Nurse307_Musculoskeletal

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musculoskeletal system consists of

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bones, joints, cartilage,
ligaments tendons and muscle

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musculoskeletal system is intricately related to

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the individual’s overall sense of independence and well being.

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Functions of musculoskeletal system

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MSRP - H

A. Support/stand erect
B. Movement
C. Protect inner vital organs
D. Hematopoiesis - production of red blood cells in the bone marrow
E. Reservoir for storage of essential minerals (calcium and phosphorus) in the bones

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Hematopoiesis

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production of red blood cells in the bone marrow

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Bones

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bones are hard, rigid, and very dense, bone cells are continuously recycling and remodeling.

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Cartilage

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connective tissue that cushions the bones and provides for smooth movement

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Joints

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place of union between 2 or more bones, permit mobility

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Ligaments

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fibrous bands running from one bone to another that strengthen the joint and prevent movement in undesirable directions

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Skeletal

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muscle under conscious control

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Tendons

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attach muscle to bone, composed of a strong fibrous cord

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Flexion

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bending of a limb at a joint

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Extension

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- straightening a limb at a joint to maximally increase its angle

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Abduction

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movement of a body part away from the body’s midline

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Adduction

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movement of a body part toward the midline

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Pronation

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movement of the forearm to place the palm downward

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Supination

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movement of the forearm to place the palm upward

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Circumduction

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moving the arm in a circle around the shoulder (sequence of flexion, abduction, external rotation and adduction)

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Inversion

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- movement of the ankle inward

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Eversion

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movement of the ankle outward

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Rotation

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movement of one bone turning on another or moving the head around a central axis

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Elevation

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raising a body part

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Depression

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lowering a body part

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Dorsiflexion

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movement of the hand or foot upward

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Plantar Flexion

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movement of the foot downward

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Protraction

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moving a body part forward and parallel to the ground, moves away from vertebral column

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Retraction

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moving a body part backward and parallel to the ground, moves toward vertebral column

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Transcultural Considerations~
(Osteoporosis)

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decreased incidence in Blacks/African Americans; increased incidence in the Chinese, Japanese and Inuits

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History (Subjective Data)
Musculoskeletal

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Any limitation of movement
Bone pain
Bone deformity, decreased
ROM
Functional assessment
Hx of accidents or trauma, hx
of fx(s), sprains, dislocation
Joint pain, stiffness, swelling,
heat, redness
Muscle pain/cramping,
weakness
Self Care Behaviors (repetitive
motion )

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Physical Exam/Assessment (Objective)
Musculoskeletal

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Inspection
Palpation
Range of motion
Muscle testing (resistant)

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Wrist and Hand tests

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Phalen’s test
Tinel’s sign

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Phalen’s test

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pt to hold hands back to back while flexing the wrists 90
degrees X 60 seconds

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Tinel’s sign

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direct percussion of the median nerve at the wrist

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Rheumatoid Arthritis

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chronic, systemic inflammatory disease of joints and surrounding connective tissue; characterized by heat, redness, swelling, and painful motion of the affected joints. Get blood work done

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Osteoarthritis

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noninflammatory, localized, progressive disorder involving
deterioration of articular cartilages and subchondral bone, and formation of new bone at joint surfaces;affected joints have stiffness, swelling with hard bpny protuberances, pain with motion, and limitation of motion. No blood work. Hurts more in morning than afternoon when they are doing more stuff.

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Osteoporosis

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decrease in skeletal bone mass occurring when rate of bone resorption is greater than that of bone formation

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Atrophy

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loss of muscle mass

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Dislocated Shoulder

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anterior dislocation (95%) is exhibited as a hollow where it
would normally look rounded. From Football, motorcycle, etc.

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Joint effusion

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swelling from excess fluid in the joint capsule. A lot in the knee.

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Torn Rotator Cuff

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characteristic “hunched” position and limited abduction of Arm. If can not abduct

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Gouty Arthritis

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joint effusion or synovial thickening; characterized by redness, heat, soft, boggy or fluctuant fullness to palpation and limited ROM. Presents cellulites. Get Blood work to find out if it’s gout or cellulitis. Auricle in the ear is sign of gout.

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Epicondylitis

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tennis elbow - chronic disabling pain at the lateral epicondyle of humerous, radiates down extensor surface of forearm frequent supination and pronation.

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Ganglion Cyst

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round cystic, nontender nodule overlying a tendon sheath or joint capsule, usually on dorsum of wrist. Benign until they grow and do something on tissue around it. But most are left alone.

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Carpal Tunnel Syndrome

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atrophy occurs from interference with motor function
due to compression of the median nerve inside the carpal tunnel, caused by chronic repetitive motion. If numbness and tingling occurs when you tap on the median nerve and if you put back of hands together for 1minute; also if you wake up and feels the symptoms all of a sudden.

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Syndactyly

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webbed fingers, congenital deformity, also in toes. Surgically separated

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Polydactyly

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extra digits

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Osgood Schlatter Disease

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painful swelling of the tibial tubercle just below the knee, due to repeated stress on the patellar tendon. More in soccer players

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Scoliosis

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curvature of the spine

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Congenital Dislocated Hip

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head of the femur is displaced out of the cup shaped
acetabulum

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Spina Bifida

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incomplete closure of the posterior part of vertebrae results in a neural tube defect, usually occurs 4th week if gestation. Should have 400grams of folic acid. 4th week of gestation.