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56 Cards in this Set

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  • Back
What components comprise the musculoskeletal system?
Bones, joints, and muscles
What are the effects of the musculoskeletal system?
1. Support the erect body
2. Movement
3. Encase and protect vital organs
4. Produce RBCs in bone marrow
5. Storage of certain minerals
What is the degree of movement for synovial joints?
The joints are freely moveable.

Bones at a synovial joint do not touch each other.
What type of cartilage covers bones in a synovial joint?
Articular cartilage
What separates bones in a synovial joint?
A synovial cavity separates the bones and cushions joint movement.
What lines the synovial cavity and what does it secrete?
Synovial membrane lines the synovial cavity and secretes a small amount of synovial fluid.
What surrounds the synovial membrane?
Fibrous joint capsule.

The joint capsule is strengthened by ligaments extending from bone to bone.
What are some examples of synovial joints?
Shoulder, elbow, knee, ankle
What is the degree of movement for cartilaginous joints?
Slightly moveable
How are bones separated in a cartilaginous joint?
Separated by fibrocartilaginous discs
What is physical characteristic of the fibrocartilaginous disc? What is its purpose?
Each disc has a nucleus pulposus at the center.

The nucleus pulposus is fibrocartilaginous material that serves as a cushion or shock absorber between bony surfaces.
What is an example of a cartilaginous joint?
Vertebral bodies of the spine
What is the degree of movement in fibrous joints?
Immovable
What is the relationship of bones to each other in fibrous joints?
Bones are almost in direct contact
What is an example of a fibrous joint?
Skull sutures
What is the articular shape of a spheroidal (ball and socket) joint?
Convex surface in a concave cavity
What movements are possible in spheroidal (ball and socket) joints?
1. Wide ranging flexion
2. Extension
3. Abduction
4. Adduction
5. Rotation
6. Circumduction
What are some examples of spheroidal (ball and socket) joints?
Shoulder, hip
What is the articular shape of a hinge joint?
Flat, planar
What movements are possible in hinge joints?
1. Flexion
2. Extension
What are some examples of hinge joints?
Elbow, interphalangeal joints of hands and feet
What is the articular shape of condylar joints?
Convex or concave
What type of movement occurs in condylar joints?
Movement of two articulating surfaces not dissociable
What are some examples of condylar joints?
Knee, temporomandibular joint
What are bursae?
Pouches of synovial fluid that cushion the movement of tendon and muscles over bone or other joint structures
What are tendons?
Collagen fibers connecting muscle to bone.
What are ligaments?
Rope-like bundles of collage fibrils that connect bone to bone
What are the different skeletal muscle movements?
1. Flexion and extension
2. Abduction and adduction
3. Pronation and supination
4. Circumduction
5. Eversion and inversion
6. Rotation
7. Protraction and retraction
8. Elevation and depression
What questions should you ask the patient for joints?
1. Pain - localized, diffuse, or systemic? Ask patient to point to the pain.
2. Stiffness?
3. Swelling, heat, redness (acute inflammation)?
What should you ask a patient regarding muscles?
1. Pain (cramps)?
2. Any weakness?
What questions should you ask the patient about bones?
1. Pain?
2. Deformity?
3. Trauma? (Fractures, sprains, dislocations)
What information should you obtain from the patient besides the health of the joints, muscles, and bones?
1. Functional assessment. Can he perform activities of daily living?
2. Self-care behaviors
What might shoulder pain be symptomatic of?
Heart problems
What are some important topics for health promotion and counseling?
1. Nutrition, exercise, and weight
2. Low back: lifting and biomechanics
3. Preventing falls
4. Osteoporosis: screening and prevention
What is important when examining joints?
The joint should be at rest
When comparing corresponding paired joints, what should you expect?
Symmetry of function and structure
What do you look for when inspecting the joints?
1. Size and contour
2. Skin and tissues over joint
What should you palpate for when assessing the musculoskeletal system?
1. Skin temperature
2. Muscles, bony articulations, areas of joint capsule
How should you assess range of motion (ROM)?
Ask the patient to do own ROM = active ROM.

