Health Assessment Chapter 22&23
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Components of musculoskeletal system
consists of the body's bones, joints, and muscles.
What are the five reasons humans need the musculoskeletal system
- (1) for support to stand erect
- (2) for movement
- (3) to encase and protect the inner vital organs (e.g., brain, spinal cord, heart)
- (4) to produce the red blood cells in the bone marrow (hematopoiesis)
- (5) as a reservoir for storage of essential minerals, such as calcium and phosphorus in the bones.
Connection between cartilage and synovial joints
In synovial joints, a layer of resilient cartilage covers the surface of opposing bones. Cartilage is avascular; it receives nourishment from synovial fluid that circulates during joint movement.
What are ligaments
Ligaments are fibrous bands running directly from one bone to another that strengthen the joint and help prevent movement in undesirable directions
What are the three types of muscles?
skeletal (voluntary; those under conscious control), smooth, and cardiac
what does a skeletal muscle attach to?
bones by a tendon
Name some movements that skeletal muscles perform?
- 1 Flexion—bending a limb at a joint
- 2 Extension—straightening a limb at a joint
- 3 Abduction—moving a limb away from the midline of the body
- 4 Adduction—moving a limb toward the midline of the body
What functions does the TMJ (temporomandibular joint) perform
speaking and chewing
33 vertebrae breakdown
7 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 3 or 4 coccygeal vertebrae.
Which spinous processes are prominent at the base of the neck?
The spinous processes of C7 and T1
How do intervertebral discs function?
disks cushion the spine like a shock absorber and help it move. As the spine moves, the elasticity of the disks allows compression on one side, with compensatory expansion on the other. Sometimes compression can be too great. The disk then can rupture and the nucleus pulposus can herniate out of the vertebral column, compressing on the spinal nerves and causing pain.
Where does lengthening occur?
Lengthening occurs at the epiphyses, or growth plates
Screening musculoskeletal examination components
- Inspection and palpation of joints integrated with each body region
- Observation of ROM as person proceeds through motions described earlier
- Age-specific screening measures, such as Ortolani sign for infants or scoliosis screening for adolescents
Inspection of Musculoskeletal system
Inspect the skin and tissues over the joints for color, swelling, and any masses or deformity.
- Deformities include:
- -dislocation (complete loss of contact between the two bones in a joint)
- -subluxation (two bones in a joint stay in contact but their alignment is off)
- -contracture (shortening of a muscle leading to limited ROM of joint)
- -ankylosis (stiffness or fixation of a joint).
Palpation of Musculoskeletal system abnormal findings
Warmth and tenderness signal inflammation.
Palpable fluid in synovial membrane is abnormal. Because fluid is contained in an enclosed sac, if you push on one side of the sac, the fluid will shift and cause a visible bulging on another side.
What is active or voluntary ROM (AROM)
Patient performs the exercise to move the joint without any assistance to the muscles surrounding the joint.
What is passive ROM
patients' muscles relaxed and with you moving the body part. Anchor the joint with one hand while your other hand slowly moves it to its limit.
Limitation in ROM is a sign of what?
limitation in ROM is the most sensitive sign of joint disease.
an audible and palpable crunching or grating that accompanies movement. It occurs when the articular surfaces in the joints are roughened. It is an abnormal finding.
What is Muscle testing
testing the strength of the prime mover muscle groups for each joint.
*See Grading System on page 577
Phalen Test procedure for muscle testing
Ask the person to hold both hands back to back while flexing the wrists 90 degrees. Acute flexion of the wrist for 60 seconds produces no symptoms in the normal hand.
Phalen test reproduces numbness and burning in a person with carpal tunnel syndrome.
Tinel Test procedure for muscle testing
Direct percussion of the location of the median nerve at the wrist produces no symptoms in the normal hand
In carpal tunnel syndrome, percussion of the median nerve produces burning and tingling along its distribution, which is a positive Tinel sign.
What does the bulge sign check for?
For swelling in the suprapatellar pouch, the bulge sign confirms the presence of small amounts of fluid as you try to move the fluid from one side of the joint to the other
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