Chapter 22: Musculoskeletal System

Question 1

By the age of 3 months, the fetus has developed what type of skeleton and what is it made of?

Answer 1

The fetus has a scale skeleton that is comprised of cartilage.

Question 2

How do long bones grow?

Answer 2

they grow in two dimensions: they increase in width or diameter by depositing new bone tissue around shafts and lengthening occurs at the epiphyses (growth plates)

Question 3

What are growth plates

Answer 3

AKA epiphyses are specialized growth centers composed of transverse disks located at the end of long bones.

Question 4

at what age does the last closure of the growth plates occur?

Answer 4

at age 20.

Question 5

What are some changes in the vertebral column that occur with an infant?

Answer 5

At birth: c-shaped spine, 3-4months: anterior curve in the cervical neck region, 1yr-18months: anterior curve in lumbar region develops.

Question 6

what three factors contribute to varying muscle size and strength of people?

Answer 6

Genetic programming, nutrition, and exercise.

Question 7

what is lordosis?

Answer 7

excessive inward curvature of the spine.

Question 8

What is bone remodeling?

Answer 8

cyclic process of bone resorption and deposition. it favors deposition until age 25-35. (bone mass reaches peak)

Question 9

At what age does resorption (loss of bone matrix) occur

Answer 9

At age 40.

Question 10

what is osteoporosis?

Answer 10

gradual loss of bone density

Question 11

What causes decreased height with age? what age does this occur?

Answer 11

shortening of the vertebral column. Begins in 40s, not significant until 60s and more progressive in 70s and 80s.

Question 12

what are some muscular, subcutaneous, and skeletal changes that occur with an aging adult?

Answer 12

Muscular: loss in muscle mass, (some atrophy, some decrease in size). Contour of muscles feel more prominent as do the tendons.
Skeletal: kyphosis, head tilt, bone loss, decrease in height.
Subcutaneous: loss of fat, bones more prominent, extremities thinner.

Question 13

how does lifestyle affect the muscular/skeletal system of the aging adult. What affect does activity have on these systems?

Answer 13

Less activlty, more risk for falls, fracture, and hastens age related changes.
More activity: decrease falls, decrease or delay in bone loss, increase skeletal mass, improves strength, flexibility, heart rate, balance, and coordination

Question 14

Which race has the highest level of BMD ?

Answer 14

Afro-Caribbean women.

Question 15

What are some defining characteristics of Rheumatoid Arthritis?

Answer 15

Auto Immune disorder, pain worse in the am, involves symmetric joints. Movement improves pain levels

Question 16

What are the defining characteristics of Osteoarthritis?

Answer 16

More pain at night, not relieved by exercise, not autoimmune. Bones of hip, spine, and wrist most often affected, no cure; is treatable.

Question 17

What might joint pain indicate if occurring 10-14 days after having strep throat?

Answer 17

Rheumatic fever.

Question 18

What might a “pop” mean in relation to a knee injury

Answer 18

Tear in ligament or fracture.

Question 19

What are the Ottawa Knee Rules?

Answer 19

Obtaining an x-ray if patient is unable to flex knee to 90 degrees, unable to bear weight, if pain is experienced at patella or head of fibula, or the person is over 55 yoa.

Question 20

Define
Flexion, extension, abduction, adduction, pronation, supination, circumduction, inversion, eversion, rotation, protraction, retraction, elevation, and depression

Answer 20

flexion: bending a limb at a joint
extension: straightening a limb at a joint
abduction: moving limb away from midline of body
adduction: moving limb toward midline of body
pronation: turning forearm so palm is down
supination: turning forearm so palm is up
circumduction: moving arm in circle around shoulder
inversion: moving sole of foot inward at the ankle
eversion: moving sole of foot outward at the ankle
rotation: moving 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

Question 21

How can you prevent Osteoporosis?

Answer 21

regular exercise, eating a well-balanced diet, avoid smoking, limit alcohol intake. Get enough Vit. D and calcium. Fast walking is best way to prevent this along with hip fracture.

Question 22

what happens if we do not consume enough calcium?

Answer 22

our body will take it from bones

Question 23

What is typical of tendinitis?

Answer 23

It is worse in the morning and gets better throughout the day.

Question 24

what should be noted with inspection of the musculoskeletal system?

Answer 24

swelling, size, contour, color, masses, or deformity.

Question 25

What is the difference between dislocation and subluxation?

Answer 25

dislocation: two bones have complete loss of contact
subluxation: two bones in a joint stay in contact, but are misaligned.

Question 26

What is contracture? What is ankylosis?

Answer 26

contracture: shortening of a muscle due to limited ROM
ankylosis: stiffness or fixation of a joint.

Question 27

what is the difference between articular and extra-articular disease?

Answer 27

articular disease: inside joint capsule, (arthritis), produces swelling, tenderness around the joints, and limits all places of ROM in both passive and active motion.
Extra-articular disease: injury to a specific tendon, ligament, nerve. This produces swelling and tenderness to that one spot in the joint and affects only certain planes of ROM.

Question 28

What is crepitation?

Answer 28

Audible and palpable crunching or grating that accompanies movement.

Question 29

what are the grades of ROM?

Answer 29

0-5 grades. 0-no contraction, 1- slight contraction, 2-Full ROM (passive motion), 3-Full ROM with gravity, 4-Full ROM against gravity with some resistance and 5-full ROM against gravity, with full resistance.

Question 30

what is a positive Thomas test?

Answer 30

flexion flattens the lumbar spine, if a deformity is noted in the opposite hip.

Question 31

what is a reliable sign of early hip disease? What is the most common motion dysfunction found in hip disease?

Answer 31

limited internal rotation of the hip.

Limitation of abduction of the hip while supine is the most common motion dysfunction found in hip disease.

Question 32

lateral tilting and forward bending occur with what condition?

Answer 32

herniated nucleus pulposus.

Question 33

how does scoliosis present?

Answer 33

differences between shoulder elevation, in level of scapulae and iliac crests.

Question 34

what symptoms are suggestive of Osgood-Schlatter disease?

Answer 34

Enlargement of the tibial tubercles with tenderness.

Question 35

what are two things common with adolescents?

Answer 35

kyphosis and an increased risk for sports related injuries.

Question 36

what is the Get Up and Go test

Answer 36

rise from an armchair, walk ten feet, turn walk back and sit down in under 10 seconds.