muscle skeletal Flashcards
STRUCTURE AND FUNCTION
Bones’ function:
Support: body’s framework
Protection: of vital organs
Movement: locomotion, attachment site for muscles.
Hematopoeisis: production of blood cells
Mineral storage: ca+ and PO4
gross structure - what is bone made of? (3 things)
Previously considered as an inert substance, Bone is actually a dynamic tissue that is constantly regenerating.
Remodeling: old bone is broken down and new bone is made.
Bone is made of :
Collagen
Calcium
phosphate
GROSS STRUCTURE: TYPES OF BONES (know this) (just 2)
Compact (dense, cortical):
cylinder shaped
Cancelous ( spongy ):
Spongy network filled with either red or yellow marrow
Epiphysis:
Epiphysis: End of long bones
Articular cartilage: (articulate the ends)
Articular cartilage: covers the ends of bones providing a smooth surface for joint movement.
Diaphysis (di shaft)
Diaphysis : main shaft of the bone (dense bone)
Metaphysis (meta middle)
Metaphysis : area between the end of bone and shaft. It contains epiphyseal plate
Epiphyseal plate (Growth plate) (long epi)
Epiphyseal plate (Growth plate): responsible for longitudinal growth in children. By 18, it hardens and fuses into mature bone.
Periosteum (connect w/ peri)
Periosteum : fibrous connective tissue that covers the bone.
Medullar Cavity - has what?
Medullar Cavity: contains bone marrow ( either red or yellow depending on age)
MICROSCOPIC STRUCTURE of BONE: (know this) - 3 types of bone cells
Three types of bone cells
Osteoblasts (OSSIFICATION)
Osteocytes
Osteoclasts (RESORPTION)
JOINTS - 3 types (amp joints are synful)
Definition: a place where two bones articulate
Joints are classified by the degree of movement they allow:
Synovial:
Synarthrotic:
Amphiarthrotic:
MUSCLE: THREE TYPES
CARDIAC :
SMOOTH: involuntary:
Walls of organs , GI tract, bladder
SKELETAL:
Largest mass of tissue in the body
Require neural stimulation to contract.
CONTRACTION OF SKELETAL MUSCLES (don’t memorize, just know they need neural stimulation)
CNS causes release of Acetylcholine at the motor end plate
This innervation causes Calcium to be released.
Calcium stimulates Actin and Myosin in the sarcomeres to slide closer together, resulting in muscle contraction
When Calcium is depleted Actin and Myosin fibers move apart, causing relaxation of the sacromeres which relaxes the muscle.
Tendon
Tendon : band of fibrous tissue that connects muscle to bone.
EFFECTS OF AGING ON THE MS SYSTEM
Bone remodeling with increase resorption (osteoclastic) and decreased osteoblastic activity
Decrease height (compression of vertebral bodies)
Dowager’s hump (kyphosis)
↓ bone density leading to osteoporosis
DJD/OA may occur.
30% of muscle mass lost by age 80’s.
Joints, tendons, and ligaments harden (Stiff, rigid)
Many of MS changes seen in aging can be halted or reversed with appropriate preventive strategies.
EXERCISES FOR THE ELDERLY WOULD INCLUDE:
FLEXION (yoga, stretching)
BALANCE (tai chi, balancing)
WEIGHT BEARING
Walking, running
STRENGTHENING
Free weight lifting…
assessment - SUBJECTIVE DATA:
CC (Chief complaint) Right great toe pain
HPI (History of present illness) 56 y/o WM noted fast onset of R great toe pain. Denies trauma
ROS (Review of systems) No complaints
PMH (Past medical history) No previous hx of similar sxs, no HIV, DM..
