Musculoskeletal System

1
Musculoskeletal System

• Prof. Valerie Bosco
• N241

2
Introduction

• Assessment involves examination of muscles,
  bones, and joints
• CNS coordinates muscle and bone function
• System supports movement, protects organs,
  produces RBCs, and is a reservoir for storage of
  minerals

3
Musculoskeletal Complaints

• Accidents
• Sports injury
• Osteoarthritis
• Age specific complaints
• Infant
• Adolescent
• Elderly

4
A P Review

• MS consists of
• Muscles
• Tendons
• Ligaments
• Bones
• Cartilage
• Joints
• Bursa

• Bones
• 206 bones in human skeleton
• Joints
• Articulation of two or more bones
• Classified by shape and motion

5
Priority Assessment Questions

• What do you do for a living? or
• What is your occupation?
• Reveals health hazards related to lifting,
  sitting, and repetitive movements
• Clues to treatment (at risk)
• Any problems with joints, muscles, bones, or
  ADLs
• Self-care behaviors

6
INSPECTION

• Posture
• Gait
• Smooth
• Coordinated
• Head leads
• Guarding
• Varies with age

7
Temporomandibular Joint (TMJ)

• Articulation of mandible and temporal joint
• Permits speaking and chewing
• Hinge and gliding action

8
Spine

• 33 connecting vertebrae
• 7 cervical
• 12 thoracic
• 5 lumbar
• 5 sacral
• 3 - 4 coccygeal

9
Shoulder

• Articulation of humerus with glenoid fossa of the
  scapula
• Ball and socket
• 4 muscles and tendons make up the rotator cuff
• Subacromial bursa
• Acromion process
• Greater tubercle
• Coraciod process

10
Elbow

• Articulations of humerus, radius, and ulna
• Hinge joint and rotation
• Landmarks medial and lateral epicondyles, and
  olecranon process

11
Wrist and Carpals of the Hand

• Articulation of radius and carpal bones
• Flexion and extension
• Side-to-side deviation
• Rotation
• Midcarpal
• Metacarpophalangeal and interphalangeal permit
  finger motion

12
Hip

• Articulation between the acetabulum and head of
  femur
• Ball and socket
• Weight-bearing function
• Landmarks anterior superior iliac spine, ischial
  tuberosity, and greater trochanter

13
Knee

• Articulation of femur, tibia, and patella
• Hinge joint
• Flexion and extension
• Ligaments cruciate and collateral
• Landmarks quadriceps and tibial tuberosity

14
Ankle and Foot

• Articulation of tibia, fibula, and talus
• Hinge joint
• Flexion (dorsiflexion)
• Extension (plantar flexion
• Inversion and eversion
• Landmarks medial and lateral malleous

15
MS Examination

• Inspection size and contour of joint, color,
  swelling, masses, or deformity
• Palpation heat, tenderness, landmarks, and any
  thickened synovial membranes
• Range of Motion (ROM) active and passive,
  flexibility of joint
• Muscle Testing test strength of muscle groups
  for a particular joint

16
Developmental Considerations

• Infants
• Ortolani maneuver of hips
• Allis Test
• Gluteal folds
• Arms and Hands
• Back
• ROM

17
Developmental Considerations

• Adolescents
• Screen for scoliosis
• Sports related injuries
• Osgood-Schlatter disease

18
Developmental Considerations

• Elderly
• Postural changes
• Contour changes
• Decrease in body fat
• Functional assessment for ADL