Exam 2 (Musculoskeletal) Flashcards
What are the functions of bones?
provide structure and protection, serve as levers, store calcium and produce blood cells
How many bones are in the body?
206
Axial skeletal is the _______.
head and trunk
Appendicular skeleton is the _______.
extremities, shoulders, hips
What is osteoporosis?
disease in which bones demineralize and become porous and fragile, making them susceptible to fractures, silent and progressive
Where is osteoporosis most common in the body?
spine, wrist, hips
Who are most at risk at for osteoporosis?
women 65+ years old, in postmenopausal women younger than 65, white women with no additional risk factors
What are some modifiable risk factors?
- alcohol intake
- smoking tobacco
- low BMI
- poor nutrition (SDOH)
- vitamin D deficiency
- eating disorders
- low dietary calcium intake
- insufficient exercise
- frequent falls
- maybe caffeine
Abduction =
moving away from the midline of the body
Adduction =
moving toward the midline of the body
Circumduction =
circular motion
Extension =
straightening the extremity at the joint and increasing the angle of the joint
Flexion =
bending the extremity at the joint and decreasing the angle of the joint
Dorsiflexion =
toes draw upward to ankle
Plantar flexion =
toes point toward the ground
Pronation =
turning or facing downward
Supination =
turning or facing upward
Rotation =
turning of a bone on its own long axis
What is a joint?
is the place where two or more bones meet, allow for ROM
What is a Bursa?
fluid-filled sacs that act as cushions and reduce friction between bones, tendons, and muscles around joints
What are the normal movements of the elbow?
- flexion and extension of the forearm
- supination and pronation of the forearm
What are the normal movements of the shoulder?
- flexion and extension
- abduction and adduction
- circumduction
- roatation (internal and external)
What are the normal movements of the hip?
- flexion with knee flexed and with knee extended
- extension and hypertension
- circumduction
- rotation (internal and external)
- abduction and adduction
What are the normal movements of the knee?
- flexion and extension
What effect does weight gain have on the MSK system?
increase physical stress and strain
Describe bone pain
dull, deep and throbbing
Describe muscle pain
aching but either mechanical or inflammatory
Describe pain of fractures
sharp, knife-life
Describe joint pain
osteoarthritis pain that begins with one set of joints on one side of the body; feels deep in the joint; better with rest; worsens on rainy weather; sensation of bones grating together; stiffness in the morning
Describe pain/sensations of Rheumatoid Arthritis
burning, throbbing, heat, soreness, weak muscles, tired and depressed, weight loss, decreased app, increased temp and stiffness for an hr
decreased or increased estrogen levels leads to greater risk for the development of osteoporosis? Why?
decreased because low estrogen levels tend to decrease the density of bone mass
Does menopause have an affect on the MSK system? Why?
yes because estrogen levels affect bone density
Name the older adult considerations for MSK system
- bones lose their density with age (risk for fractures, esp of the wrists, hips, and vertebrae)
- joint stiffening conditions may be misdiagnosed as arthritis
- slower movements, reduced flexibility, decreased muscle strength, joint degeneration, reduced elasticity of the tendons, joint capsule calcification
What are some examples of family history related conditions (MSK system)
- RA
- gout
- osteoporosis
Protein promotes…
muscle tone and muscle growth
Vitamin C promotes …
healing of tissues and bones
Vitamin D promotes …
needed to absorb calcium
Diet high in purine and alcohol can trigger what condition?
gouty arthritis
How does medications affect the MSK system?
- Diuretics alter electrolyte levels causing muscle weakness
- Steroids deplete muscle mass (osteoporosis)
- Reactions to -statins can lead to myopathy (muscle pain, soreness, tiredness, and weakness)
T/F tobacco, alcohol, and caffeinated beverages increase risk of osteoporosis
True
Does calcium deficiency increase risk of osteoporosis?
Yes
What vitamin is required to absorb calcium via sun exposure, diet, or supplement?
