Musculoskeletal System Overview

Musculoskeletal System

Skeletal Muscles

  • Control Mechanism: Controlled by neuromuscular signals from the brain via muscle fibers, causing contraction.
  • Voluntary Muscles: Type of skeletal muscles that control voluntary movements of limbs, head, neck, and body.

Bones

  • Role:
    • Provide rigid support to the body.
    • Protect vital organs.
    • Facilitate body movement in conjunction with muscles.
    • Produce blood cells in bone marrow.
    • Store minerals like calcium and phosphorus.

Cartilage

  • Definition: A flexible connective tissue.
  • Function:
    • Provides support and reduces friction between bones in joints.
    • Maintains the shape of body parts (found in joints, respiratory tract, and external ear).

Ligaments

  • Definition: Bands of fibrous tissue connecting bones to other bones.
  • Function:
    • Provide joint stability and prevent excessive movement.

Tendons

  • Definition: Bands of connective tissue that attach muscles to bones.
  • Function:
    • Facilitate movement of body parts.
    • Stabilize joints.

Fascia

  • Definition: Fibrous connective tissue surrounding muscles, blood vessels, and organs.
  • Function:
    • Provides support and separation of muscles, allowing independent movement.

Bursae

  • Definition: Small, fluid-filled sacs located between tendons, muscles, and bones (especially in joints).
  • Function:
    • Cushions to reduce friction and allow smooth movement.
    • Prevents irritation and inflammation during joint movement.

Types of Bones

  • Total Bones: 206 bones in the human body.
  • Classification:
    • Long Bones: Elongated, with a shaft (diaphysis) and two ends (epiphyses). Examples: femur, humerus.
    • Short Bones: Cube-shaped, composed of spongy bone (cancellous) covered by a thin layer of compact bone. Examples: carpals (wrist bones) and tarsals (ankle bones).
    • Flat Bones: Thin and flat, often curved. Two layers of compact bone with spongy bone in between. Protects internal organs. Examples: skull, ribs, sternum.
    • Irregular Bones: Complex shapes that do not fit into other categories. Examples: facial bones, vertebrae.
    • Sesamoid Bones: Small and round, embedded in tendons. Example: patella (kneecap).

Muscle Strength Assessment (0 to 5 Scale)

  • 0: No muscle contraction.
  • 1: Barely detectable contraction.
  • 2: Active movement without gravity.
  • 3: Active movement against gravity.
  • 4: Active movement against gravity and resistance.
  • 5: Full strength.

Scoliosis

  • Definition: Abnormal sideways curvature of the spine.
  • Types: Can be mild, moderate, or severe.
  • Location: Commonly occurs in the thoracic region.

Diagnostic Studies for the Musculoskeletal System

  • X-ray: Initial method for assessing bones.
  • Bone scan: Detects cancer spread or bone lesions.
  • CT and MRI: Imaging methods for detailed structures.
  • EMG: Evaluates muscle and nerve health.
  • DEXA scan: Measures bone density.
  • Myelogram: Imaging of the spinal cord and nerves.
  • Thermography: Measures skin temperature.
  • Ultrasound: Checks bone mineral status.
  • Arthroscopy: Visual examination of joints.

Intervertebral Disc Diseases

  • Degenerative Disc Disease (DDD): Normal wear and tear of discs leading to loss of cushioning.
  • Herniated Disc: Bulging or rupture of a disc due to degeneration or trauma.

Spinal Surgery and Care

  • Postoperative Care: Focus on maintaining proper spine alignment, pain management, and monitoring neurological status.
  • Positioning: Use of pillows to maintain alignment after spine surgery.
  • Mobility Restrictions: Avoid bending, lifting, or twisting until cleared by a doctor.
  • Physical Therapy: Encouragement of activity once stable.

Spinal Cord Injuries

  • Cause: Often due to trauma, resulting in temporary or permanent function alterations.
  • Primary Injury: Direct impact to the spinal cord; can lead to paralysis and loss of reflexes.
  • Secondary Injury: Ongoing damage following the initial injury.
  • Vasogenic Shock: Occurs with high cervical injuries, leading to hypotension and bradycardia.

Fractures

  • Definition: Break in the continuity of bone.
  • Types of Fractures:
    • Closed: Skin intact.
    • Open: Bone protrudes through the skin.
    • Types: Includes transverse, spiral, greenstick, comminuted, oblique, pathologic, and stress fractures.

Complications of Fractures

  • Fat Embolism: Fat globules enter the bloodstream and block vessels, particularly after long bone fractures.
  • Non-union: Failure of a fracture to heal.
  • Malunion: Healing in an incorrect alignment.

Healing Process for Fractures

  • Stages of healing: hematoma formation, granulation tissue, callus formation, ossification, consolidation, and remodeling.
  • Influential factors: blood supply, mobility, nutrition, and smoking.

Cast and Splint Care

  • Importance of immobilization for healing.
  • Monitoring of neurovascular status and complications such as pressure ulcers or disuse syndrome.
  • Education regarding activity restrictions and use of assistive devices post-removal.

Patient Education for Rehabilitation

  • Importance of physical therapy, occupational therapy, and continuous management of pain and neurological function.
  • Teaching movements appropriate to limitations and ensuring supportive devices are utilized effectively.