NURS 210: Quiz 5 Study Guide

what do you need the musculoskeletal system for?

- support to stand erect

- for movement

- it encases and protects inner vital organs

- produce the red blood cells, and platelets in the bone marrow

- reservoir for storage of essential minerals such as calcium and phosphorus in the bones

what is the functional unit of the musculoskeletal system?

joint

what is a place of union of 2 or more bones and that permits the mobility needed for ADL's?

joint

what is this joint?

- in these joints, the bones are united by interjacent fibrous tissue or cartilage and are immovable

- example: sutures in the skull

fibrous joint

what is this joint?

- separated by fibrous cartilage discs and are one slightly movable

- example: vertebrae

cartilaginous joints

what is this joint?

- freely movable because their bones are separated from one another and enclosed in a joint cavity

- lined with synovial membrane which secretes a lubricant, or synovial fluid

- contains a layer of avascular cartilage

- surrounded by ligaments

- bursae are located in areas of potential friction to facilitate movement of muscles and tendons

synovial joint

what does this describe?

- cushions the bone

- avascular

- receives nourishment from synovial fluid

- slow cell turnover

- tough and firm but flexible

cartilage

what does this describe?

- connect bone to bone

- fibrous bands running directly from one bone to another bone that strengthens joint and help prevent movement in undesirable directions

ligaments

What is ankylosis?

stiffness or fixation of a joint

what is an enclosed sac filled with viscous synovial fluid, located in areas of potential friction, and helps muscles and tendons glide smoothly over bone?

bursa

what are these muscles?

- composed of bundles of muscle fibers or fasciculi

- attached to bone by a tendon

skeletal

what is a strong fibrous cord that connects muscle to bone?

tendon

what is this movement?

bending a limb at a joint

flexion

what is this movement?

straightening a limb at a joint

extension

what is this movement?

moving a limb away from the midline of the body

abduction

what is this movement?

moving a limb toward the midline of the body

adduction

what is this movement?

turning the forearm so the palm is down

pronation

what is this movement?

turning the forearm so the palm is up

supination

what is this movement?

moving the arm in a circle around the shoulder

circumduction

what is this movement?

moving the sole of the foot inward at the ankle

inversion

what is this movement?

moving the sole of the foot outward at the ankle

eversion

what is this movement?

moving the head around a central axis

rotation

what is this movement?

moving a body part forward and parallel to ground

protraction

what is this movement?

moving a body part backward and parallel to ground

retraction

what is this movement?

raising a body part

elevation

what is this movement?

lowering a body part

depression

what are the 3 motions of TMJ?

- hinge action to open and close jaws

- gliding action for protrusion and retraction

- gliding side to side movement of lower jaw

what is the articulation of the mandible and temporal bone?

temporomandibular joint

where can you feel the TMJ?

in the depression anterior to tragus of ear

the _________ permits jaw function of speaking and chewing

TMJ

when looking at the TMJ what should you observe?

- compare right and left sides for firmness, size, and strength

- listen for snap of jaw when opening, this is normal

- slight deviation, abnormal finding

- swelling

describe the bones of the spine?

33 connecting bones

- 7 cervical

- 12 thoracic

- 5 lumbar

- 5 sacral

- 3 to 4 coccygeal

what are the movements of the spine?

extension

flexion

lateral bending

rotation

what are the movements of the cervical spine?

extension

flexion

lateral bending

rotation

what are the movements of the shoulder?

flexion

rotation

hyperextension

abduction

adduction

external rotation

what is this pertaining to the shoulder?

- belt of 3 bones (humerus, scapula, clavicle)

- joints and muscles

shoulder girdle

what is the articulation of the humerus with the glenoid fossa of the scapula?

glenohumeral joint

what muscles and tendons stabilize the shoulder?

the group of SITS muscles or rotator cuff muscles

what are palpable landmarks in the shoulder?

- scapula and clavicle form the shoulder girdle

- you can feel the bump of the acromion process at the top of the shoulder

what does this describe?

