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NUR 502 > Musculoskeletal System (complete) > Flashcards

Musculoskeletal System (complete) Flashcards

1
Q

What are the components of the musculoskeletal system?

A

Bones (axial and appendicular)
Cartilage
Joints
Bursae
Ligaments
Tendons
Muscles

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2
Q

How many bones are there? How many of each type?

A

Axial - 80; skull, ribs, vertebral column
Appendicular - 126; limbs, shoulders, feet, hands, wrist

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3
Q

What are the functions of bone

A
  • provides structure
  • provides protection
  • enables voluntary movement
  • stores minerals: calcium
  • produce blood cells: hematopoiesis
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4
Q

Components of bone structure

A

Epiphysis - muscle attachment
Diaphysis - Shaft
Metaphysis - between epiphysis and diaphysis
Epiphyseal plate - growth plate
Periosteum - thin membrane

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5
Q

Info about bones

A

have a dynamic metabolism, with continuous turnover and remodeling

connective tissue

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6
Q

How are bones classified

A

long, short, flat or irregular

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7
Q

What are joints

A

articulations; connect two or more bones, allowing mobility

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8
Q

What are the types of joints

A

Synovial joints
Nonsynovial joints
- cartilaginous and fibrous

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9
Q

What are synovial joints

A

freely moveable, opposing bones are separated and enclosed in a joint cavity filled with synovial fluid

ex: knee, shoulder

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10
Q

What are nonsynovial joints

A

joined by fibrous tissue or cartilage; immovable or slightly moveable

cartilaginous and fibrous

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11
Q

What is cartilage? what does it do

A
  • it is a connective tissue
  • allows bones to glide over each other
  • covers the opposing bone surface
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12
Q

What are bursae

A

fluid-filled sacs

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13
Q

What are ligaments? what do they do

A
  • fibrous bands that go from one bone to another
  • help strengthen joint
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14
Q

What do tendons do

A

connect muscle to bone

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15
Q

What are the three types of muscle

A

skeletal, smooth, cardiac

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16
Q

Developmental considerations in pediatrics

A

concern for damage to epiphyseal plate (growth plate)

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17
Q

Developmental considerations in pregnancy

A
  • hormones increase joint mobility
  • lordosis
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18
Q

What is lordosis

A

a condition where the lower back has an exaggerated inward curve
can cause the buttocks to appear more prominent

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19
Q

Developmental considerations in older adults

A
  • osteoporosis
  • postural change
    – decreased height
    – kyphosis
  • loss of height and sub-Q fat
  • decreased fat in periphery with re-deposition to abdomen and hips
  • bony prominences become more obvious
  • decreased muscle and bone strength
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20
Q

What is kyphosis

A

spinal deformity that causes the upper back to curve abnormally

rounded or hunched appearance

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21
Q

Implications of decreased muscle strength and bone strength in older adults

A
  • increased risk for weakness which leads to reduced ability to function
  • person less willing to walk
    – results in immobility issues
  • walking: one of the most important methods of sustaining independence
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22
Q

Types of spinal abnormalities

A

kyphosis, lordosis, scoliosis

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23
Q

Focused questions to ask on

A
  • pain: location, pattern, radiating, quality, severity
  • warmth
  • redness or swelling
  • stiffness: intermittent or continuous
  • movement limitations: issues with ROM
  • remitting or exacerbating factors
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24
Q

Objective components of assessment

A

inspection
palpation
- tone
ROM
muscle testing

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25
Q

What is included in inspection

A
  • joint: size and contour
  • color
  • swelling
  • deformity including masses
  • crepitus
26
Q

What is included in palpation

A
  • temperature
  • swelling
  • masses
  • only an abnormal synovial membrane is palpable (inflamed or warm)
27
Q

Where to assess skeletal muscles

A
  • head/neck
  • temporomandibular joint (TMJ)
  • spine
  • upper extremities: shoulder, elbow, wrist, hand
  • lower extremities: hip, knee, ankle, foot
28
Q

Assessment with landmarks

A
  • find the landmarks
  • begin at the most proximal joint of extremity
  • move distally with grasping movements: any abnormal findings?
  • incorporate passive ROM: support the joint
29
Q

What is the temporomandibular joint (TMJ)

A

formed by the fossa and articular tubercle of the temporal bone and the condyle of the mandible

Functions:
- hinge: open and close
- gliding: protrusion and retraction
- gliding: side-to-side at lower jaw (lateral)

30
Q

Pain locations with the spine

A

if pain is midline -> over the spinal processes of the vertebrae

if pain is off the midline -> in the paraspinal muscles surrounding the spine

31
Q

Shoulder information

A

ball-and-socket

rotator cuff
- four muscles
- tendons
- glenohumeral joint

palpable landmarks:
- acromion process
- greater tubercle

32
Q

Elbow

A

three bony articulations
- hinge action

landmarks:
- medial epicondyle (humerus)
- lateral epicondyle (humerus)
- olecranon process (ulna)

33
Q

Wrist and Hand

A
  • radiocarpal joint
  • condyloid action
    – flexion
    – extension
    – side to side
34
Q

