Chapter 22: Musculoskeletal Flashcards
Function of musculoskeletal system
- Provides structure and movement for the body
- Consists of bones, skeletal muscles, and joints
- Allows the body to stand erect and move
- Supports and protects organs
- Produces red blood cells
- Stores fat and minerals
- Generates heat
Non synovial joints
Synovial joints are bones united by fibrous tissue or cartilage are
Example of a immovable non synovial joint
Suture in the skull
Example of a slightly moveable non synovial joint
Vertebrae
Synovial joints
Freely moveable because bones are separated and enclosed in joint cavities
**Cavity filled with lubricant, or synovial fluid; synovial fluid allows sliding which permits movement
Example of a pivot joint
Between C1 and C2 vertebrae
Example of a Ball and socket joint
Hip joint
Example of condyloid joint
Between radius and carpal bones of the wrist
Example of plane joint
Between tarsal bones
Example of saddle joint
Between trapezium carpal bones and 1st metacarpal bone (thumb and wrist bone)
Example of a hinge joint
Elbow
How is movement produced?
When muscles contract
What are the 3 kinds of muscles?
Skeletal, smooth and cardiac
Are skeletal and voluntary muscles under conscious or unconscious control?
Conscious control
TMJ
Articulation of mandible and temporal bone
TMJ permits jaw function of speaking and chewing
What three motions does TMJ produce?
Hinge action to open and close jaws
Gliding action for protrusion and retraction
Gliding for side-to-side movement of lower jaw
How many of each vertebrae are there?
7 cervical 12 thoracic 5 lumbar 5 sacral 3 to 4 coccygeal
Talipes equinovarus (clubfoot)
Inward turning foot
Including: 1) inversion 2) forefoot adduction 3) foot pointing downwards (equinus)
Metatarsus adductus
Turning of forefront of foot
Metatarsals bones deviate inward
Ortolani and Barlows test
Examination of the newborn:
Ortolani is abducting the hips, Barlows is adducting the hips
Allis test (Galeazzi)
Patient flat, both knees up, with heels to the butt, the knees should be the same level unless there is hip dislocation
Signs of Neural tube defect
Tuft of hair, Skin dimpling
What to keep in mind regarding clavicles when delivering a baby
Can fracture when infant delivered vaginally
Polydactyl
Multiple digits
Syndactyl
Webbed fingers
Lordosis
Lower spine curves in and butt pops out
Genu Varum
Bowlegged
Genu valgum
Knock-knees
Scoliosis screening
No curvature of the spine
Shoulder, Hip and Scapula symmetry
When does the last epiphyses close
Age 20
Developmental competence in the pregnant woman
Increased levels of circulating hormones cause increased mobility in joints
Lordosis
Lower back pain
Waddle gait
Developmental competence in aging adults
Bone reabsorption occurs more rapidly Postural changes leading to decreased height Loss of subcutaneous fat Loss in muscle mass (atrophy) Osteoporosis
Osteoporosis factors
Alcohol use, Corticosteroid use, Low Calcium, Low estrogen, Smoking, Sedentary lifestyle
Morse fall risk scale
High risk: 45 or higher
Moderate risk: 25 - 44
Low risk: 0 - 24
What is the rating for full muscle strength?
5
Signs of TMJ
Pain, Deviation and Swelling
Audible and palpable snap or click (occurs often)
What are you assessing when you are assessing the cervical spine?
Alignment of head and neck Sternomastoid, trapezius
What upper extremity movements in the shoulder do you do during an assessment
Shrug shoulders
Raising arms
Rotating arm
What upper extremity movements in the elbow do you do during an assessment
Flex elbows and rotate forearm
What upper extremity movements in the wrist and hand do you do during an assessment?
Roll Wrists
Spread fingers in and out
Phalen’s Test
Flexion of wrist at 90 degrees, no pain
Positive if pain
Tinel’s sign
Tap median nerve
If Pain, Positive
Which lower extremities do you do assessments on
Hip
Knee
Ankle and foot
Knee: Bulge sign
For swelling in suprapatellar pouch, bulge sign confirms presence of fluid as you try to move fluid from one side of joint to other.
Knee: Ballottement or Patella
Test reliability when larger amounts of fluid are present
Tap Patella, if it rebounds against your fingers, fluid is present
McMurray’s Test
Special test for meniscal tears
Rotation test for demonstrating torn cartilage of the knee.
Lasegue’s Test “Straight leg test”
Maneuvers reproduce back and leg pain and may confirm presence of herniated disc
Inflammatory conditions of the joints
Rheumatoid arthritis and Ankylosing Spondylitis
Degenerative conditions of the joints
Osteoarthritis and Osteoporosis
Osteoarthritis
- *Degenerative joint disease
- Only joints affected
- Rheumatoid arthritis is an autoimmune
- Non inflammatory, localized, progressive disorder involving deterioration of articular cartilage and subchondral bone and formation of new bone on surface
Osteoporosis
Bone reabsorption
Decrease in bone mass and bone mineral density
Inflammation of joints
Can lead to hip fractures in the aging adult at the femur cross section
Rheumatoid arthritis
Chronic autoimmune disease with inflammation of synovial tissues
Bone erosion, swollen inflamed synovial membrane, worn down cartilage, reduced joint space
Swan-neck and boutonniere deformities, Ulnar deviation or drift are signs of what
Seen in late stage rheumatoid arthritis
Degenerative joint disease or osteoarthritis
a common “wear and tear” disease that occurs when the cartilage that serves as a cushion in the joints deteriorates. This condition can affect any joint but is most common in knees, hands, hips, and spine.
Heberden nodes
Bony swellings that can develop in the distal interphalangeal joints (DIP) (the joints closest to the end of the fingers and toes). Also a sign of osteoarthritis
Bouchard nodes
Bony enlargements in the of the middle joints of the fingers, also known as proximal interphalangeal (PIP) joints, sign of osteoarthritis
Swan neck
Hyperextension of the proximal inter-phalangeal joint, and flexion of the distal inter-phalangeal joint
Boutonniere deformity
Knuckle looks as if its been pushed through a button hole
Flexion of proximal inter-phalangeal joint w/ compensatory hyperextension of distal inter-phalangeal joint
Acute rheumatoid arthritis
Painful swelling and stiffness of joints with fusiform or spindle-shaped swelling of the soft tissue of proximal inter-phalangeal joints
Ulnar deviation
Finger drift to the ulnar side because of stretching of the articular capsule and muscle imbalance
Ankylosing Spondylitis
Fusion of inflamed vertebrae
Chronic, progressive inflammation of the spine and sacroiliac joints
Osteoarthritis signs
Asymmetric joint involvement
Affected joints have stiffness
Swelling with hard, bony protuberances
Pain with motion and limitation of movements
Signs of spina bifida
Incomplete closure of posterior part of the vertebrae resulting in neural tube defect
Signs: skin defect along spine, protrusion of sac containing meninges, spinal fluid, malformed spinal cord,
Myelomeningocele
Sign of spina bifida
Which the meninges and neural tissue protrude
Congenita; dislocated hip
Head of femur is displaced out of the cup-shaped acetabulum
Positive trendelenburg sign in older children is a sign
Trendelenburg sign
A positive test is one in which the pelvis drops on the contralateral side during a single leg stand on the affected side.
