Exam 3 HA

How many bones are in the adult body?

206

What are the four types of bones?

Long, short, flat, and irregular

What do joints do?

Connect bones and allow movement

What type of joint is immovable and hold skull together?

Fibrous joint

What type of joint is slightly movable?

Cartilaginous joint

What type of joint is freely movable?

Synovial joint

Which joints are hinge joints?

Elbow and knee; allow flexion and extension

Which joints are ball and socket joints?

Hip and shoulder; allow multiple movements

Which joint is a condyloid joint?

Wrist; allow flexion, extension, and hyperextension

What do ligaments connect?

Bone to bone

What do tendons connect?

Muscle to bone

What is the periosteum?

Membrane that nourishes bone, contains blood vessels, nerves, and lymphatic tissue

What are the main functions of the skeleton?

• Support and movement

• Protection of internal organs

• Calcium storage

• Hematopoiesis (produces RBC)

What are the three types of muscle?

Skeletal, smooth, and cardiac

Where is skeletal muscle found?

Attached to bones via tendons

Where is smooth muscle found?

Lining organs

Where is cardiac muscle found?

Heart

What are the functions of muscles?

• Allow movement of body

• Form and contour to body

• Key factors in body posture

How many vertebrae are in the spine?

33

How many cervical vertebrae are there?

7

How many thoracic vertebrae are there?

12

How many lumbar vertebrae are there?

5

How many sacral vertebrae are there?

5

How many coccygeal vertebrae are there?

3 to 4

What is the function of intervertebral (fibrocarilaginous) discs?

Shock absorbers

Where is the spinal cord?

Starts at medulla and extends to L1 - L2

Structure of shoulders

• Ball and socket joint

• Humerus, clavicle, scapula

• Rotator cuff – lateral rotation

• Subacromial bursa – fluid filled sac, smooth abduction

• Trapezius muscle

Structure of elbows

• Hinge joint

• Humerus, radius, ulna

• Epicondyles –sides of elbow

• Olecranon process and bursa

• Biceps and triceps muscles

Structure of wrist and hands

• Fine motor skills and dexterity

• Distal radius and ulna

• Carpals, metacarpals, phalanges

• Multiple joints and muscles

• Three major nerves

  • Median nerve – associated with carpal tunnel disorder

Structure of hips

• Hips – ball and socket

• Hip Joint - head of femur, acetabulum, muscles, ligaments

• Bursas – fluid filled sacs

• Muscle Groups

  • Flexor

  • Extensor

  • Adductor

  • Abductor

What do hip flexors do?

Decrease the joint angle

What do hip extensors do?

Increase the joint angle

What do hip adductors do?

Move toward the body

What do hip abductors do?

Move away from the body

Structure of knees

• Hinge joint – femur, tibia, patella

• Flexion and extension

• Quadricep and hamstring muscles

• Bursae – reduce friction

• Meniscus and ligaments - support

Structure of ankles and feet

• Hinge joint – tibia, fibula, talus

• Flexion, extension, inversion, eversion

• Heel – calcaneus

• Principal landmarks – medial and lateral malleolus

• Metatarsals

Active ROM

Client can move joint without assistance

Passive ROM

Moving the muscle for the client unable to perform active ROM

What is flexion?

A movement that decreases the angle between two adjacent bones like in the neck, shoulder, elbow, wrist, fingers, thumb, hip, knee, toes

What is extension?

A movement that increases the angle between two adjacent bones like the neck, shoulder, elbow, wrist, fingers, thumb, hip, knee, toes

What is hyperextension?

A movement of a body part beyond its normal extended position like the neck, shoulder, wrist, fingers

What is supination?

A movement of a body part so the ventral (front) surface faces up like the forearm

What is pronation?

A movement of a body part so the ventral (front) surface faces down like the forearm

What is abduction?

The movement of an extremity away from the midline of the body like the shoulders, wrists, fingers, thumbs, hips, toes

What is adduction?

The movement of an extremity toward the midline of the body like the shoulders, wrists, fingers, thumbs, hips, toes

What is dorsiflexion?

Flexing the foot and toes upward in the ankle

What is plantar flexion?

Bending the foot and toes downward in the ankle

What is eversion?

Turning the body part away from the midline in the feet

What is inversion?

Turning the body part toward the midline in the feet

What is external rotation?

Rotating a joint outward like the neck, shoulders, wrists, thumbs, hips

What is internal rotation?

Rotating a joint inward like the neck, shoulders, wrists, thumbs, hips

What is lateral flexion?

Movement that tils the head toward the shoulder, allowing side-to-side bending of the cervical spine in the neck

What is opposition?

Ability of the thumb to move across the palm to touch the pads of other fingers

What is circumduction?

