Module 15: Musculoskeletal

Question 1

What are articular structures?

Answer 1

The joint capsule and articular cartilage, the synovium and synovial fluid, intra-articular ligaments, and junta-articular bone.

Question 2

What are the extra-articular structures?

Answer 2

periarticular ligaments, tendons, bursae, muscle, fascia, bone, nerve, and overlying skin.

Question 3

What are ligaments?

Answer 3

Rope like bundles of collage fibrils that connect bone to bone.

Question 4

What does articular disease involve?

Answer 4

Swelling and tenderness of the entire joint and limits active and passive range of motion.

Question 5

What is all involved with extra-articular disease?

Answer 5

Selected regions of the joint and types of movement.

Question 6

What are tendons?

Answer 6

Collage fibers connecting muscle to bone.

Question 7

What is cartilage?

Answer 7

Collagen matrix that overlies bony surfaces.

Question 8

What are bursae?

Answer 8

Pouches of synovial fluid that cushion the movement of tendons and muscles over bone or other joint structures.

Question 9

What is the extent of movement of the synovial joint?

Answer 9

Freely moveable. The bones do not touch each other. Ex: knee, shoulder

Question 10

What is the extent of movement of the cartilaginous joint?

Answer 10

Slightly movable. Fibrocartilaginous discs separate the bony surfaces. Ex: vertebral bodies of the spine.

Question 11

What is the extent of movement of the fibrous joint?

Answer 11

Immoveable. Intervening layers of fibrous tissue or cartilage hold the bones together. Ex: Skull sutures.

Question 12

What are some times of synovial joints?

Answer 12

• Spheroidal (ball and socket)-rounded convex surface articulating with a cup-like cavity.
• Hinge -flat, planar, or slightly curved, allowing only a gliding motion in a single plane.
• Condylar - the articulating surfaces are convex or concave, termed condyles.

Question 13

What do bursae do?

Answer 13

Ease joint action. They are roughly disc-shaped synovial sacs that allow adjacent muscles or muscles and tendons to glide over each other during movement.

Question 14

What are some common or concerning symptoms?

Answer 14

• LBP
• Neck pain
• Monoarticular or polyarticular joint pain
• Inflammatory or infectious joint pain.
• Joint pain with systemic features such as fever, shills, rash, anorexia, weight loss, weakness.
• Joint pain with symptoms from other organ systems.

Question 15

Tips for assessing joint pain?

Answer 15

• Point to the pain.
• Clarify and record the mechanism of injury
• Determine whether the pain is localized or diffuse, acute or chronic, inflammatory or non-inflammatory.

Question 16

If a patient c/o midline back pain (over the vertebrae) what would you assess for?

Answer 16

musculoligamentous injury, disc herniation, vertrebral collapse, spinal cord metastases, or rarely epidural abscess.

Question 17

What would assess in a patient that c/o off midline pain?

Answer 17

sacroilitis, trochanteric bursitis, sciatica, or hip arthritis.