Vitamin D
What is the significance of routine exercise to prevent disease in the MSK system?
- regular exercise promotes flexibility muscle tone, and strength
- weight bearing exercises promote density
What device do you use to measure the ROM when you identify ROM is limited?
goniometer
Name the muscle strength classifications (0-5)
0 = no muscular contraction (paralysis)
1 = slight flicker of contraction (severe weakness)
2 = passive ROM (poor ROM)
3 = active motion against gravity (average weakness)
4 = active motion against some resistance (slight weakness)
5 = active motion against full resistance (normal)
What is the difference between passive and active ROM?
Passive = not assisted by gravity and has help
Active = has gravity involved and no help
What is the clinical manifestation of TMJ?
- decreased ROM
- clicking, popping, or grating sound may be noted
What is crepitus?
clicking, popping, or grinding sound that occurs when opening or closing the mouth
What is Ankylosing Spondylitis?
a chronic, inflammatory disease causing inflammation, pain, and stiffness, potentially leading to fusion of the vertebrae
Herniated disc & ankylosing spondylitis =
flattened lumbar curvature
Pregnancy & obesity =
an exaggerate lumbar curve (lordosis)
T/F Kyphosis is not normal with aging
False, kyphosis is normal with aging
What is the Straight Leg test? What’s another name for this test?
- checks for back pain
- checks for a herniated nucleus pulposus
- have pt lie supine, raise each leg independently to the point of pain and dorsiflex the foot and document the point of pain and result from dorsiflexion of foot
- Lasegue test
Dislocation of the shoulders result in ________ shoulders.
flat, hollow, or less-rounded
Describe rotator cuff tear
painful and limited abduction accompanied by muscle weakness and atrophy
What is a Bursitis?
redness, heat, and swelling seen d/t inflammation of a bursa, a fluid-filled sac that cushions bones, tendons, and muscles
What is the Anatomic Snuffbox?
the hollow area on the back of the wrist at the base of the fully extended thumb
What does a tender Snuffbox indicate?
scaphoid fracture
What tests do you perform for CTS? (Carpal Tunnel Syndrome)
- Phalen Test: upside down praying position
- Tinel Sign: finger percuss over the median nerve
What nerve is entrapped in CTS?
the median nerve
What findings are seen in acute RA?
swollen, stiff, tender, finger joints
What findings are seen in those with Osteoarthritis?
hard, painless nodules over distal interphalangeal joints (Heberden nodes) and over the proximal interphalangeal joints (Bouchard nodes)
What is the difference between Heberden and Bouchard nodes?
- Heberden = distal
- Bouchard = proximal
What is Genu Valgum?
knees turn in
What is Genu Varum?
knees turn out
What test is performed to test a torn meniscus?
McMurray Test
What is the normal range for knee flexion and extension to extension?
- 120 to 130 degrees of flexion
- 0 degrees extension to 15 degrees of hyperextension
What does the Bulge test and the Ballottement test test for? Which is performed first?
swelling of the knee
- Bulge test is done first
Name the positive test: bulge of fluid appears on the medial side of the knee, with a small amount of joint effusion
Bulge Test
Name the positive test: Fluid wave or click palpated, with large amounts of joint effusion
Ballottement test
Name the positive test: pain or clicking of the knee
McMurray Test
When test should be given if the patient complains of “giving in” or “locking” of knees?
McMurray Test
laterally deviated great toe with possible overlapping of second toe an possible formation of a bunion on medial side =
Hallux Vagus
Feet with no arches =
Pes Palnus
Feet with high arches =
Pes Cavus
Painful thickening of skin over bony prominences and at pressure points =
corns
Painful warts =
Verruca Vulgaris
What are the symptoms of Gouty Arthritis?
- tenderness
- reddened hot and swollen
- of the metatarsophalangeal joint of the great toe
What is the most common cause of heel pain?
Plantar Fasciitis
What is Hammer Toe?
when the index toe stays curled
