Ch. 22 :musculoskeletal system Flashcards
joints
+nonsynovial (immovable) and synovial joints (freely movable)
+cartilage: cushions bones and gives smooth surface to facilitate movement
+ligament: run from one bone to another. strengthen the joint and prevent undesirable direaction of movement
+bursa: enclosed sac filled with synovial fluid. helps muscles and tendons glide smoothly over bone
muscles
+account for 40-50% of body’s weight
+skeletal muscles
-Fasciculi- bundles of muscle fibers
-tendon- strong fibrous cord which attaches to bone
-skeletal muscle movements (flexion/extension, abduction/adduction, inversion/eversion, protraction/retraction, rotation, elevation/depression, pronation/supnation, circumfrence)
Tempoormandiubular joint (structure)
articulation of mandible and temporal bones
spine (structure)
\+vertebra- 33 connecting bones -7 cervical -12 toracic -5 lumbar -5 sacral -3-4 coccygeal vertebrae \+intervetebral disks \+landmarks: T1, C7, T7,T8,T12,L1,L4,S2 and scapula
shoulder (structure)
- glenohumeral joint
- rotator cuff
- subacromial bursa
- acromion process
- greater tubercle of the humerus
- coracoid process
Elbow (structure)
- 3 bony articulations of the humerus, radius, and ulna
- medial and lateral epicondyles
- olecranon process of ulna
wrist and carpals (structure)
- radiocarpal join
- midcarpal joint
- metacarpophalangeal joints
- interphalangeal joints
Hip
- acetabulum and head of femur
- anterior superioir iliac spine
- ischial tuberosity
- greater trochanter of femur
Knee
- femur, tibia, and patella
- suprapatella pouch
- medial and lateral menisci
- cruciate ligaments
- prepatella bursa
- quadriceps muscle
ankle and foot
- tibiotala joint
- medial and lateral malleolus
- metatarsals
dev. care
+growth plates closure @ age 20
+lordons: lower back arches
+good for bones bone: dark green leafy. beans. almonds
obj. data
-preperation:
+screening musculoskeletal exam: for most people, normal screening. inspection and palpation of joints integrated and ROM
+complete musculoskeletal exam: appropriate for a persons with articular disease, a history of musculoskelteal symptoms, or any problems with ADLs
Oder of exam
+inspect: size, contour of joint, skin, tissue over joint for color, swelling, massses, or deformity
+palpate: skin temp., muscles, bony articulations, area of joint capsules
Range of motion
active/passive
muscles testing
- apply opposing force
- grading muscle strength
temporomandibular joint (jaw)
- inspect joint area
- palpate as person opens mouth
-motion and expected range
+open mouth maximally, protrude lower jaw and move side to side
+stick our lower jaw
-palpate muscles of mastication
Cervical spine
- inspect alignment of head and neck
- palpate spinous processes and muscles
- motion and exepcted range: chin to chest, lift chin, each ear to shoulders, turn chin to each shoulder
shoulders
- inspect joint
- palpate shoulders and axilla
-motion and expected range:
+arms forward and up, arms behind back and hands up, arms to sides and up over head, touch hands behind head
elbow
- inspect joint in flexed and extended positions
- palpate joint and bony prominences
-motion and expected range
+bend and straighten elbow
+pronate and supinate hand
Wrist and hands
- inspect joints and dorsal and palmar sides
- palpate each joint
-motion and expected range
+bend hand up, down
+bend fingers up and down
+ turn hands out and in
+spread fingers, make fist
+ touch thumb to each finger
Phalen’s test
asking person to hold both hands back to back while flexing the wrists 90 degrees. normal hand should produces acure flexion of wrist for 60 seconds
tinel sign
= direct percussion of the location of the median nerve at the wrist produces no symptoms in the normal hand
Bulge sign
+ swelling in suprapatellar pouch (fluid)
+small amounts of effusion 4-8 ml, from fluid flowing across the joint
McMurray’s test
test is performed when person has reported history of trauma followed by locking, giving way, or local pain in the knee
+ If a “click” is heard, test is positive
Ch. 27 &28: Sequence of head to toe exam
- health history
- general appearance
- measurement
- neurologic system
- respiratory system
- cardiovascular system
- skin
- abdomen
- genitourinary
- activity
