Health Assessment - Musculoskeletal

Front 1

musculoskeletal system functions

Back 1

Provides support and mobility for body
Provides protection for internal organs
Produces blood cells and stores minerals such as calcium and phosphorus

Front 2

functions of bones

Back 2

Support for soft tissues and organs
Protection of organs—brain and spinal cord
Body movement and hematopoiesis
Continual remodeling and changing collagen and mineral composition to accommodate stress

Front 3

skeletal muscles

Back 3

muscle fibers attached to bone, ligament, tendon, fascia
voluntary control
some move by reflex
arranged parallel to long axis of bones

Front 4

Articulations

Back 4

two or more bones come together
classified by material or degree of movement

Front 5

articulation by material

Back 5

Fibrous
Cartilaginous
Synovial

Front 6

articulation by degree of movement

Back 6

Synarthrodial—immovable joints (sutures of skull)
Amphiarthrodial—slightly movable joint (symphysis pubis)
Diarthrodial—freely movable joints (knee joint)

Front 7

hinge joints (diarthrodial)

Back 7

Permit extension and flexion; not lateralization
Some allow hyperextension
Example: Knee, elbow

Front 8

pivot joints (diarthrodial)

Back 8

Permit movement of one bone with a ring or notch of another bone
Example: Between radius and ulna and between 1st and 2nd cervical vertebrae

Front 9

condyloid or ellipsoidal (diarthrodial)

Back 9

Condyle of one bone fits into elliptically-shaped articulating bone
Example: Example: Metacarpophalangeal joints

Front 10

ball and socket joints (diarthrodial)

Back 10

Ball-shaped bone fits into concave area of articulating bone
Example: Hip

Front 11

gliding joints (diarthroidal)

Back 11

Permit movement along axes through flat articulating surfaces
Example: Joints between two vertebrae, feet

Front 12

Ligaments

Back 12

strong, dense, flexible bands of CT
hold bones together
encircle joint, grip obliquely, lie parallel to bone ends

Front 13

tendons

Back 13

strong, flexible, nonelastic cords of collagen
attach muscles to bones
contract muscles to bones without sustaining injury

Front 14

Cartilage

Back 14

semi smooth, gel-like, supports weight
forms caps over ends of long bones
allows thorax to move when lungs expand/contract
reinforces respiratory passages of nose, larynx, trachea, bronchi

Front 15

bursae

Back 15

small sacs in CT adjacent to some joints
reduce frictions when muscles/tendons rub

Front 16

present health status

Back 16

chronic disease
medications
changes in ability to move
exercise
smoke
alcohol
sports
work injuries?

Front 17

past medical history

Back 17

accidents/trauma
congenital bone/joint problems
surgery on bones, joints, muscles

Front 18

family history

Back 18

hx of curvature of spine/back problems
hx of arthritis, gout

Front 19

inspect axial skeleton and extremities

Back 19

alignment, contour, symmetry, size, and gross deformities
Body symmetric, straight spine, knees straight line

Front 20

muscles

Back 20

size
symmetry - bilateral
circumference

Front 21

palpate

Back 21

Bones for tenderness
Joints and muscles for tenderness, heat, edema, tone
Should be nontender, same temp as tissue, no swelling
Muscles firm

Front 22

muscle strength scale

Back 22

0/5: no contraction
1/5: muscle flicker, but no movement
2/5: movement possible, but not against gravity
3/5: movement possible against gravity, but not against resistance by the examiner
4/5: movement possible against some resistance by the examiner
5/5: normal strength

Front 23

regions - face and neck

Back 23

inspect muscles for symmetry
palpate TMJ
JAW ROM
palpate neck = pain
neck ROM
neck muscles- strength

Front 24

shoulders and spine

Back 24

alignment, symmetry
vertebrae aligned
ROM (75 degrees to touch toes, 30 degrees hyperextension, 35 degrees lateral flexion)
height and countour
palpate for firmness/tenderness/masses