Note any limited ROM and follow-up with passive ROM.

Note any pain or crepitus.
How do you perform muscle testing?
1. Apply opposing force
2. Grade muscle strength (out of 5)
What is the scale for muscle strength?
0 = no contraction, complete paralysis, no visible or palpable movement
1 = slight contraction, but very severe weakness, weak contraction visible but extremity doesn't move
2 = full ROM with gravity eliminated (passive motion)
3 = full ROM with gravity but not against resistance (moderate weakness)
4 = full ROM against gravity, with some resistance
5 = full ROM against gravity, with full resistance (normal muscle strength)
How should you assess the temporomandibular joint?
1. Inspect joint area
2. Palpate as person opens mouth
3. Motion and expected range
a) open mouth maximally
b) protrude lower jaw and move side to side
c) stick out lower jaw
4. Palpate muscles of mastication (masseter, temporalis, internal/external pterygoids)
How should you assess the shoulders?
1. Inspect joint
2. Palpate shoulders and axilla
3. Motion and expected range
a) arms forward and up
b) arms behind back and hands up
c) arms to sides and up over head
d) touch hands behind head
How should you assess the elbow?
1. Inspect joint in flexed and extended positions
2. Palpate joint and bony prominences
3. Motion and expected range
a) bend and straighten elbow
b) pronate and supinate hand
What are the three phalangeal joints?
1. Metacarpophalangeal joint (MCP)
2. Proximal interphalangeal joint (PIP)
3. Distal interphalangeal joint (DIP)
How do you assess the wrist/hand?
1. Inspect the joints on dorsal and palmar sides
2. Palpate each joint for bogginess or tenderness
3. Motion and expected range
a) bend hand up, down
b) bend fingers up, down
c) turn hands out, in
d) spread fingers, make fist
e) touch thumb to each finger
What is Phalen's sign test?
Assesses for carpal tunnel (median nerve compression).

Patient bends both hands and wrists and makes dorsal surfaces touch. Wait 30 seconds and see if numbness develops.
What is Tinel's sign test?
Assesses for carpal tunnel (median nerve compression).

Tap lightly over patient's median nerve. If numbness develops, it is a positive test result.
What are the characteristics of osteoarthritis?
1. Hard, nontender nodules
2. 2-3 mm or more in size
3. Heberden's nodes (DIP), bony overgrowth
4. Bouchard's nodes (PIP), less common
5. Metacarpophalangeal joints are sparred
Who is most commonly affected by osteoarthritis?
Middle-aged or elderly patients
What are the characteristics of rheumatoid arthritis?
1. Tender, painful, stiff joints
2. Symmetric involvement
3. PIP and MCP joint involvement
4. Boutonniere deformity
5. Swan neck deformity
6. Ulnar deviation
How should you assess the hip?
1. Inspect as person stands
2. Palpate with person supine
3. Motion and expected range
a) raise leg
b) knee to chest
c) flex knee and hip, swing foot out/in
d) swing leg laterally/medially
e) stand and swing leg back
How should you assess the knee?
1. Inspect joint and muscle
2. Palpate
3. Motion and expected range
a) bend knee
b) extend knee
c) check knee while ambulating
How should you assess the ankle/foot?
1. Inspect with patient sitting, standing and walking
2. Palpate joints
3. Motion and expected range
a) point toes down/up
b) turn soles out/in
c) flex and straighten toes
How should you assess the cervical spine?
1. Inspect alignment of head and neck
2. Palpate spinous processes and muscles
3. Motion and expected range
a) chin to chest
b) lift chin
c) each ear to shoulder
d) turn chin to each shoulder
How should you assess the spine?
1. Inspect while person stands
2. Palpate spinous processes
3. Motion and expected range
a) bend forward/back
b) bend sideways
c) twist shoulders to each side
4. Straight leg raising
5. Measure leg length discrepancy