INCOMPLETE: Muskoloskeletal (Grant) Flashcards
4 class of bones
- Long (extremities)
- Short (hands/feet)
- Flat (skull/sternum)
- Irregular (vertebrae)
Fx of skeletal system
- support
- protection
- movement
- mineral storage (Cal, Phos)
- hemopoiesis (RBC formation in bone marrow @ end of long bones)
Articulations (Joints)
-allow movement
Articulations (joints): 3 types
- Synarthrosis (no mvmt)
- Amphiarthrosis (slight mvmt)
- Diarthrosis (free mvmt)
Ariticultions: Division of Skeleton
- Axial skeleton (skull/vertebral col; thorax)
- Appendicular skeleton (upper/lower extrem)
- shoulder/pelvic girdle
bones held together by ?
connective tissue
joint is the point of contact btwn
individual bones
-every bone in body connects or articulates with at least one bone in body, except 1 (hyoid bone, anchors tongue)
Fx of Muscular System
- motion (result of contraction and relaxing individual muscles)
- maintenance of posture (contraction of certain skeletal muscles w exert a pull on various bones to maintain posture of sitting an/or standing)
- production of heat (as muscles contract, they produce 85% body heat)
- there are over 600 muscles
3 Fx of Muscles
when muscles contract they form 3 actions; Motion, Posture, Heal?
Skeletal Muscle Structer
- Epimysium (connective tissue surrounding skel musc)
- Perimysium (inner covering join along w epimysiuman extend beyond muscle to form touch hard of connect tissue called TENDONS)
- Endomysium (wispy layer of areolar connective tissue that ensheaths each individual myocyte (muscle fiber, or muscle cell). It also contains capillaries and nerves.
Nerve and Blood supply
- BVs provide constant supply of O2 and nutrition,
- Nerve cells/fibers supply constant source of information
Muscle Contraction
- upon stimulation
- skeletal muscles are in constant state of readiness for action
Types of Body movements
- flexion (sm angle at joint, bending knee)
- extension (open angle btwn adjoining bones)
- abduction (away from midline, open legs)
- adduction (toward middle)
- rotation (mvt of bone around it longintudinal access. pivot motion)
- supination (palms up)
- pronation (palm down)
- dorsiflexion (flex foot)
- plantar flexion (extend foot)
Dx Tests
RADIOGRAPH
- Myelogram (radiopaque dye into lumbar spine)
- Nuclear scan (record images using radioactive tracer in arm, isotopes w NOT affect visitors, need signed CONSENT)
- MRI (magnetic Resonance imaging)
- CT, Computed Axial Tomography (need signed CONSENT, clearer, 3D)
- Bone Scan (mets, inflam bone disease)
ENDOSCOPIC EXAM
- Arthroscopy
- Endoscopic spinal microsurgery
NI:
need signed consent
Myelogram
inject radiopaque dye into lumbar spine (herniated disc, tumor) assess for Iodine or shellfish allergy. If alergic, use non-ionic dye or steroids/anithistamine prior to dye (for low - min reaction
more Dx Tests
-Aspiration (synovial fluid)
-EMG, Electromyogram
-Lab Tests:
.Cacium (up w mets to bone, Addison’s, Pagets, Aromegaly, acute osteopersoisis, hyper parathyroid, renal failure)
.ESR (Erythrocyte sedimentation rate
.Lupus erythematosus (LE) prep
.RF, Rheumatoid Factor
.Uric acid (blood)
RA, Rheumatoid Arthritis
- most serious form of arthritis
- Chronic, Systemic, progressive, inflammatory
- most common in women of childbearing age
- most affected: Native Am
- may affect Lungs, heart, bv, muscles, eyes, skin, joints and other connective tissue, organs
- chronic inflammation of synovial membrane of diarthrodial joints (destroys syn fluid)
- NOT r/t age, obesity or injury
CAUSE:
unknown
Diarthrosis
synovial (moveable) joints
RA: SS
4 Classis Symp (am stiff, jt pn, musc wkn, fatigue)
- periods of remission and exacerbation
- *malaise
- *muscle weakness (grip strength)
- loss of appetite
- generalized aching
- *edema an tenderness of joints
- *limited ROM (morning stiffness, can last most of day)
Sometimes mistaken for Fibromalgyia
- hard to heal injuries
- more at risk for Sjogrens Syndrome
- locked joints (knee, elboy), COMMON complaint
Sjogrens Syndrome
Dryness in eyes, mouth, throat, skin d/t inflammation that stops glands from releasing moisture
RA: Dx tests
No definitive testing
- Med Hx, Fam Hx
- Radiography (loss of articular cartilage and change in bone structure)
LAB: (Immunological tests based on antibody reactions)
ESR, Erythrocyte sedimentation rate (non specific marker of inflame, used w other tests)
-RF, Rheumatoid Factor (measures RF antibodies present in blood. RF antibodies attach to healthy tissue and destroy it
-Latex agglutination test (mixes blood w latex beads covered in human antibodies. RF present w clump onto beads)
-Synovial fluid aspiration (aspirate synovial fluid, arthrocenthesis) (UP protein, UP WBC
Synovial Fluid
- cushion joints
- clear to straw color
- fluid cloudy w inflam (less or more viscous)
RA: MM/NI
- MEDS (salicylates, NSAIDs, COX2 Inhibitors, potent anti inflam, slow acting antiinflam, disease modifying antirheumatoid drugs)
- 8-10 hrs sleep
- ROM 2-3 x/day
- hot packs, heat lamp, hot paraffin
- rehab (traction, splints, prolong joint fx, wt mgmt)
- encourage pts to do own ADLs
Ankylosis Spondylitits (AKS)
Chronic, progressive disorder of sacroiliac and hip joints, synovial joints of spine, adjacent soft tissue. Joints fuse together)
-does not affect synovial membrane like RA
-can affect cervical joint, jaw, shoulder, knees, hip
-common in young men, milder in women
-strong Hx
NO CURE
BURNS out after 20yrs?
Ankylosis Spondylitits (AKS): SS
- pain/stiffness in back, DEC ROM
- UP temp, tachycardia, hyperpnea
- inflammation of spine –> bones fuse together in spine(RARE)
- rib cage can’t properly expand d/t kyphosis
- vision loss (chronic ask)
- ligaments become hardened (ossify)
- altered rest rate d/t kyphosis
- glaucoma
- pupil damage
Ankylosis Spondylitits (AKS): Dx tests
- Hgb, Hct (low, anemic)
- ESR (inflammation indicator)
- alkaline phosphates (enzyme re: bone reabsorption rate, UP levels when immobilized or liver damage etc.
- Radiographic (Xrays)
Ankylosis Spondylitits (AKS): MM/NI
- Analgesics, NSAIDs
- Exercise program; swimming/walking
- Sx, replace fused joints
- maintain spine alignment (firm mattress ,bed board, back brace)
- turn, position, breathing q2hrs (prevent ulcer, log roll w spine sx.)
- MED: *Indocin, *Naproxin, NSAIDs
Osteoarthritis
-Degenerative joint disease. Non systemic, noninflammatory.
-progressively causes bones and joints to degenerate
-r/t aging,
NO REDNESS, NO SWELLING
-most pts over 60 yrs will exhibit some osteoarthritic changes
-WOMEN (hands)
-Men (Hips)
CAUSE:
Primary: Unknown
Secondary: trauma, infections, fx,RA, stress on weight bearing joints.
Osteoarthritis: SS
-pain, stiffness
