Exam 4 - Musculoskeletal System Flashcards
1
Q
Function of the musculoskeletal system
A
Support - to stand erect Movement Protect inner organs Produce blood cells Reservoir - stores essential minerals
2
Q
Immovable joints
A
Fibrous
3
Q
Example of a fibrous joint
A
Sutures of skull
4
Q
Joints that are separated by fibrocartilaginous discs and are only slightly movable
A
Cartilaginous joints
5
Q
Freely movable joints
A
Synovial joints
6
Q
Components of a synovial joint
A
Joint cavity lined with synovial membrane Synovial fluid Cartilage Surrounded by fibrous capsule Supported by ligaments
7
Q
What do ligaments connect?
A
Bone to bone
8
Q
What is a bursa?
A
Enclosed sac filled with synovial fluid, much like a joint
9
Q
Examples of areas with bursa
A
Shoulder
Knee
10
Q
What do tendons connect?
A
Skeletal muscle to bone
11
Q
What is flexion?
A
Bending a limb at a joint
12
Q
What is extension?
A
Straightening a limb at a joint
13
Q
What is abduction?
A
Moving a limb away from the midline of the body
14
Q
What is adduction?
A
Moving a limb toward the midline of the body
15
Q
What is pronation?
A
Turning the forearm so the palm is down
16
Q
What is supination?
A
Turning the forearm so the palm is up
17
Q
What is circumduction?
A
Moving the arm in a circle around the shoulder
18
Q
What is inversion?
A
Moving the sole of the foot inward at the ankle
19
Q
What is eversion?
A
Moving the sole of the foot outward at the ankle
20
Q
What is rotation?
A
Moving the head around a central axis
21
Q
What is protraction?
A
Moving a body part forward and parallel to the ground
22
Q
What is retraction?
A
Moving a body part backward and parallel to the ground
23
Q
What is elevation?
A
Raising a body part
24
Q
What is depression?
A
Lowering a body part
25
How many cervical vertebrae?
7
26
How many thoracic vertebrae?
12
27
How many lumbar vertebrae?
5
28
How many sacral vertebrae?
5
29
How many coccygeal vertebrae?
3 or 4
30
Where is the spinous process?
C7 and T1 - base of neck
31
Where is the inferior angle of the scapula?
Interspace between T7 and T8
32
Imaginary line connecting the highest point on each iliac crest crosses which vertebrae?
L4
33
An imaginary line joining the two symmetric dimples that overlie the posterior and superior iliac spines crosses where?
The sacrum
34
What happens if compression of a nucleus pulposus becomes too great?
The disc can rupture and the nucleus pulposus can herniate out of the vertebral column,
compressing on the spinal nerves and causing pain
35
Function of cartilage
Covers surface of opposing bones
36
What is bursitis
Inflammation of the bursa
37
Which joint, the shoulder or hip, has a wider range of motion?
Shoulder
38
Why doesn’t the hip have as much ROM as the shoulder?
The hip is a more stable joint because it needs to bear weight
39
What causes the hip to be stable?
Powerful muscles spread over the joint
Strong fibrous articulate capsule
Very deep insertion of head of femur
40
Muscles of the hip
Anterior flexor (iliopsoas)
Posterior extensor (gluteus Maximus)
Adductor muscles that swing the thigh toward midline
Abductor muscles that swing it away
41
How many bursae in hip?
3
42
Palpable structures in hip
Entire iliac crest
Ischial tuberosity
Greater trochanter
43
What produces movement of muscle?
Contraction
44
What is skeletal muscle composed of?
Muscle fibers (fasciculi) and tendons
45
Difference between osteoarthritis and rheumatoid arthritis
OA is worse in PM
| RA is worse in AM
46
What is the most common musculoskeletal concern?
Joint pain and loss of function
47
What increases most joint pain? And when is there an exception to this?
Movement
| Except with rheumatoid arthritis
48
What is myalgia?
Usually felt as cramping or aching of muscles
49
What is functional assessment?
Screens the safety of independent living, the need for home health services, and quality of life
50
What environmental hazards could pose risk?
Heavy liftin
Repetitive motion
Chronic stress to joints
51
What is the difference between a screening musculoskeletal examination and a complete musculoskeletal examination?
Screening assesses the function for ADLs and checks for abnormalities. Normally adequate for most patients
Complete musculoskeletal examination is for people with articulate disease, history of musculoskeletal symptoms, or problems with ADLs
52
Order of examination for musculoskeletal system
Inspection
Palpation
Range of motion
Muscle strength testing
53
How do you perform muscle strength testing?