Hip

A

less mobility than shoulder but stronger; has greater weight bearing ability

landmarks:
- anterior superior iliac spine (ASIS)
- ischial tuberosity
- greater trochanter

35
Q

Possible hip movements

A

flexion
extension
abduction (AWAY)
adduction
external/internal rotation

36
Q

Knee

A

largest joint in the body
three bones involved:
- femur
- tibia
- patella

hinge joint

landmarks:
- patella
- tibial tuberosity
- quadriceps muscle
- ligament supports

37
Q

Ankle and foot

A
  • total weight of the body is transmitted through the ankle and foot
  • balance the body and absorbs the impact of walking
  • hinge joint
    – tibia, fibula, talus
  • landmarks:
    – medial malleolus
    – lateral malleolus
38
Q

What is active ROM

A

the individual moves a body part on their own without assistance

39
Q

What is passive ROM

A

when someone or something else moves the body part for the individual

40
Q

What is muscle testing

A
  • muscle strength is graded on a scale of 0 to 5
  • assesses person’s ability to resist gravity
41
Q

Muscle testing/strength grading scale: 0 to 5

A

5: Active movement against full resistance without evident fatigue.
4: Active movement against gravity and some resistance
3: Active movement against gravity
2: Active movement of the body part with gravity eliminated (planar motion)
1: A barely detectable flicker or trace of contraction
0: No muscular contraction detected

42
Q

Joint movements (just list of movements)

A

flexion
extension
abduction
adduction
pronation
supination
circumduction
inversion
eversion
rotation
protraction
retraction
elevation
depression

43
Q

What is a goniometer

A

an instrument for the precise measurement of angles, like within joints

44
Q

Musculoskeletal abnormalities

A
  • inflammatory conditions (rheumatoid arthritis)
  • degenerative conditions (osteoarthritis; osteoporosis)
  • dislocation
  • subluxation
  • fracture
  • effusion
  • torn rotator cuff
  • tennis elbow
  • carpal tunnel syndrome
  • scoliosis
45
Q

What is subluxation

A

incomplete or partial dislocation of joint or organ

46
Q

Soft tissue injuries

A

Sprain: ligament damage from twisting
- 1st, 2nd, or 3rd degree

Strain: excessive muscle stretch, sheath, or tendon
- usually in large muscle groups
- when severe, patient may have hemarthrosis

47
Q

Management of soft tissue injury

A
  • usually soft tissue injuries are self-limiting
  • RICE
  • surgical repair if severe
  • x-ray to r/o fracture
48
Q

What is hemarthrosis

A

bleeding into joint spaces

49
Q

Assessing for the 6Ps with injury

A
  • pulses
  • pallor
  • pain
  • paresthesia
  • paralysis
  • poikilothermia
50
Q

What is poikilothermia

A

inability to regulate core body temperature

51
Q

What is paresthesia

A

burning or prickling sensation usually in hands, arms, legs or feet

burning, itching, tingling, prickling, numbness, pins, needles, heat or cold

52
Q

Degenerative conditions: Osteoarthritis

A

-Most common joint disease
- Slowly progressive, non-inflammatory disorder
- Cartilage damage
– Secondary synovitis
- Aging women
- Systemic and local signs and symptoms

53
Q

Degenerative conditions: Osteoporosis

A
  • bone becomes porous
  • progressive and chronic
  • 80% women in those diagnoses
  • high risk for fracture
  • “silent disease”
    – back pain
  • monitor bone mineral density (BMD)
54
Q

Osteoarthritis (DJD)

A
  • bone ends rub together
  • thinned cartilage
55
Q

Rheumatoid arthritis

A
  • swollen inflamed synovial membrane
  • bone erosion
56
Q

Knee pain

A

Swelling
- from fluid accumulation
– bulge sign
– ballottement

Meniscal tears

57
Q

What is the bulge sign in fluid accumulation in knee pain

A

simple physical exam that can help identify people at higher risk for developing OA

To perform:
- gently press inside of patella
- move hand up
- press firmly on outside of knee
- if inside of knee bulges out after applying pressure on the outside, this is a positive bulge sign

58
Q

What is ballottement in fluid accumulation in knee pain

A

AKA patellar tap test
medical procedure that can help determine if there is excess fluid in the knee joint

To do: (patient lying on back with knee extended)
- push down on front of leg to move fluid to the knee
- gently tap patella while applying pressure with other hand

Positive result: if patella floats or bounces - indicates excess fluid in knee joint

always compare to opposite knee

59
Q

Carpal tunnel syndrome

A

relates to median nerve problem

Phalen test: patient holds wrists flexed and backs of hands pressed together for 30-60 seconds
- positive result: pain, tingling, or numbness in thumb, index, middle and half of ring finger
- positive results indicates pressure being applied to median nerve in wrist

60
Q

Promoting bone health / preventing OA

A

Diet
- milk, fish, greens, soy
- calcium supplements
- vitamin D

Exercise
- weight training
- lifestyle changes

Annual exam
- measure height
- bone density tests

NUR 502 (10 decks)

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