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MUSCULOSKELETAL SYSTEM

 The body system that provides support, stability, shape,


and movement to the body.
 muscles
 bones
 joints

10 Facts about the Musculoskeletal System: A review of the


Anatomy & Physiology:
1. The Skeletal System Consists Of More Than Bones

 Joint: The point at which two (or more) bones meet;


can be fixed, slightly movable, or freely movable.
 Ligaments: Connective tissue that attaches bone to bone
at a joint; help stabilize the joint, keeping it from moving 4. Some Bones
outside of its intended range of motion. Produce Red
 Tendons: Connective tissue that attaches muscle to bone; Blood Cells
When muscle contracts, the tendon acts on the bone,  Red bone marrow
causing movement. is soft tissue
 Fascia: Connects muscles to other muscles located in
 Cartilage: Soft connective tissue found between joints; acts networks of
as a shock absorber to reduce friction spongy bone
 Bursa: A flat, fluid-filled sac found between a bone and a tissue inside some
tendon or muscle. It forms a cushion to help the tendon or bones. In adults
muscle slide smoothly over the bone. the red marrow in
 Synovial joint: Joins bones with a fibrous joint capsule that bones of the
is continuous with the periosteum of the joined bones, filled cranium,
with synovial fluid and surrounds the bones' articulating vertebrae, scapulae, sternum, ribs, pelvis, and at the
surfaces. epiphyseal ends of the large long bones produce blood
 Enthesis: The connective tissue between tendon or cells.
ligament and bone 5. Bones Are Grouped into the Axial Skeleton and the
Appendicular Skeleton which protects vital organs
2. The Adult Human Skeleton Is Made Up of 206 Bones The axial skeleton consists of:
3. Interactions Between the Skeleton, Muscles, and 1. the skull
Nerves Move the Body 2. the vertebral column (spine
 Somatic signals are sent from the cerebral cortex to nerves 3. the thoracic (rib cage
associated with specific skeletal muscles. Most signals The appendicular skeleton consists of:
travel through spinal nerves that connect with nerves that 1. the pectoral girdle (shoulders):
innervate skeletal muscles throughout the body. 2. upper and lower limbs (arms and legs)
 When a muscle fiber receives a signal from the nervous 3. the pelvic girdle (hip bones)
system, myosin filaments are stimulated, pulling actin
filaments closer together. This shortens sarcomeres within
a fiber, causing it to contract.
 Extension: increasing the angle between two bones
Abduction: moving away from the body’s midline.
 Adduction: moving toward the body’s midline.
 Pronation: rotating the forearm so the palm is facing
backward or down.
 Supination: rotating the forearm so the palm is facing
forward or up.
 Elevation: moving a body part up.
 Depression: moving a body part down.
 Protraction: moving a bone forward without changing the
angle.
 Retraction: moving a bone backward without changing the
angle.
 Inversion: turning the sole of the foot inward.
 Eversion: turning the sole of the foot outward.
 Dorsiflexion: bringing your foot upward toward your shin.
 Plantar flexion: depressing your foot.
6. What percent body weight is composed of muscle?
40-50% 10. Muscle Actions Have Prime Movers, Synergists,
 Over 600 Skeletal Muscles Stabilizers, and Antagonists (NO PICS KASE GANUN
HAHA)
 Prime movers/ agonist: is the muscle that provides the
primary force driving the action.
 Antagonist: is in opposition to a prime mover in that it
provides some resistance and/or reverses a given
movement. Prime movers and antagonists are often paired
up on opposite sides of a joint, with their prime
mover/antagonist roles reversing as the movement
changes direction.
 Synergists. One or more synergists are often involved in
an action. Synergists are muscles that assist the prime
mover in its role.
 Stabilizers. Stabilizers act to keep bones immobile when
needed. Your back muscles, for example, are stabilizers
7. The body contains three types of muscle tissue when they are keeping your posture sturdy.
 Skeletal muscle is voluntary and striated. These are the
muscles that attach to bones LIFESPAN CONSIDERATIONS:
and control conscious  Palpate the clavicles of newborns. A mass and crepitus
movement. may indicate a fracture experienced during vaginal delivery.
 Smooth muscle is  Infants should be able to sit without support by 8 months
involuntary and non- of age, crawl of 7 to 10 months, and walk by 12 to 15
striated. It is found in the months.
hollow organs of the body,  Check muscle strength by holding the infant lightly under
such as the stomach, the arms with feet placed lightly on a table.
intestines, and around blood  Pronation of the feet are common 12-30mos.
vessels.  Bowleg is normal for about 1 year after beginning to walk
 Cardiac muscle is  Genu valgus (knock knee) is normal in preschool and early
involuntary and striated. It is pre-school children.
found only in the heart and is
 Lordosis is common in children before age 5.
specialized to help pump Children should be assessed for scoliosis by age 12.
blood throughout the body.
 Children at risk for injury r/t physical activity should be
8. Muscles have 5 properties
assessed for nutritional status, physical conditioning and
 excitable/irritable -capable of receiving and responding to
safety precautions.
stimulation from the nerves
 Athletic adolescent girls are at risk for delayed menses,
 contractible- capable of shortening after receiving osteoporosis and eating disorders.
stimulation
 extensible-can be stretched without damage DISEASES: (WALANG PICS KASE CREEPY NA HO
 elasticity-return to its original resting shape and length MASYADO HAHAHA)
 adaptability- can be changed in response on how it is used A. Gangrene
(hypertrophy thru work out)  Gangrene of the first to fourth toes of the right foot in a
9. Muscles Act on Synovial Joints to Move the Body person with diabetes