Circular or conical movement of a limb like the shoulders and hips

What is retraction?

Pulling back or drawing in of a part of the body like the jaw

What is protraction?

Forward movement of a part of the body away from the midline of the body like the jaw

What do you inspect in a musculoskeletal assessment?

Joints, muscles, and bones for size, symmetry, alignment, ROM, deformities, inflammation

What do you palpate for in a musculoskeletal assessment?

Warmth tenderness muscle tone crepitus

What is crepitus?

Crackling or grating feeling

Unexpected findings when inspecting head and neck

Asymmetry

Unexpected findings when inspecting shoulders and upper extremities

• Erythema

• Muscle atrophy

• Swelling

• Spasms

• Swelling of subacromial bursa

Unexpected findings when inspecting elbows

• Swelling, erythema

• Change in pigmentation around olecranon bursa

• Fluid effusion - gouty arthritis

• Misalignment - dislocation

Unexpected findings when inspecting wrists and hands

• Swelling

• Nodules - arthritis

• Ulnar deviation - arthritis

• Limitation in movement

• Cysts

Unexpected findings when inspecting spine and body alignemnt

• Lateral deviation of head, spine

• Asymmetry

• Exaggerated curvatures

• Unstable, shuffling, ataxic gait

Unexpected findings when inspecting hips and lower extremities

• Asymmetry - curvature of spine

• Pain with movement - neuro conditions, dislocation, or fracture

• Wide based gait - neurological deficits

• Erythema

• Swelling

Unexpected findings when inspecting ankles and feet

• Swelling, inflammation

• Lesions, ulcers, corns, calluses

• Misalignment of toes

Unexpected findings when palpating head and neck

• Pain

• Spasms

• Altered sensation

Unexpected findings when palpating shoulders and upper extremities

• Swelling, heat, tenderness

• Atrophy

• Unilateral swelling

• Flattened - dislocation of humerus

Unexpected findings when palpating elbows

• Erythema, edema

• Displacement

• Nodules - rheumatoid arthritis

Unexpected findings when palpating wrists and hands

• Tenderness

• Swelling

• Nodules

Unexpected findings when palpating spine and body alignment

• Curvature

• Tenderness

• Spasms

Unexpected findings when palpating hips and lower extremities

• Tenderness

• Pain

• Crepitus

Unexpected findings when palpating ankles and feet

• Swelling

• Tenderness

What muscle strength grade is expected?

Greater than 3

What is an unexpected muscle strength finding?

Grade 3 or less or unequal strength

Where is ROM assessed on head and neck?

• Jaw

• Chin

• Head

• Neck

What ROM assessed on shoulders and upper extremities?

• Flexion

• Hyperextension

• Internal and external rotation

• Abduction and adduction

What ROM assessed on elbows?

• Extension

• Flexion

• Supination and pronation

What ROM assessed on Wrists and hands?

• Bend wrist down (flexion)

• Bend wrist back (extension)

• Bend wrist inward (radial deviation)

• Bend wrist outward (ulnar deviation)

What ROM assessed on spine and body alignment?

• Bend forward

• Bend sideways

• Bend backwards

• Twist shoulders

What ROM assessed on ankles and feet?

• Plantar flexion

• Dorsiflexion

• Inversion vs. eversion

Unexpected findings in muscle strength

• Muscle testing grade of 3 or less

• Discomfort while maintain resistance

• Unequal muscle testing grades between the right and left sides

What are common signs of arthritis?

Pain swelling tenderness stiffness

What finger change is common in arthritis?

Ulnar deviation in which the fingers are not in alignment with the wrist and forearm

How does arthritis affect ROM?

Decreases ROM

How does arthritis affect grip strength?

Grip becomes weaker

When is arthritis stiffness usually worse?

Morning or after rest

What helps manage arthritis?

Exercise ROM pain medicine heat or cold

What is scoliosis?

Sideways (lateral) curve of the spine

What is lordosis?

Exaggerated lumbar curve

What is kyphosis?

Exaggerated thoracic curve

What is Grade 5 muscle strength?

Full ROM against full resistance

What is Grade 4 muscle strength?

Full ROM against some resistance

What is Grade 3 muscle strength?

Full ROM against gravity

What is Grade 2 muscle strength?

Full ROM with gravity eliminated (passive motion)

What is Grade 1 muscle strength?

Slight muscle contraction

What is Grade 0 muscle strength?

No muscle contraction

What are the four musculoskeletal health promotion categories?

• Ergonomics

• Injury prevention

• Exercise

• Calcium and vitamin D

What is ergonomics?

Using proper body mechanics to prevent injury

How do you lift safely?

Lift with your legs not your back