- elastic fibrocartilaginous plates that constitute 1/4th of the length of the column

- each disc center has a nucleus pulposus made of soft, semifluid, mucoid material that has the consistency of toothpaste in the young adult

- disc cushion spine like a shock absorber and help it move

intervertebral discs of the spine

what are the movements of the wrist and hand?

flexion

extension

abduction

adduction

what is the articulation of the distal radius and a row of 8 carpal bones?

wrist or radiocarpal joint

what permits movement in 2 planes at right angle (flexion and extension, side-to-side deviation)?

condyloid action

what is the articulation that allows flexion, extension, and some rotation?

midcarpal joint

what permits finger flexion and extension?

metacarpophalangeal and interphalangeal joint

What are the 3 bony articulations of the elbow?

humerus, radius, ulna of forearm

what movement does the the elbow do?

pronation and supination

flexion and extension

what movements do the hip do?

flexion

extension

adduction

abduction

what are the muscles of the hip?

iliopsas

gluteus maximus

what is the articulation between acetabulum and head of femur, it is a ball and socket joint, provides stability for weight-bearing, and the bursae facilitate movement?

hip

what do focused musculoskeletal assessments assess?

range of motion

muscle strength

joint function

what are common concerns of the musculoskeletal system?

joint pain, stiffness

muscle pain

weakness

ADL concerns

what should not be present when doing an musculoskeletal assessment?

muscular spasm

heat

atrophy

swelling

tenderness

redness

deformities

crepitation

when inspecting during a musculoskeletal assessment what do we inspect?

response

LOC

tone

involuntary movements

muscle size

motor function

what do we palpate during a musculoskeletal assessment?

joints

articulation

swelling

muscle strength/movement

the patient should have a __________ gait

stable

___________ causes crepitus because ________ tears down the cartilage between 2 bones

arthritis

what is usually felt as cramping or aching?

myalgia

what ROM allows the patient complete control?

active ROM

what ROM requires the nurse to intervene and assist?

passive ROM

what are the aging concerns of the musculoskeletal system?

- posture (kyphosis)

- contour

- prominence

- osteoporosis

- decreased height

- ROM

- some atrophy

- loss of water content and thinning of intervertebral discs

- loss of subcutaneous fat

- muscle size decrease

what is the phalen test? what does it test for?

- Ask the person to hold both hands back to back while flexing the wrists 90 degrees.

- Acute flexion of the wrist for 60 seconds produces no symptoms in the normal hand.

- this test reproduces numbness and burning in a person with carpal tunnel syndrome.

What is Tinel sign used to diagnose? and how do you do it?

carpal tunnel syndrome

percuss median nerve in the wrist if patient has burning and tingling this is abnormal and patient may have carpal tunnel

what is the strength grading of muscles and joints?

5 - full ROM against gravity, full resistance 100%

4 - full ROM against gravity some resistance 75%

3 - full ROM with gravity 50%

2 - full ROM with gravity eliminated (passive ROM) 25%

1 - slight contraction 1%

0 - no contraction 0%

what 3 bones are the articulation of the knee joint?

femur

tibia

patella

What kind of joint is the knee?

hinge joint

what cushion the tibia and femur?

medial and lateral menisci

what are the 2 ligaments that stabilize the knee?

- cruciate: anterior and posterior stability, help control rotation

- collateral: medial and lateral stability, prevent dislocation

what are the movements of the knee?

flexion and extension

what kind of joint are the ankle and foot?

hinge joint

what are the movements of the ankle and foot?

dorsiflexion

plantar flexion

eversion

inversion

what joint in the ankle permits inversion and eversion of the foot?

subtalar joint

what are the two bony prominences of the ankle and foot?

medial malleolus

lateral malleolus

what type of joint is the elbow and knee?

hinge joint

what type of joint are the hip and shoulder?

ball and socket

greater than 10 seconds with the get up and go test considers the patient?

a risk for falls

what are the 3 things to remember about rheumatoid arthritis?

swan neck fingers

ulnar deviation

boutonniere

what are common symptoms of RA?

swollen

inflamed

warm to touch

subcutaneous nodules

redness

stiffening of joints

What is an autoimmune disorder when the body attacks its joints and the cartilages between joints?

Rheumatoid Arthritis

What is swan neck deformity?

joints stiffen up and is caused by RA

what arthritis is caused by heavy wear and tear on the joints and aging and obesity are risk factors?

osteoarthirits

what is the build-up of uric acid/purine, common in toes, painful, gets swollen, recoverable in a few weeks, and normally contained to one area?

gout

what does ROM prevent?

contractures

what are contractures?

permanent stiffening of a joint or muscle

What is atrophy?

decrease in muscle size

what is dystrophy?

loss of tissue mass

What is hypertrophy?

increase in muscle size

what is the straight leg test testing for?

possible sciatica/herniated disc

What is the bulge sign test? tests for?

Firmly stroke up on medial aspect of the knee 2-3 times to displace fluid. Then tap lateral aspect and watch medial side in the hollow for a bulge from a fluid wave.

- tests for small amounts of fluid in the knee