 Flexion: decreasing the angle between two bones
B. Rheumatoid Arthritis (RA)  Or polydactylism also known as hyperdactyly, is a
 Inflammatory disease of joints and surrounding connective congenital physical anomaly resulting in supernumerary
tissue. The disorder is bilateral and symmetrical fingers
characterized by heat, redness, swelling and painful motion T. Dupuytren contracture
of the affective joints.  Is a progressive tightening of the bands of fibrous tissue
C. Bursitis (called fascia) inside the palms, causing a curling in of the
 Bursitis is painful inflammation of a bursa (a flat, fluid-filled fingers that eventually can result in a claw-like hand.
sac that provides cushioning where skin, muscles, tendons, U. Hand abscess
and ligaments rub over bones).  Is an accumulation of pus affecting the hand, usually
D. Ingrown Toenail (Onychocryptosis, Unguis Incarnatus) caused by a bacterial infection.
 Results when the toenail grows into the nail fold. V. Herpetic whitlow
E. Athlete's foot (tinea pedis)  Is a viral infection of the fingertip.
 Is a common cutaneous condition in which fungus infects W. Carpal tunnel syndrome
the skin of the foot  Is a painful compression (pinching) of the median nerve as
F. Clubfoot it passes through the carpal tunnel in the wrist.
 Is a deformity in which a foot is turned inward, often so
severely that the bottom of the foot faces sideways or even Subjective Data: History & Present Illness:
upward. 1. JOINTS
G. Knock Knees Ask: Pain
 Are angular deformities at the knee, in which the head of Ask: Stiffness
the deformity points inward. Ask: Swelling, heat, redness
H. Bowlegs Ask: Limitation of Movement
 Is a condition in which the knees stay wide apart when a 2. MUSCLES
person stands with the feet and ankles together. Ask: Pain/Cramping
I. Ankylosing Spondylitis Ask: Weakness
 Chronic progressive inflammation of spine, sacroiliac and 3. BONES
larger joints of the extremities, leading to bony ankylosis Ask: Pain
and deformity. Ask: Deformity
J. Lordosis Ask: Accidents or trauma
 Also called swayback, the spine of a person with lordosis Ask: numbness, tingling, limping
curves significantly inward at the lower back. 4. FUNCTIONAL ASSESSMENT (ADL)
K. Kyphosis Ask: Problems create any limits on ADLs
 Kyphosis is characterized by an abnormally rounded upper  If YES: Bathing-turning faucents
back (more than 50 degrees of curvature).  Toileting-urinating, removing bowels, wipe self
L. Scoliosis  Dressing-doing buttons, pulling dress or sweater over head,
 A person with scoliosis has a sideways curve to their spine. pulling up pants, tying shoes
The curve is often S-shaped or C-shaped.  Grooming-brushing teeth, shaving, brushing har, applying
M. Osteoporosis make-up
 Decrease in skeletal bone mass occurring when rate of  Eating-preparing meals, bringing food to mouth, drinking
bone resorption is greater than that of bone.  Mobility- walking, walking up & down the stairs, getting
N. Osteoarthritis in/out of bed
 Noninflammatory, localized, progressive disorder involving  Communicating-talking, using phone, writing
deterioration of articular cartilages and subchondral bone 5. SELF-CARE BEHAVIORS
and formation of new bone at joint surfaces Ask: Any occupational hazards
O. Ectrodactyly, split hand, cleft hand Ask: Exercise program (pain)
 Involves the deficiency or absence of one or more central Ask: Recent weight gain
digits of the hand or foot and is also known as split Ask: Medications for MS system
hand/split foot malformation (SHFM). Ask: Chronic disability or crippling illness
P. Ganglia 6. Infants and Children
 Are swellings that occur over joints or on coverings of Ask: Trauma during labor and deliver (forceps?)
tendons in the hands and wrists and that contain a jellylike Ask: Baby resuscitation
fluid. Ask: Motor milestones
Q. Swan-neck deformity Ask: Broken bones, dislocations
 Is a bending in (flexion) of the base of the finger, a Ask: Medications for MS
straightening out (extension) of the middle joint, and a Ask: Chronic disability or crippling illness
bending in (flexion) of the outermost joint. 7. Adolescents
R. Radial dysplasia Ask: Sports
 Is an under-development, abnormal development, or Ask: Special equipment, training program
absence of the structures on the radial side (“thumb side”) Ask: Daily warm-up
of the forearm, wrist and/or hand. Ask: Actions when getting hurt
S. Polydactyly 8. Aging adult
Ask: Change in weakness
Ask: Increase in falls or stumbling  Quadriceps. Patient is supine, knee partially extended;
Ask: Use any mobility aids patient resists while you attempt to flex the knee.
 Ankles and feet. Patient resists while you attempt to
OBJECTIVE DATA: dorsiflex the foot and again when you flex the foot.
Purpose:
 Assess function for ADL f. Inspect the skeleton for
 Screen for any abnormalities structure.
Equipment: g. Palpate the bones to
 Tape measure locate any areas of
 Goniometer edema or tenderness.
 Skin marking pen h. Inspect the joint for
Approach: swelling.
 Make pt comfortable i. Palpate each joint for
 Orderly tenderness, smoothness
 Head to Toe of movement, swelling,
 Proximal to distal crepitation, and presence
of nodules.
 Support each joint at rest
 Firm support, gentle movement, gentle return to a relaxed
TEMPEROMANDIBULAR JOINT
state
NECK: PIVOT JOINT
 Compare corresponding paired joints
SHOULDER: BALL & SOCKET JOINT
ELBOW: HINGE JOINT
MUSCLES
a. Inspect the muscles for size. For any discrepancies,
WRIST: CONDYLOID JOINT
measure the muscle with tape.
b. Inspect for contractures.
HAND AND FINGERS:
c. Inspect tremors.
Metacarpophalangeal Joints: CONDYLOID JOINTS
d. Palpate muscles at rest
Interphalangeal Joints: HINGE JOINT
e. Palpate for flaccidity, spasticity, smoothness of movement.
Thumb: SADDLE JOINT
Normal: Equal strength on each body side
Deviations from N: 25% or less of normal strength
HIP: BALL & SOCKET JOINT
KNEE: HINGE JOINT
ANKLE: HINGE POINT

