musculoskeletal system

the musculoskeletal system produces

red blood cells, stores fat and minerals, generates body heat

bone shapes

long, short, flat, irregular

bone tissue

osseous tissue - dense smooth compact structure or cancellous spongy

bone functions

support, protection, movement, mineral storage, blood cell formation

joint classification

fibrous, cartilaginous, synovial

fibrous joints

consists of inflexible layers of dense connective tissue, holds the bones tightly together

cartilage joints

slightly movable

synovial joints

created where two bones articulate to permit a variety of motions

Bursae

flattened fibrous sacs lined with synovial membrane and containing a thin film of synovial fluid - called tendon sheaths to protect joints

plane joint

short slipping or gliding movements; i.e. carpals

tendon

Connects muscle to bone or muscle to muscle

Ligament

Connects bone to bone

hinge joint

elbow and knee

pivot joint

rotating bone turns around an axis; i.e. connection between radius/ulna and humerus

condyloid joint

synovial joint that does everything except rotating

saddle joint

type of joint found at the base of each thumb; allows grasping and rotation, between carpals and metacarpals

ball and socket joint

shoulder and hip

gliding

nearly flat bone surfaces slide or glide over each other, gliding side to side movement

flexion and extension

bending and extension of a limb

Dorsiflexion

bending of the foot or the toes upward

plantar flexion

pointing toes

abduction and adduction

(n.) moving away from median plane (limbs); moving away from midline (fingers); moving forward (thumb)

Circumduction

circular movement of a limb at the far end

rotation

rotation of a joint, head side to side

supination and pronation

palm up to palm down

inversion and eversion of foot

Inversion is moving the foot so that the sole faces medially (inward) and eversion is moving the foot so that the sole faces laterally (outward).

protraction/retraction

anterior to posterior movement of scapula or mandible

elevation/depression

up and down

opposition

Movement of the thumb to touch the fingertips

landmarks of the shoulder

scapula, acromion process, greater tubercle, coracoid process

subacromial bursa

helps during abduction of the arm, so the greater tubercle of the humerus moves easily under the acromion process of the scapula

Elbow landmarks

lateral and medial epicondyles, olecranon process and bursa

Ulner nerve

Nerve that runs along the little finger side of the arm and the palm of the hand, synovial membrane palpable when inflamed

scaphoid and lunate

only carpals that articulate with radius to form wrist joint

hip landmarks

iliac crest, acetabulum, greater trochanter of femur, anterior inferior iliac spine

Cruciate and collateral ligaments

Two major types ligaments that provide knee joint stability

special considerations

african ancestry has stronger bone density, women and asian and caucasians are prone to osteoporosis, asians have lower bone density, 24 vertebrae is average, poorly designed furniture can cause problems, frequent movements can cause inflammation and degeneration

joints tested in cephalocaudal pattern

shoulders, elbow, wrists and hands, knees, ankles and feet, spine

Goniometer

instrument used to measure joint angles

what force do you use to test muscle strength?

opposing force

What is Phalen's test?

Hold the wrist flexed to each other

What is Tinel's sign?

tap over inner wrist, positive if tingling in thumb and first three fingers

kyphosis

hunchback

Scoliosis

abnormal lateral curvature of the spine

benign juvenile lordosis

large curve at lumbar

TMJ syndrome

painful jaw movement

rotator cuff tear

traumatic rip of one or more of the muscles or tendons within the rotator cuff of the shoulder

Olecranon Bursitis

inflammation of the bursa located over the olecranon process of the elbow

joint effusion

swelling from excess fluid in the joint capsule

Rheumatoid nodules

Firm, nontender, unattached subcutaneous nodules at pressure points (e.g., elbow, back of forearm and fingers) associated with rheumatoid arthritis

carpal tunnel syndrome

A condition caused by compression of the median nerve in the carpal tunnel and characterized especially by weakness, pain, and disturbances of sensation in the hand and fingers past the ring finger

Dupuytren's contracture

A gradual thickening and tightening of tissue under the skin in the hand.

swan neck and boutonniere deformity

flexion contracture resembles curve of a swan's neck; occurs with ulnar drive and chronic RA

Osteoarthritis

inflammation of the bone and joint

rheumatoid arthritis

a chronic autoimmune disorder in which the joints and some organs of other body systems are attacked - characterized by deviation of joints and deformity of fingers in late stages

synovitis

inflammation of the synovial membrane of a joint

Gout

Swollen, red, acutely painful great toe joint

hallux valgus

an abnormal enlargement of the joint at the base of the great toe (bunion)

hammertoe

condition in which the toe is bent downward at the proximal interphalangeal (PIP) joint

types of muscles

skeletal, smooth, cardiac

ligament

Connects bone to bone

joint

where two bones meet

review of systems for infants and children

birth trauma, anoxia or cyanotic events, premie, motor milestones

review of systems for adolescents

sports participation, warm-up routine, reports of any injury

review of systems for older adults

abilities, limitations, function and assistive devices

order of operations for assessment

inspection, palpation, ROM, strength

goniometer

instrument used to measure joint angles

strength grading

phalen's test

carpal tunnel syndrome

tinel's sign

"pins and needles" sensation felt when an injured nerve site is tapped - carpal tunnel syndrome

bulge sign

Effusion of fluid in the knee

ballottement

a palpation technique used in detecting or examining a floating object in the body

osteoarthritis

inflammation of the bone and joint; degenerative and fusiform swelling of joints, heberden's nodes

muscle tremor

rhythmic, involuntary, purposeless contraction that produces a quivering or shaking movement (like in Parkinson's)

muscle spasms

sudden, painful, involuntary muscle contractions

fasciculation

rapid continuous twitching of resting muscle without movement of limb

Osteoporosis

A condition in which the body's bones become weak and break easily.

lordosis

abnormal anterior curvature of the lumbar spine (sway-back condition)

genu varum "bow leg"

legs cannot go together when standing straight, can resolve in early age but can also be permanent

genu valgum "knock knee"

A deformity in which the knees are abnormally close together and the space between the ankles is increased due to a lateral angulation of the tibia in relation to the femur

subluxation

partial dislocation

low dislocation

dislocation that is worse than a subluxation, but is lower placed than high dislocation

high dislocation

complete dislocation - not even in socket area

ortolani's maneuver

A manual procedure performed to rule out the possibility of developmental dysplastic hip.

simple fracture

bone is broken cleanly; the ends do not penetrate the skin

comminuted fracture

fracture in which the bone is splintered or crushed

open fracture

compound fracture; broken bone with an open wound

what are relevant lab values and testing for the musculoskeletal system?

calcium (total vs. ionized), creatinine kinase, antibody markers for disorders, X-ray, CT, MRI, bone scanning