Assessment Of The Musculoskeletal System Flashcards
Body’s central framework
Skeletal System
Makes up the skeletal system
Bones and connective tissue, including cartilage, tendons, and ligaments
How many bones in adult body
206
5 functions of bones
- Structure
- Protection
- Acts as levers
- Produce RBC’s
- Stores calcium
Organ system consisting of skeletal, smooth, and cardiac muscles
Muscular System
Permits movement of the body, maintain posture, and circulates blood throughout the body
Muscular System
How many muscles in the body
650
2 functions of muscles
- Allow for movement and position
- Produce heat
Point of articulation of two bones; provides range of motion
Joints
Bone to bone
Ligaments
Connect muscle to bone
Tendon
Supports and shapes, acts as a shock absorber
Cartilage
Sacs filled with synovial fluid inside, cushion and reduces friction between joints
Bursae
Joint that permits rotation in one axis
Pivot
Supinates, pronates, rotates
Pivot
Allows movement in one axis
Hinge
Flexion, extension
Hinge
Joint that permits movement in two axes, also known as “egg and spoon joint”; with long diameter of oval and short diameter of oval serving as axes
Condyloid
Flexion, extension, abduction, adduction, circumduction
Condyloid
Moves across many possible axes, ex. Hip and shoulder joint
Ball and socket joint
Flexion, extension, internal rotation, external rotation, abduction, adduction, circumduction
Ball and socket joint
Moves across many surface, articular surface are flat and bones rides over the other in many directions (limited in many directions)
Plane/gliding
Has 2 axes like condyloid, articular surface are saddle shaped, moves in similar fashion to condyloid joint
Saddle joint
Abduction, adduction, opposition, and reposition
Saddle
Normal/abnormal findings in musculoskeletal system assessment
- Symmetry/asymmetry
- Skin color and appearance
- Rash
- Ulcers
- Lack of sweating
- Hair abnormalities
- Warmth and heat
- Swelling including effusions, nodules
- Inflammatory findings like synovial and periarticular thickening
Usually associated with movement
Cramping or soreness
Muscle pain
Fracture
Deep, dull, and throbbing
Bone pain
Joint pain and stiffness are worse in the morning
Rheumatoid Arthritis
Joints are stiff after rest and pain is worse at the end of the day
Osteoarthritis
Migrates from muscle or to groups of muscle
Muscle weakness
Can help identify the disease process responsible for weakness
Known symptom patterns
Is usually a myopathy
Proximal weakness
Usually a neuropathy
Distal weakness
Difficulty lifting objects or combing hair
Proximal weakness of upper extremities
Difficulty with walking or crossing the knees
Proximal weakness of lower extremities
Difficulty in dressing or turning the knob
Distal weakness of the upper extremities
Common musculoskeletal complaint
Stiffness
- indicate a neurological problem
- manifest as gait problems or difficulty in ADL
- falling or losing balance
Balance and Coordination problems
Irregular and uncoordinated voluntary movements
Ataxia
- a neurodegenerative genetic disorder that affects muscle coordination and leads to cognitive decline and psychiatric problems.
- becomes noticeable in mid-adult life
- most common genetic cause of abnormal involuntary writhing movements (chorea)
Huntington’s disease
Abnormal involuntary writhing movements
Chorea
- rigid stooped posture with head leaning forward and arms, knees, and hips stiffly flexed
- rapid, short, shuffling steps
- cause; Parkison’s disease
Propulsive gait
- bilateral spastic paresis of legs; arms not involved
- legs flexed at hips and knees
- knees adduct and meet or cross like scissors
Causes: cerebral palasy, ms, spinal cord tumors
Scissors gait
Unilaterally stiff, dragging leg from leg, muscle hypertonicity
Spastic gait (hemiplegic)
Abnormal gait caused by stoke, MS, brain tumor
Spastic gait
Abnormal gait caused by parkinson’s disease
Propulsive gait
Abnormal gait caused by cerebral palsy, MS, spinal cord tumors
Scissors gait
- duck like walk with a wide base of support, chest thrown back, exaggerated lumbar curve, and protruding abdomen
- normal in toddlers and late sign of pregnancy
- weak pelvic girdle muscles (gluteus medius, hip flexors, and extensors
Waddling gait
- foot drop with external rotation of the hip, and hip and knee flexion
- foot slaps when it hits the ground
Steppage gait
Abnormal gait caused by: MS, perineal muscle atrophy, or nerve damage
Steppage gait
5 abnormal gaits
- Propulsive gait
- Scissors gait
- Spastic gait
- Waddling gate
- Steppage gait
Equine, prancing, paretic, or weak
Steppage gait
Normal spinal curve
Cervical - concave
Thoracic - convex
Lumbar- concave
Sacral - convex
Accentuated thoracic curve
Kyphosis
Dowager’s hump
Senile kyphosis
Lateral “S” spinal deviation
Scoliosis
Accentuated lumbar curve
Lordosis
- plantar flexion of the foot with toes bent
- characteristic sign of certain peripheral nerve or motor neuron disorder
- results from the weakness or paralysis of dorsiflexor muscles of the foot and ankle
- may also stem from prolonged immobility
Footdrop
Where is muscle spasm most common
Calf and foot
- strong painful contractions
- most common in calf and foot
- muscle fatigue, exercise, electrolyte imbalances, neuromuscular disorder, and pregnancy
Muscle spams (cramps)
- muscle wasting
- degeneration or prolonged muscle disuse
- occur with aging
Muscle atrophy
- crunching or grating sound you can hear or feel a joint with a rough articular surface moves
- RA, Osteoarthritis, fracture
Crepitus
Excessive muscle size
Unexplained muscle hypertrophy
- Atony
- lack of muscle tone or stiffness
Flaccidity
Weakness
Hypotonicity
Involuntary twitching of muscle fibers
Fasciculation
Involuntary contractions of muscles
Termors
Musculoskeletal injury is described in 5ps:
Pain, paresthesia, paralysis, pallor, pulse
Refers to location , severity, and quality
Pain
Refers to loss of sensation
Paresthesia
Inability to move maybe caused by tendon or nerve damage
Paralysis
Paleness, discoloration, and coolness
Pallor
Distal to the site of injury
Pulse
- autoimmune disease causing inflammation of the joints
- swollen, stiff, tender joints
- more common in woman
- most serious and disabling
Rheumatoid Arthritis
2 deformities in chronic RA
- boutonniere deformity
- swan neck deformity
- deformities and nodules of the hands
- hereditary metabolic disorder with hyperuricemia in the joints
- men than woman
- controlled by medications and diet
Gouty Arthritis
- DJD (degenerative joint disease)
- deterioration of bone cartilage in the joint, leading to pain and limited movement
- “wear” and “tear” arthritis
Osteoarthritis
Hard, painless, nodules over the distal interphalangeal joints
Herbenden’s nodes
Nodes that are proximal in OR
Bouchard’s nodes
- symptom of Systemic Lupus Erymatosus
- symptoms include, fever, joint pain, butterfly shaped rash on the face
Lupus Arthritis
- type of arthritis that affects some people with the skin condition psoriasis
- causes affected joints to become swollen, stiff, and painful
Psoriatic Arthritis
- often on the medial side, may present laterally deviate great toe with overlapping of the second toe
Hallux valgus
Enlarged painful, inflamed bursa
Bunion
Hyperextension of the metatarsophalangeal joint
Hammer toe
Painfully thickened skin over bony prominences and pressure points
Corns
Painless thickened skin over pressure points
Callus
Round, enlarged, fluid filled cyst (dorsal side of the wrist)
Non tender but maybe painful near tendon sheath
Ganglion