Front 25

carpal tunnel syndrome

Back 25

median nerve compressed
repetitive movements, fluid retention
findings: numbness/tingling, burning of hands, + phalen's/tinel's

Front 26

scoliosis

Back 26

S/C curve of spine
uneven shoulders, shoulder/scapula prominence
respiratory difficulties, pain, GO dysfunction

Front 27

gout - definition + risk factors

Back 27

metabolic disorder - hyperuricemia (lack of enzyme to metabolize purines)
Male gender, diet high in red meat and seafood but low in dairy, alcohol abuse, family history, obesity, renal failure, hematologic cancers, medications/drugs

Front 28

gout- clinical findings

Back 28

Elevated serum uric acid (Hyperuricemia)
Severe pain, redness, and swelling of joint
Limited ROM
Tophi
Possibility of kidney stone formation

Front 29

bursitis - def/precip factors

Back 29

inflammation of bursa
r/t constant friction (elbow/hip/knee/shoulder)
precipitating factors - arthritis, injury, excess use

Front 30

bursitis clinical findings

Back 30

Painful ROM, edema, redness, point tenderness

Front 31

osteoarthritis - definition

Back 31

degenerative change in articular cartilage
weight bearing joints - repetitive movement

Front 32

osteoarthritis - clinical findings

Back 32

Aching joints, joint tenderness, effusions, morning stiffness <30 minutes, crepitus, limited ROM affecting 1 or 2 joints, asymmetrical joint involvement, narrowing of joint space
weight bearing = aggravates
rest = alleviates

Front 33

osteoarthritis joint deformities

Back 33

minimal
heberden's nodes - idstal interphalangeal joints
bouchard's nodes - peripheral interphalangeal joints

Front 34

rheumatoid arthritis

Back 34

chronic, autoimmune disorder
Fever, fatigue (chronic inflammatory reponse), weakness, weight loss, generalized myalgias and arthralgias, stiffness
Joints are painful, stiff, warm, and swollen
Morning stiffness lasting at least an hour
Swelling in symmetric and widespread – bilateral involvement

Front 35

RA deformities

Back 35

severe
Swan neck deformity, boutonniere deformity, and ulna deviation
Loss of ROM
Cyst formation

Front 36

osteoporosis/osteopenia

Back 36

loss of bone density/decrease in strength
osteoporosis - BMD more than 2.5 standard deviations below the mean
osteopenia - BMD 1-2.5 standard deviations below mean

Front 37

osteoporosis risk factors

Back 37

Aging, family history, calcium and vitamin D deficiency, female sex, estrogen deficiency in females (may affect osteoblast activity), low body weight, medications (glucocortiocoids), smoking, chronic liver or kidney disease, immobility

Front 38

osteoporosis clinical findings

Back 38

Asymptomatic
May present with fracture
Presence of kyphosis of the thoracic spine, loss of height, difficulty bending

Front 39

open fracture

Back 39

skin intact

Front 40

closed fracture

Back 40

skin borken

Front 41

displaced vs non displaced fracture

Back 41

Ends of fracture fragments are separated
vs
Fracture fragments remained aligned and in position

Front 42

depressed fracture

Back 42

Fracture in which fragment is displaced below the level of the surface of the bone

Front 43

complete vs. incomplete fracture

Back 43

Fracture whose line disrupts bone continuity through the whole thickness of the bone
vs
Fracture in which the cortex of the bone buckles or cracks without disrupting bone continuity

Front 44

transverse fracture

Back 44

Straight line at approximately at a 90 degree angle to the longitudinal axis of the bone

Front 45

longitudinal fracture

Back 45

Bone split length wise

Front 46

comminuted fracture

Back 46

More than one fracture line and more than 2 bone fragments

Front 47

impaced fracture

Back 47

Caused by excessive forces that drives or telescopes one fragment into another

Front 48

greenstick fracture

Back 48

Incomplete break in bone with the intact side of the corex flexed

Front 49

avulsion fracture

Back 49

Separation of a small fragment of bone at attachment site of a ligament or tendon

Front 50

compression fracture

Back 50

Crushing fracture