week 5: musculoskeletal sys Flashcards
how many bones for supporting the body
206!
what is a joint
Place of union of 2+ bones; aids in mobility (activities of daily living; ADL’s)
non synovial joints
Not freely moveable, slightly moveable (ex., skull, vertebrae)
synovial joints
Freely moveable, bones are separated, has enclosed cavity
- Cavity has synovial fluid, covered with cartilage on bone surface
- Ligaments support joint: Fibrous bands from one bond to other, strengths the joint and prevents undesired movement
developmental considerations for bones: infants/children
Has a single C-shaped curve to the spine at birth
Secondary anterior curves in cervical (3-4 months) and lumbar (12-18 months)
Bones lengthen at the epiphyses (growth plates); trauma or infection can deform
Longitudinal growth continues until closure at around 20 years
developmental considerations for older adults
Resorption/Bone Loss happens more than Deposition/Bone Growth; osteoporosis happens, vertebral column shortens, calcium is lost
Postural changes: Kyphosis (humpback), backward head tilt, knee/hip flexion, balance
Losing subcutaneous fat: Bones get bonier; bony prominences seem sharper
Losing muscle mass = weakness
Lifestyle (exercise, weightlifting) can prevent, delay changes
flexion
Bending limb at joint
extension
Straightening a limb at joint
abduction
Move limb away from midline
adduction
Move limb towards midline
pronation
Turning palms down
supination
Turning palm up
circumduction
Moving arm in a circle around shoulder
inversion
Turning sole of foot in
eversion
Turning sole of foot out
rotation
Moving head around central axis
protraction
Moving body part forward parallel to ground (ex., jaw forward)
retraction
Moving body part backward parallel to ground
elevation
Raising body part (ex., shoulders)
depression
Lowering body part
disorder examples
Arthritis, Osteoporosis, Gout, Lower Back DIsorders, Fractures/Dislocations, Joint replacements (hips and knees), amputations
osteoporosis
Decrease in bone mass and density
Tested with bone mineral density for women/men over 65, those with fractures over 40 or a family history of osteoporotic fractures, or use of steroids for >3 months
osteoporosis risk factors
Women moreso than men, the older you get, if you’re white/Asian, if you have a family history, if you’ve had a hip fracture, if you have a small frame (you have less overall bone mass)
Hormone levels (too much/little), lowered sex hormones, thyroid hormones or other gland issues (overactive parathyroid/adrenal)
DIET: Low calcium, vitamin D, eating disorders (less intake and therefore less calcium), GI surgery (less absorption), taking steroids, lifestyle choices
osteoporosis prevention
Diet: Including milk, fish, greens, soy, onions, reducing caffeine
Exercise: Doing weight-bearing exercises (do you even lift bro)
Lifestyle: Reducing smoking and alcohol
Supplements: Calcium and Vitamin D
hand problems
Rheumatoid Arthritis (thick knuckles):
Bouchard (Proximal IP joint) nodes and Heberden’s (Distal IP joint) nodes
Swan Neck deformity (knuckles “swan neck” inward)
Ulnar Deviation (it’s like way up)
subjective assessment: joints
Have you had any problems or pain with any of your joints?
Where is it (both sides), how does it feel/strength, when did it start, when does it happen/how long does it last, what makes it better/worse?
Indicative of arthritis, rheumatoid arthritis, osteoarthritis
Is there any stiffness in your joints?
Is there any swelling, redness, or heat? (acute inflammation)
Any limitation of movement and in which joint?
subjective assessment: muscles
Have you had muscle problems like pain or cramping? (myalgia = weakness/pain)
Is there any weakness in the muscles? Where, how long?
Claudication: Leg cramps, in calf, peripheral vascular disease, reduced O2
subjective assessment: bones
Any bone pain? Is it affected by movement?
Any deformities of bone/joint? What caused it? Does it affect your ROM?
Any accidents/trauma to your bones like fractures, dislocations, sprain, joint strain?
functional assessment
Do your problems affect any Activities of Daily Living? Which ones?
Bathing, Toileting, Dressing, Grooming, Eating, Mobility, Communicating
Assess for safety for independent living, if they need home healthcare services
Instrumental Activities of Daily Living (IADL) - Activities for independent community life
Shopping, meal prep, housekeeping, laundry, finances, transport, medications
general: self-care behaviours
Do you have any occupational hazards like heavy lifting, repetitive motion, joint stress?
What do you do to it better?
What kind of exercise do you do? Do you warm up? Do you get pain during exercise?
Weight gain, loss of independence, self-esteem, body image, role changes?
subjective history for infants/children
Were you told about any birth trauma? (Ex., dislocations during birth)
Did the child need to be resuscitated? (anoxia)
Did the child reach the motor milestones at a normal age?
Any bone injuries/dislocations?
Any bone deformities? Like strange toes/feet, spinal curvature, when? Treatment?
subjective history for adolescents
Are you involved in any athletics/sports? Do you use safety equipment? Warm up?
What do you do if you get hurt? Any adult supervision?
Time management(? The textbook is weird)
subjective history for aging adults
Any changes in weakness over the past few months/years?
Any increase in falls or stumbling or injuries?
Do you use any mobility aids or anything to help you walk?
Assess home environment, community resources, risk for elder abuse (dependence, impairments, social isolation)
objective assignment things to note
- size/contour/colour
- swelling/masses/deformities
- effusion (fluid)
- dislocation
- subluxations (partial dislocations)
- contracture (shortening of a muscle; therefore limited ROM of a joint)
- ankylosis (stiffness/fixation of joint)
- gait?
- posture
inspection and palpation
Note size and contour (bilaterally), any colour, swelling, masses, deformities
Feel for skin temperature, bony articulations, any tenderness, heat, swelling, masses
ROM
Generally, you model Active ROM and assist with passive if they can’t do it
Passive ROM: Assisting them to do flexion/extension
Active ROM: Them moving their joint themselves
rating muscle strength
On a 5 point scale, where 5 is normal
0. No contraction
Slight Contraction
Full ROM, Passive Motion no Gravity
Full ROM, with Gravity
Full ROM, against Gravity, some Resistance
Full ROM, against Gravity, full Resistance
