Chapter_044muscosketel

Care of the Patient With a Musculoskeletal Disorder

Functions of the Skeletal System

  • Support: Provides framework for internal tissues and organs.

  • Protection: Shields internal structures (e.g., cranium protects brain).

  • Movement: Enables leverage for movement through muscle attachments.

  • Mineral Storage: Stores minerals like calcium and phosphorus; releases when needed.

  • Hematopoiesis: Blood cell formation occurs in red bone marrow, which may convert to yellow with age.

Divisions of the Skeletal System

  1. Axial Skeleton

    • Composed of skull, hyoid bone, vertebral column, thorax.

  2. Appendicular Skeleton

    • Composed of upper and lower extremities, shoulder girdle, pelvic girdle.

Structure of the Musculoskeletal System

  • Bones and Joints: Framework of the body.

  • Muscles: Necessary for movement and contraction.

  • Types of Body Movements: Flexion, extension, abduction, adduction, rotation, supination, pronation, dorsiflexion, plantar flexion.

Functions of the Muscular System

  • Motion: Facilitates body movements.

  • Maintenance of Posture: Supports standing upright.

  • Production of Heat: Assists in thermoregulation—important for physiological function.

  • Venous Return: Aids in the return of blood to the heart.

Diagnostic Examinations for Musculoskeletal System

  • X-ray

  • Laminography

  • Scanography

  • Myelogram

  • Nuclear scanning

  • MRI

  • Computed tomography

  • Bone scan

  • Aspiration (including synovial fluid aspiration)

  • Endoscopic examination

Types of Arthritis

Rheumatoid Arthritis

  • Serious form of arthritis that leads to crippling.

  • Characterized by chronic inflammation of synovial membranes.

Osteoarthritis

  • Degenerative joint disease; nonsystemic and noninflammatory.

  • Commonly affects hand, knee, hip, cervical, and lumbar joints.

  • Symptoms: Pain and stiffness.

Gouty Arthritis (Gout)

  • Caused by uric acid accumulation.

  • More common in men; onset often at night.

  • Symptoms: Excruciating pain and swelling in joints.

Osteoporosis

  • Disorder resulting in loss of bone density.

  • High-risk group: Women aged 55-65.

Bone Healing Process

  1. Hematoma Formation: Bleeding at fracture site.

  2. Organization: Hematoma organizes and forms a fibrin network.

  3. Callus Formation: Osteoblasts enter and create a callus.

  4. Remodeling: Bone is strengthened and reformed.

Common Soft Tissue Injuries

Contusions

  • Most common injury; severity varies.

  • Management: Ice application for vasoconstriction.

Sprains

  • Result from joint hyperextension; can cause hemarthrosis.

  • Management (RICE): Rest, Ice, Compression, Elevation.

Strains

  • Microscopic tears from overstretching.

  • Symptoms: Soreness, stiffness, tenderness.

Dislocations

  • Subluxation: Partial dislocation.

  • May require closed reduction or surgery for correction.

Phantom Pain

  • Occurs in amputees; nerves send pain messages despite absent limb.

Spine Deformities

  • Kyphosis: Rounded thoracic spine.

  • Scoliosis: Lateral curvature.

  • Lordosis: Lumbar spine curvature.

Degenerative Diseases

  • Conditions such as Multiple Sclerosis, Parkinson's, etc., affecting nervous system health.

Multiple Sclerosis (MS)

  • Attacks central nervous system; damages myelin.

  • Symptoms vary; includes fatigue and mobility issues.