Musculoskeletal System Flashcards
structure and fnx of the musculoskeletal system
consists of the body’s bones, joint & muscles
1. support to stand erect
2. mvmt
3. encase and protect vital organs
4. protects red blood cells, white blood cells & platelets in bone marrow (hematopoiesis)
5. reservoir for storage of esssential minterals i.e calcium and phosphorus
structure and fnx
* there are 206 bones
Joints
- Place of union between two or more bones
- Functional units of MSK system – permit mobility needed for ADL’s
- Fibrous joints – bones united by fibrous tissue or cartilage. Immoveable. (Sutures in skull)
- Cartilaginous joints – separated by fibrocartilaginous discs. Slightly moveable. Vertebrae
- Synovial joints – freely moveable because bones are separated from one another and enclosed in joint cavity. Cavity is lined with synovial membrane that secretes lubricated synovial fluid that allows for sliding of opposing surfaces.
Cartilage
* Avascular
* Tough, firm consistency, yet flexible
* Absorbs shock and allows bones to move over one another due to smooth surface
structure and function
Ligaments
Connect bone to bone; stabilizes bone and limits movement
Bursae
Fluid filled sacs that cushion bones & ligaments
Located in areas of potential friction (shoulder, prepatellar of knee)
Tendons
Connect muscle to bone
Strong, fibrous cord
Muscles
40%-50% of body weight
Give the body shape
facilitate movement through joints
skeletal muscle is under conscious control
inspection of muscuoskeletal
*Note:
Size, Contour, color, swelling, masses, or deformities
Swelling is significant and signals joint irritation. Always compare to other side.
Swelling = excess joint fluid, inflammation of surrounding tissue, or bony enlargement
Deformities:
Fracture – break in bone
Dislocation – complete loss of contact between two bones in a joint
Subluxation– two bones in joints stay in contact, but their alignment is off
Contracture – shortening of a muscle leading to limited ROM in joint
Ankylosis – stiffness or fixation in joint
palpation of the MSK
Palpate each joint:
Temperature, Tenderness, Swelling, Masses
Warmth and tenderness = inflammation
muscle strength
- Muscle strength should be equal bilaterally.
- This is a part of every head to toe assessment.
- Have patient grip hands.
- Press down on hands, then up. Repeat with feet/legs.
- Grade muscle strength
grade 0-5, 5 being normal, 4 is good, 3 is fair, 2 is poor, 1 is trace & 0 is zero
range of motion
Start with active motion
* The patient moves the body part themselves
* Demonstrate movement if needed
Passive motion:
- If limitations are assessed, gently help the patient move the body part. Anchor with one hand while you other hand slowly move it to its limit
- ROM should be equal bilaterally.
Crepitation= audible and palpable crunching or grating that accompanies movement. Occurs when articular surfaces in joints are roughened (Rheumatoid arthritis)
range of motion-Temporomandibular joint
- Have patient remain seated, inspect area just above ear
- Place tips of fingers in front of each ear and have person open and close mouth then clench jaw.
- Should feel smooth movement of the mandible
- Some people may have audible click or palpable snap as mouth opens.
- Note any swelling
- TMJ dysfunction = crepitus and pain during movement or chewing. Tenderness with palpation.
- Decrease ROM = TMJ inflammation or arthritis
range of motion- cervial spine
flexion- touch chin to chest
extension- lift chin towards ceiling
lateral bending- touch ear to shoulders
rotation- turn chin towards shoulder
ROM- Hands and Wrists
Extension
Bend hand up at wrist
Flexion
Bend hand down at wrist
Ulnar Deviation
With palms flat, turn them outward and in (like your hands were shaking head no)
Abduction
Tight fist
Adduction
Spead fingers apart
Phalen Test
Hold both hands back to back. If patient has carpal tunnel it will cause numbness and burning.
ROM- Hips
Hip Flexion (90 degrees)
Raise leg with knee extended
Hip Flexion (120 degrees)
Bend knee and raise leg, while other leg remains straight
Internal and external rotation
Flex knee and swing foot outward and inward
Abduction and Adduction
Swing leg laterally, then medially
ROM-Ankle and Foot
Plantar Flexion
Point toes towards floor
Dorsiflexion
Point toes towards nose
Eversion
Turn soles of feet out
Inversion
Turn soles of feet in
Pregnancy MSK
- lordosis is the most characteristic posture chage
- torward the 3rd trimester, may experience anterior cervical flecion, kyphosis and slumped shoulders
Aging adult MSK
- bone remodeling occurs which is the cyclic process of bone reabsorption and and deposistion responsible for skeletal maintance at sites that need repair or replacement
- may experience a decrease in height and slight flexion of the hips and knees
adolescence MSK
- kyphosis is common because of poor posture (scoliosis screening should be completed)