208: Musculo-Skeletal System Flashcards
Joints united by fibrous tissue or cartilage and are immovable.
non synovial joint
Freely movable joints
synovial
Fibrous bands that connect bone to bone
ligaments
Enclosed sac filled with viscous synovial fluid.
bursa
What are the three types of muscle?
a) smooth b) cardiac c) skeletal
Bending a limb at a joint.
flexion
Straightening a limb at a joint.
Extension
Moving a limb away from the midline of the bod.y
Abduction
Moving a limb toward the midline of the body
Adduction
Turning the forearm so that the palm is down
pronation
turning the forearm so that the palm is up
supination
moving the arm in a circle around the shoulder
circumduction
move the sole of the foot inward at the ankle
inversion
moving the sole of the foot outward at the ankle
eversion
moving the head around a central axis
rotation
moving a body part forward and parallel to the ground
protraction
moving a body part backward and parallel to the ground
retraction
raising a body part
elevation
lowering a body part
depression
non synovial joint
Joints united by fibrous tissue or cartilage and are immovable.
synovial
Freely movable joints
ligaments
Fibrous bands that connect bone to bone
bursa
Enclosed sac filled with viscous synovial fluid.
a) smooth b) cardiac c) skeletal
What are the three types of muscle?
flexion
Bending a limb at a joint.
Extension
Straightening a limb at a joint.
Abduction
Moving a limb away from the midline of the bod.y
Adduction
Moving a limb toward the midline of the body
pronation
Turning the forearm so that the palm is down
supination
turning the forearm so that the palm is up
circumduction
moving the arm in a circle around the shoulder
inversion
move the sole of the foot inward at the ankle
eversion
moving the sole of the foot outward at the ankle
rotation
moving the head around a central axis
protraction
moving a body part forward and parallel to the ground
retraction
moving a body part backward and parallel to the ground
elevation
raising a body part
depression
lowering a body part
The TMJ allows for which three motions?
1) hinging action to open and close jaws
2) gliding action for protrusion and retraction
3) gliding action for side-to-side movement of lower jaw
What is the breakdown of the vertebrae?
7 cervical
12 thoracic
5 lumbar
5 sacral
3-4 coccygeal
True or false: The vertebral column has 4 curves?
True: It is like a double S-shape. The cervical and lumbar curves are concave (inward or anterir) and the thoracic and sacrococcygeal curves are convex.
at what point during gestation is there a “scale model” of the skeleton?
at 3 months gestation
True or false: bone growth continues rapidly during infancy and steadily during childhood
True, also steadily during adolescence
Where does lengthening of bones occur?
At the epiphyses (growth plates)
When does longitudinal bone growth stop?
At closure of the epiphyses, typically at 20 years old.
When is muscle fibre growth most marked?
during adolscent growth spurt
What is muscle size and strength variance attributable to?
- genetic programming
- nutrition
- exercise
What factors help prevent obesity and promote peak bone growth?
- regular exercise
- diet rich in dark green and deep yellow vegetables
- dairy products
- diet low in fried foods and carbonated beverages
What are potential risk factors for developmental dysplasia of the hip (DDH)?
- having first degree relative with it
- breech delivery
- clinical evidence of instability
- girls more predisposed than boys
- Indigenous people in Canada have a high risk
What is the most common cause of childhood MSK pain?
growing pains (non-inflammatory pain syndrome that affects children mainly between the ages of 3 and 12)
Describe the pain associate with growing pains (common between ages of 3-12 years old)
Usually nonarticular, bilateral, and located in lower extramities
- occurs late in the day or is nocturnal, waking the child
- frequently occurs on days of increased physical activity
True or false: increased levels of hormones cause increased mobility in the joints.
True, particularly the sacroiliac, scrococcygeal, and the pubic symphysis pubis joints. These contribute to noticeable changes in posture.
What is the posture change in pregnant women termed?
progressive lordosis: shifts weight farther back on the lower extremities and can causelower back pain
How might a pregnant woman compensate for lordosis?
Anterior flexion of the neck and slumping of the shoulder girdle. This can create nerve pressure and some women have aching, numbness, and weakness in the upper extremities
When is skeletal maturity reached?
25-35 years old, when bone mass reaches peak
At what age does resorption (loss of bone matrix) exceed deposition (new bone growth)?
After 40 years old
True or false. Men are more affected by osteoporosis than women.
False. Women are more affected than men because of lack of estrogen after menopause; this causes bone loss to accelerate.
What are the risk factors for fracture associated with osteoporosis in older adults?
- age 65 and older
- fragility fracture after age 40
- prolonged use of glucosteroids
- use of other high risk medications
- parental hip fractue
- vertebral fracture or osteopenia identified on radiography
- current smoking
- high alcohol intake
- low body weight or major weight loss (> than 10% of body weight at age 25 years)
- rheumatoid arthritis
What postural change is associated with older adults?
