Musculoskeletal system Flashcards
What are the two classifications of joints?
by the material between them (fibrous, cartilaginous, synovial)
OR
their degree of movement
(immovable: synarthrodial aka: skull suture, slightly moveable joints are amphiarthrodial aka: symphysis pubis, and freely movable joints are diarthrodial aka: the knee and distal interphalangeal DIP joint of distal fingers
Flexion vs Extension (elbow, hips, neck)
Flexion: bicep show off
Extension: knife hands at sides
Abduction vs Adduction (shoulder)
Abduction: Lift arms away from body
Adduction: Arms towards body
Pronation vs Supination (elbow/wrist/hand)
Pronation: Palm down
Supination: Palm up
Protraction vs Retraction (jaw)
Protraction: Chin out
Retraction: Chin tucked
Circumduction (shoulder)
Softball toss (shoulder rotates 360)
Rotation (head)
Turn head left and right
Elevation vs Depression (shoulder)
Elevation: Shoulder shrug up
Depression: Shoulder shrug down
Name the 8 important joints
Temporomandibular
Spine
Shoulder
Elbow
Wrist and Carpals
Hip
Knee
Ankle/Foot
What are the 3 types of muscles?
Smooth, cardiac, and skeletal
How many bones/cartilage in skeleton?
206
How to inspect temporomandibular joint (TMJ)
Palpate for smooth movement (up and down) for Sounds (clicks) and tenderness. Observe jaw for ROM. Motion smooth, without pain. Protrude and retract chin without pain or difficulty.
How to inspect the shoulder joint
Structures smooth, regular, bilaterally symmetrical; shoulders
level, rounded, firm, smooth contour, no bony prominences or
crepitus. Each shoulder equidistant from vertebral columns.
Hand behind head, hand on small of back, standing superman, shoulder shrug strength test
How to inspect the elbow joint
Inspect size and contour in flexed and extended
positions. Palpate elbow flexed at ~ 70 degrees and relaxed.
Look for deformity, redness, or swelling. Note heat, swelling, tenderness, or nodules
Test muscle strength by stabilizing arm with one hand, flex elbow against resistance applied just proximal to wrist. Extend elbow against resistance
How to inspect the wrists and hands
Inspect and palpate. “Skin appears smooth with knuckle
wrinkles present and no swelling or
lesions; muscles appear fully
developed”. “Joint surfaces feel
smooth, without swelling,
bogginess, nodules, or tenderness”
Test ROM and muscle strength. Bend hand up and down at wrist,
bend fingers up and down at joints,
spread fingers apart, make a fist,
touch thumb to each finger and
base of little finger, turn palms
outward and in while on a flat
surface. Position forearm palm up and
resting on a flat surface; stabilize at
midforearm; instruct to flex wrist
against resistance at palm
How to inspect the Hip
inspect and palpate: STANDING Note symmetric levels of iliac crests, gluteal folds,
and equally sized buttocks
Smooth, even gait reflects equal leg lengths and functional
hip motion
Help person into supine position and palpate hip
joints
joints should feel stable and symmetric, with no tenderness
or crepitation
Asses ROM: LYING DOWN leg up foot 90 degree to hip knee straight. Leg up knee bent move leg further than 90 degrees back. Both legs down legs together slide one leg as far to side as can. Reset legs together knee bent foot on floor lay knee on one leg and law it on outside of body.
How to inspect the ankle and foot
INSPECT sitting, standing and walking
* Compare feet, noting contour of joints
and foot alignment
* Weight-bearing should fall on middle
of foot
* Toes point straight forward and lie flat;
note locations of calluses as they
reveal areas of abnormal friction
Support ankle and palpate joint
spaces; should feel smooth, with no
swelling or tenderness. Palpate metatarsophalangeal; note
swelling, inflammation or tenderness.
Instruct to point toes up and
down, soles of feet in and out. Ability to maintain
dorsiflexion and plantar
flexion against resistance
What are the Activities of Daily Living, according to the Katz Index?
bathing, dressing, toileting, transferring, continence, and feeding
What health history questions would you ask a person to determine if the individual is having a problem with the musculoskeletal system
Any chronic diseases?
Loss of bone density or
osteoporosis?
Take medications? Pain meds?
Any changes in ability to move during
usual activities?
Changes in muscle strength? How did
you adapt to changes?
Accidents? Trauma? Surgery on bones or
joints?
* If yes, what was the outcome?
history of:
Arthritis?
* Rheumatoid arthritis? Osteoarthritis?
* Gout?
Curvature of spine?
Back problems in your family?
Muscular problems?
Do you exercise?
* How often?
* Sports?
* Which ones, and how often?
* Protect yourself from injury while
exercising or playing sports?
* Do you lift, push, pull, bend, or stoop
frequently as part of daily routine at
home or work?
* How do you protect yourself from
muscle strain or injury?
What are common problems in musculoskeletal system?
What are physical findings of RA and OA?
RA: Osteoporosis. >50 y.o.
Women
Caucasians and Asians have increased risk
Family hx
Smoking, alcohol, diet low in Ca++
Inadequate weight bearing
Low estrogen, testosterone
OA: Arthritis
Increases with age
Women > men
Overweight
Joint injury
Occupations/sports involving repeated knee bend or squatting
Family hx
Identify the muscles for which strength testing is appropriate and describe how to conduct the test.
Upper and lower extremities. Ask person to flex the muscle being evaluated
and then to resist when you apply opposing
force against it
How do you inspect the spine for scoliosis?
Inspect & Palpate shoulders and cervical,
thoracic, and lumbar spine for alignment and
symmetry and pain/tenderness
How do you assess gait? balance? What are expected findings for each test, how do you document results if abnormal?
Observe gait for conformity,
symmetry, and rhythm.
* Expected: “Regular
smooth rhythm, leg
swing, length symmetry,
and smooth symmetric
arm swing.”
Abnormal: An nunstable.exaggerated gait, limp, irregular strdide length, arm swing unrealted to gait,
Be able differentiate the subjective data from objective data for the musculoskeletal system.
What health history questions are asked about the problems associated with the musculoskeletal system?
