for first 24-48 hours. Arm is supported with sling for first few days.