FOOT: PLANAR/GLIDING JOINT


TOES:
Metatarsophalangeal Joints: HINGE JOINTS
Interphalangeal Joints: HINGE JOINT
Intertarsal Joints: PLANAR/GLIDING JOINT
TRUNK: PLANAR/GLIDING JOINT
 Patient turns the head to one side against the resistance of
your hand. Repeat with the other side.  Pivot joints consist of the rounded end of one bone fitting
 Patient shrugs the shoulders against the resistance of your into a ring formed by the other bone. This structure allows
hands. rotational movement, as the rounded bone moves around
 Biceps: Patient fully extends arm and tries to flex it while its own axis. NECK
you attempt to keep arm in flexion.
 Triceps: Patient flexes arm and tries to extend it against
your attempt to keep it in flexion.
 Wrist and finger muscles. Patient spreads the fingers and
resists as you attempt to push the fingers together.
 Grip strength: Patient grasps your index and middle
fingers while you try to pull them out.
 Hip muscles. Patient in supine, legs extended. Raises one
leg at a time while you attempt to hold it down.
 Hip abduction. Supine, legs extended. Place hand on  Ball-and-socket joints possess a rounded, ball-like end of
lateral surface of each knee; patient spreads the legs apart one bone fitting into a cuplike socket of another bone. This
against your resistance. organization allows the greatest range of motion, as all
 Hip adduction. Place your hands between the knees; movement types are possible in all directions. SHOULDER
patient brings the legs togethen against your resistance. & HIP
 Hamstrings. Patient is supine, both knees bent. Patient
resists while you attempt to straighten the legs.
 In hinge joints, the slightly rounded end of one bone fits
into the slightly hollow end of the other bone. In this way,
one bone moves while the other remains stationary, like the
hinge of a door. ELBOW, KNE, ANKLE
METATARSOPHALANGEAL JOINTS,
INTERPHALANGEAL JOINTS
 Planar/Gliding joints have bones with articulating surfaces
that are flat or slightly curved faces. The range of motion is
limited in these joints and does not involve rotation. FOOT,
INTERTARSAL JOINTS, TRUNK

 Condyloid/ellipsoidal joints consist of an oval-shaped


end of one bone fitting into a similarly oval-shaped hollow
of another bone This type of joint allows angular movement
along two axes. WRIST, METACARPOPHALANGEAL
JOINTS

 Saddle joints are so named because the ends of each


bone resemble a saddle, with concave and convex portions
that fit together. Saddle joints allow angular movements
similar to condyloid joints but with a greater range of motion.
THUMB

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