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.