Exam 2: Musculoskeletal

Question 1

How many bones are in an adult human skeleton?

Answer 1

206

Question 2

What is the difference of Synovial V. Non Synovial Joints? Name an Example of each.

Answer 2

Synovial Joints are considered freely moveable due to bones being seperate from one another despite being encased in the same joint cavity. A Prime example includes the joints of the Hip, Knees, and Shoulders.
Non-Synovial Joints are frequently considered slightly immovable/ Immovable due to secure and tight connections that hold them in place. Such as the sutures of the skull.

Question 3

What are the two types of Non-Synovial Joints?

Answer 3

Non-Synovial joints can be divided into Fiborous and Cartilogenious Joints.
Fibrous Joints, such as the sutures of the skull are completely immoveable and connected directly by fibers or cartilage.
Cartilogenous Joints are deemed slightly moveable and connected by fibrocartilagenous tissue. Such as the Vertebrae of the spine.

Question 4

What are Bursae?

Answer 4

Bursae are enclosed sacs of synovial fluid that act to prevent friction in a joint.

Question 5

What are Tendons V. Ligaments?

Answer 5

Tendons are strong fribrous connections from muscle to bone.
Whereas Ligaments are a firbrous band that connects bone to bone.

Question 6

What are the three types of muscle in the body and which one makes up the majority of muscle mass in our body?

Answer 6

There are three types of muscle classes in the body;
Cardiac
Smooth
and SKeletal
With Skeletal making up about 40-50% of our body weight.

Question 7

Describe Skeletal Tissue.

Answer 7

Skeletal Tissue is simply voluntary muslces that move at our discretion. Such as Shoulder muscles.

Question 8

What age does the Skeleton stop growing at typically?

Answer 8

Around age 20.

Question 9

Where are bones most vulnerable and likely to cause deformity if injured in children/ YA?

Answer 9

The epiphyses (or growth plates).

Question 10

What are some unique adjustments to the Musculoskeletal system that occur in pregnant women?

Answer 10

In pregnant women you will often note that;
The Thorax expands Bilaterally in order to support the force of the developing fetus pressure up on and on the diaphram.
As well as a steady lordosis (or curve of the spine) which helps counterbalance the weight of the growing fetus.
And of course the pelvic joints will relax at birth.

Question 11

What are key developments for the Musculoskeletal system in Aging Adults?

Answer 11

Very common in aging adults is;
Posture changes such as Kyphosis (exageratted rounding of the upper back) as well as fat deposits begin to shift leaving older adults with less protection at bony prominences. Hence older adults are often at an increased risk for pressure ulcers.

Question 12

What is Subjective Assessment Data you should collect on the MS system?

Answer 12

In a subjective MS assessment you always want to ask in regards to;
The prescensce of any muscle cramps or weakness
Prescence of bone pain, deformity, or injuries (Fractures, Sprains, and Dislocations)
Asking the patient to describe any pain, redness, stiffness, swelling, and heat as well as any limited movement of the joints.
And how such subjective findings are effecting their ADL

Question 13

What is involved in an Objective Assessment of the Musculoskeletal System?

Answer 13

Size and Contour of each joint, they should be symmetrical
Inspect skin color and charactersitics around the joint, such as indications of any swelling or redness.
Assessing ROM
Palpate the skin, muscles, bony articulations, and joint capsule for any heat, tenderness, or bogginess.
As well as muscle testing.

Question 14

Describe Active ROM v. Passive ROM.

Answer 14

Active ROM involves modeling movement for the patient to repeat.
Whereas Passive ROM requires you to support the weight of the limb, often due to limited mobility, and move it through the motion.

Question 15

When is Passive ROM examination typically used?

Answer 15

Most often Passive ROM is used for Older Adult patients due to development of limited mobility.
Though patients with suspected joint injuries would also require a Passive ROM exam.

Question 16

What are s/sx of Rheumatoid Arthritis?

Answer 16

s/sx of RA include Redness, Swelling, Heat, and Pain that is often symetric bilaterally.
This is can also be accompanied by limited ROM and deformities.

Question 17

What causes RA?

Answer 17

RA is a chronic inflammatory pain due inflammation of the synovial joints, hyperplasia (organ swelling), and swelling. All of which leads to the destruction of fibrosis, cartilage, and bone.

Question 18

What additional Nursing considerations should be taken into account with RA?

Answer 18

In RA it is important to carefully monitor patient for increased cardiovascular risk and signs of stroke, as RA is known to increase risk of Myocardial Infarction and stroke.

Question 19

What are s/sx of Oseteoarthritis?

Answer 19

s/sx of osteoarthritis include;
Stiffness, Swelling, and Pain with movement that is often unsymetrical and unilateral.
This can be accompanied by Limitied ROM and body nodules as well.

Question 20

What causes OA?

Answer 20

OA is a localized and NONINFLAMMATORY disorder that is best characterized by the deteroration of articular cartilage and the remodeling of new bone at joint surfaces in it’s place.

Question 21

Who is at increased risk for OA?

Answer 21

Older Adult patients, women, and Caucasions.
With OA also being associated with Obesity and overuse.

Question 22

How are minor Sports injuries often treated?

Answer 22

With RICE;
Rest
Ice
Compression
Elevation

Question 23

How are major sports injuries often treated?

Answer 23

Major sports injuries often require Stabilization and Surgery.

Question 24

START ON SLIDE 16 of PPX

Question 25

Are the normal findings/ranges of Active ROM the same as Passive ROM? If they are different describe why.

Answer 25

Both Passive and Active ROM findings/ ranges are the same.

Question 26

What are the 4 signs of acute inflammation in a joint?

Answer 26

1)Redness
2)Swelling
3)Tenderness
4)Heat

Question 27

Identify the 6 things to inspect on a joint.

Answer 27

1) Color of skin at joint
2) Contour of the joint
3) The size of the joint
4) Palpation over the joint for any heat, tenderness, bony artiulations, ect.
5) Perform muscle testing (Grade from 0-5)
6) ROM

Question 28

What should you inspect further if a joint is tender upon palpation?

Answer 28

Keep assessing the area over the joint in order to localize the tenderness (Is it in the skin, muscles, ligaments?)

Question 29

Describe the each grade on the Muscle testing and ROM Grade Scale.

Answer 29

0- No Contraction= Zero
1- Slight Contraction= Trace
2- Full ROM w/ Gravity eliminated= poor
3- Full ROM with Gravity= Fair
4- Full ROM with gravity and some resistance= Good Assessment
5- Full ROM with Gravity, Full Resistance= Normal Assessment

Question 30

what are s/sx of carpal tunnel syndrome?

Answer 30

s/sx of Carpal Tunnel inlcude;
Pain along thumb, index and middle fingers
Nighttime painoften noted as “Burning” with numbness present in above areas.
Possible Atrophy of thenar muscles

Question 31

What is Scoliosis?

Answer 31

Scoliosis is the abnormal curvature of the spine, particularly in the thoracic and lumbar regions.

Question 32

Differentiate Functional Scoliosis from Structural Scoliosis.

Answer 32

Functional Scoliosis is noted by it’s felxibility, where the curve of the spine is apparant while standing straight, but the curve disappears upon the person bending forward.
Structural Scoliosis is fixed and therefore the curve of the spine is always present and noted by a unequal elevation of the scapulae, hips, and shoulders.