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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
What is included in inspection
- joint: size and contour - color - swelling - deformity including masses - crepitus
26
What is included in palpation
- temperature - swelling - masses - only an abnormal synovial membrane is palpable (inflamed or warm)
27
Where to assess skeletal muscles
- head/neck - temporomandibular joint (TMJ) - spine - upper extremities: shoulder, elbow, wrist, hand - lower extremities: hip, knee, ankle, foot
28
Assessment with landmarks
- 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
What is the temporomandibular joint (TMJ)
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
Pain locations with the spine
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
Shoulder information
ball-and-socket rotator cuff - four muscles - tendons - glenohumeral joint palpable landmarks: - acromion process - greater tubercle
32
Elbow
three bony articulations - hinge action landmarks: - medial epicondyle (humerus) - lateral epicondyle (humerus) - olecranon process (ulna)
33
Wrist and Hand
- radiocarpal joint - condyloid action -- flexion -- extension -- side to side
34
Hip
less mobility than shoulder but stronger; has greater weight bearing ability landmarks: - anterior superior iliac spine (ASIS) - ischial tuberosity - greater trochanter
35
Possible hip movements
flexion extension abduction (AWAY) adduction external/internal rotation
36
Knee
largest joint in the body three bones involved: - femur - tibia - patella hinge joint landmarks: - patella - tibial tuberosity - quadriceps muscle - ligament supports
37
Ankle and foot
- 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
What is active ROM
the individual moves a body part on their own without assistance
39
What is passive ROM
when someone or something else moves the body part for the individual
40
What is muscle testing
- muscle strength is graded on a scale of 0 to 5 - assesses person's ability to resist gravity
41
Muscle testing/strength grading scale: 0 to 5
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
Joint movements (just list of movements)
flexion extension abduction adduction pronation supination circumduction inversion eversion rotation protraction retraction elevation depression
43
What is a goniometer
an instrument for the precise measurement of angles, like within joints
44
Musculoskeletal abnormalities
- inflammatory conditions (rheumatoid arthritis) - degenerative conditions (osteoarthritis; osteoporosis) - dislocation - subluxation - fracture - effusion - torn rotator cuff - tennis elbow - carpal tunnel syndrome - scoliosis
45
What is subluxation
incomplete or partial dislocation of joint or organ
46
Soft tissue injuries
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
Management of soft tissue injury
- usually soft tissue injuries are self-limiting - RICE - surgical repair if severe - x-ray to r/o fracture
48
What is hemarthrosis
bleeding into joint spaces
49
Assessing for the 6Ps with injury
- pulses - pallor - pain - paresthesia - paralysis - poikilothermia
50
What is poikilothermia
inability to regulate core body temperature
51
What is paresthesia
burning or prickling sensation usually in hands, arms, legs or feet burning, itching, tingling, prickling, numbness, pins, needles, heat or cold
52
Degenerative conditions: Osteoarthritis
-Most common joint disease - Slowly progressive, non-inflammatory disorder - Cartilage damage -- Secondary synovitis - Aging women - Systemic and local signs and symptoms
53
Degenerative conditions: Osteoporosis
- 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
Osteoarthritis (DJD)
- bone ends rub together - thinned cartilage
55
Rheumatoid arthritis
- swollen inflamed synovial membrane - bone erosion
56
Knee pain
Swelling - from fluid accumulation -- bulge sign -- ballottement Meniscal tears
57
What is the bulge sign in fluid accumulation in knee pain
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
What is ballottement in fluid accumulation in knee pain
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
Carpal tunnel syndrome
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
Promoting bone health / preventing OA
Diet - milk, fish, greens, soy - calcium supplements - vitamin D Exercise - weight training - lifestyle changes Annual exam - measure height - bone density tests

NUR 502 (13 decks)

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