ALLERGIES/ MEDS? NKDA, no meds
SH/FH (social and family history) No IVDU, Drugs, smoking, family hx of gout
assessment - OBJECTIVE DATA
INSPECTION
General body build, posture
Symmetry, deformity
Skin discoloration, swelling, masses
ROM (range of motion)
Degree’s of flexion/Extension 0-360 degree’s
Arm-abduct 180°, Knee-flex 130°, Neck-rotate 90°
PALPATION
Point tenderness, palpation tenderness
Crepitation
Warmth, coolness
MUSCLE STRENGTH TESTING
GRADING RUE, LUE, RLE, LLE
5/5 Movement against gravity with full resistance
4/5 Movement against gravity with some resistance
3/5 Movement against gravity only
2/5 Movement with gravity eliminated
1/5 Visible or palpable muscle contraction only (bedbound)
0/5 No contraction
REFLEXES (just numbers)
GRADING
4+ = Hyperactive
with clonus
3+ = Hyperactive
2+ = Normal
1+ = Hypoactive
0 = No reflex
MOVEMENT OF JOINTS - FLEXION
FLEXION: Decreasing angle between two bones
common deformities - lordosis
Lordosis:
Sway to lower back
MSK SOFT TISSUE INJURIES - sprain - what is injured?
SPRAIN: Injury to ligaments surrounding a joint. Usually caused by wrenching or twisting motion
BONE HEALING (bleed granola, add calcium 1st week, ossify and remodel)
FRACTURE HEMATOMA: BLEEDING AT BROKEN ENDS OF BONE WITH HEMATOMA FORMATION
GRANULATION TISSUE: ORGANIZATION OF HEMATOMA INTO GRANULATION TISSUE
CALLUS FORMATION: CALCIUM, PHOSPHORUS, AND MAGNESIUM ARE DEPOSITED IN THE FRACTURE AREA. USUALLY STARTS AFTER THE FIRST WEEK.
OSSIFICATION: OSSIFICATION OF THE CALLUS BEGINS WITHIN 2 TO 3 WEEKS.
CONSOLIDATION: CALLUS CONTINUES TO DEVELOP AND DISTANCE BETWEEN BONE FRAGMENTS ↓’s.
REMODELING: EXCESS TISSUE AND DEAD BONE IS ABSORBED BY OSTEOCLASTS. NEW BONE IS LAID DOWN BY OSTEOBLAST. COMPLETE BONY UNION.
he gave capt oliver cooked ravioli
bone healing
periostium - what does it do? and what direction of growth? (peri is an anchor for tendon and bone. he is trans)
Anchor site for tendons and muscles. It is essential in transverse bone growth.
Synovial (free to syn)
Synovial: freely moving and the most common
Synarthrotic (arthrotic skull)
Synarthrotic: no movement: I.E skull
Amphiarthrotic (amphibian)
Amphiarthrotic: allows for slight movement. I.E vertebrae
movement - EXTENSION
EXTENSION: Increasing angle between two bones
movement - HYPEREXTENSION
HYPEREXTENSION: Extreme extension
movement - ABDUCTION
ABDUCTION: Moving part away from the midline
movement - ADDUCTION
ADDUCTION: Moving part toward the midline
movement - PRONATION
PRONATION: Palm downward, or sole outward
movement - SUPINATION:
SUPINATION: Palm upward, or sole inward
movement - CIRCUMDUCTION
CIRCUMDUCTION: Circular motion of part (shoulder)
movement - ROTATION
ROTATION: Movement about longitudinal axis (head turning)
movement - INVERSION
INVERSION: Turning sole inward toward midline
movement - EVERSION
EVERSION: Turning sole outward away from midline
deformities - Scoliosis
Scoliosis:
Lateral curvature of the spine ( S shaped spine)
deformities - Kyphosis (down ky)
Kyphosis:
Commonly known as the Dowager hump
Excessive curvature of the thoracic spine.
Tends to progress with age
STRAIN - and what part? (strain the sheath)
STRAIN: Stretching of a muscle and its fascial sheath
dislocation
DISLOCATION: Complete displacement or separation of the articular surfaces of a joint.
SUBLUXATION - and what part of the body? (join the sublax)
SUBLUXATION: Incomplete or partial displacement of the articular surfaces of a joint.
Osteoblasts (OSSIFICATION)
Basic bone-forming cells
Makes new bone
Osteocytes (mature cyte)
Mature bone cells
Osteoclasts (RESORPTION)
Break down and remove old bone tissue
Ligament
Fibrous tissue that connects bone to bone.
Bursa
small fluid filled sac lined by synovial fluid.
Fascia (connect the fascist)
connective tissue that surrounds muscle, blood vessels and nerves,