Kyphosis. Associated changes are a backward head tilt to compensate for the kyphosis, and slight flexion of hips and knees.
What are some of the main recommendations related to bone health?
- Diet (dairy, fish, greens, soy, limit caffeine, onions)
- Exercise (3 x 30 minute per week of weight bearing activity)(get 15 minutes sun exposure daily for vitmain D)
- Lifestyle (avoid smoking and excessive alcohol intake, seek help for depression)
- Medical options (speak to physician about bone density scan needs)
- Supplements (May need calcium or vitamin D supplements).
True or false. Muscle and joint status are interdependent and should be interpreted together.
True. Same applies in the neuro assessment.
What is the most prevalent type of arthritis?
osteoarthritis
What are the risk factors of osteoarthritis?
increasing age, family history, excess weight, and joint injury
When does rheumatoid arthritis usually appear and which gender does it affect most?
- 40 - 60 years old
- females 3x as likely
What type of fracture is a serious consequence of falls in older adults and which gender is most susceptible>
- hip fractures; females more susceptible
What are typical outcomes of hip fractures?
- loss of mobility and independence
- financial difficulties
- increased use of health care studies
- adults aged 50 and older with hip or vertebral fractures wre more likely to die during the 5-year follow up than were those without fractues
What are four recommendations for maintaining back health?
1) sitting: limit to 30 minutes at a time then take 1 - 2 minute braks
2) Standing: when stnading for prolonged periods, rest one foot on a low stool to relieve pressure and switch feet every 5 - 15 minutes
3) Lifting: lift close to body, smoothly, no twisting and with legs
4) Lifestyle: exercise and limit abdominal weight
What are the characteristics of rheumatoid arthritis?
- symmetrical, involving the same joints on both sides
- Pain is worse in the morning on arising
- Movement decreases pain
- Stiffness occurs in the morning and after rest periods
What are the characteristics of osteoarthritis?
- pain is worse later in the day
- Movement increases joint pain
What might cause a decrease in range of motion?
- joint injury to cartilage or capsule
- May result from musce contracture
What is myalgia?
Usually felt as cramping or aching
Widespread MSK pain lasting 3 months or longer and associated with fatigue is suggestive of what?
fibromyalgia
What could muscle weakness be a sign of?
MSK or neurological problem
What is atrophy?
decrease in muscle size
How is bone pain characterized in a fracture?
sharp
What are some deformities that can occur is MSK?
1) dislocation (one or more bones in a joint being out of position)
2) sublexation (partial dislocation of a joint)
3) Contracture (shortening of a muscle leading to limited ROM of joint)
4) ankylosis (stiffness or fixation of a joint)
What are warmth and tenderness in a joint indications of?
inflammation
What is the most sensitive sign of joint disease?
limitation is ROM
What is articular disease?
Inside the joint capsule, such as arthritis. Produces swelling and tenderness around the whole joint, and it limits both active and passive ROM in all planes.
What is extra-articular disease?
Injury to a specific tendon, ligament or nerve. Produces swelling and tenderness to that one spot in the joint and affects ROM in only certain planes, especially during active (voluntary) motion.
What is crepitation?
An audible and palpable crunching or grating that accompanies movement. Occurs when articular surfaces in the joint are roughened, as in rheumatoid arthritis.
What test(s) is/are used to assess for carpal tunnel syndrome?
Phalen test and Tinel’s sign.
What test do you perform to assess for meniscal tears?
McMurray test
What is a hallux valgus?
Abnormal finding where the distal part of the great toe is directed away from the body midline.
What does the Ortolani manoeuvre test for and how often should it be done?
checks the hips for congenital dislocation in infants and should be performed at every visit until the infent in 1 year old.
What does the Allis test assess?
Also used to check for hip dislocation by comparing leg lengths.
What is syndatyly and polydactyly?
Polydactyly is the presence of extra fingers or toes and syndactyly is webbing between adjacent fingers or toes.
In infants, what do you inspect the spine for?
- normal single C shaped curve
- tuft of hair, dimple in midline, cycst or mass (normally none present)
When is scoliosis most apparent?
During the preadolescent growth spurt.
What system can you use to grade ROM and muscle testing?
0 - 5 scale, 0 being no contraction and 5 being full ROM against gravity, full resistance
Define strain.
Injury to a muscle or the tendons that connect muscles to bones ► Common strains include back and hamstring.
Define sprain.
Stretching or tearing of ligaments ► Injures the bands of tissues that connect two bones together. ► Most common site is the ankle.
What ADLs may be impacted with MSK issues?
Bathing, Toileting, Dressing, Grooming, Eating, Mobility, Communicating
Older Adults and the Functional Assessment for ADLs. Includes musculoskeletal, neurological and sensory systems. What does it involve?
Walk (with shoes on)
Climb up stairs
Walk down stairs
Pick up object from the floor
Rise up from sitting in chair
Rise up from lying in bed