By applying opposing force to muscles
54
What is a fracture
Break in bone
55
What is dislocation?
Completely loss of contact between two bones
56
What is subluxation?
Two bones in a joint stay in contact, but alignment is off
57
What is contracture?
Shortening of a muscle leading to limited ROM of joint
58
What is ankylosis?
Stiffness or fixation of a joint
59
What is active ROM?
Patient moving independently
| What you should ask patient to do first
60
What is passive ROM?
Patient relaxes muscles while you move the body part for them
Should be done if pt is unable to move independently
61
What is limited range of motion?
Reduction in normal distance and direction through which a joint can move
When a joint does not move fully and easily in its normal manner
62
How is muscle strength graded during muscle testing?
```
5 = full ROM against gravity, full resistance
4 = full ROM against gravity, some resistance
3 = full ROM with gravity
2 = full ROM with gravity eliminated
1 = slight contraction
0 = no contraction
```
63
Where is the TMJ?
Area just anterior to the ear
64
How do you palpate the TMJ?
Have patient open and close mouth
| Note smooth motion of mandible
65
What is a variation of normal in TMJ?
Audible and palpable snap or click as mouth opens
66
What is cracking or popping of a joint called? (Spelling)
Crepitus
67
What should you tell a pt who has a crepitus TMJ?
Avoid chewing gum or eating hard to chew foods
68
How should you inspect the cervical spine?
Check alignment of head and neck
Spine should be straight and head should be erect
Pt should be able to move head and neck independently
69
What should you palpate in the cervical spine?
Spinous processes
Sternomastoid
Trapezius
Paravertebral muscles
70
What should cervical spine muscles feel like?
Firm
No muscle spasm
No tenderness
71
What should you do while checking ROM of shoulders?
Cup one hand over shoulder to note any crepitus
72
How should you test muscle strength of shoulders?
Have pt shrug shoulders against resistance
73
How should you test muscle strength of elbow?
Stabilize arm with one hand
| Have pt flex elbow against resistance applied just proximal to wrist
74
How should you palpate wrists and hands?
Palpate each joint
Palpate metacarpopharyngeal joints with each thumb
Palpate sides of interphalangeal joints
Pt should have no pain
75
How should you test muscle strength of wrist and hands?
Forearm supinated
Stabilize
Ask pt to flex wrist against resistance at palm
76
What does phalen’s test test for?
Carpal tunnel
77
How do you have pt perform Phalen’s test?
Hold both hands back to back while flexing wrist 90 degrees
| Acute flexion for 60 seconds
78
What are normal vs abnormal results of a phalen’s test and what do they mean?
Normal: no symptoms = no carpal tunnel
Abnormal: numbness and burning = carpal tunnel
79
What does Tinel’s sign test for?
Carpal tunnel
80
How do you perform Tinel’s sign?
Direct percussion of median nerve at wrist
81
Normal vs abnormal results of Tinel’s sign
No symptoms = normal
| Burning and tingling = carpal tunnel
82
Tests that assess for carpal tunnel
Phalen’s test
| Tinel’s sign
83
How should you assess muscle strength in a patients ankles and feet?
Ask person to maintain dorsiflexion (toes to nose) and plantar flexion (toes down) against your resistance
84
How should you inspect the spine?
Is the spine straight?
Convex thoracic curve
Concave lumbar curve
85
What should you palpate on patient’s spine?
Spinous processes
86
What is carpal tunnel syndrome caused by? And who gets it?
Caused by chronic repetitive motion
Occurs between 40-60 years old
More common in women
87
Symptoms of carpal tunnel
Pain
Nighttime pain
Burning and numbness
Often atrophy of thenar muscles
88
What is degenerative joint disease also called?
Osteoarthritis
89
Symptoms of osteoarthritis?
Stiffness and swelling
Hard bony protuberances
Pain with motion
Limitation of motion
90
What is an ingrown toenail? What causes it?
Toenail does not grow in, soft tissue grows over nail
Can become infected when nail grows and corner penetrates the soft tissue
Caused by trimming nail too short or toe crowding in tight shoes
91
What is kyphosis?
An enhanced thoracic curve
| Common in aging people
92
What is lordosis?
And pronounced lumbar curve
| Common in obese people
93
What is scoliosis?
Lateral curvature of thoracic and lumbar segments of spine
Usually with some rotation involved
Can be functional (visible only when standing)
Or structural (visible when standing and bending)
