Assessment of MusculoSkeletal System

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Assessment of MusculoSkeletal System
2010-12-15 02:09:16

Iggy Chap 52: 1140-1151
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  1. Long Bone
    • Cylindric with rounded ends
    • Often bear weight
    • ex. femur
  2. Short Bone
    • small
    • bear little or no weight
    • ex. phalanges
  3. Flat Bone
    • protect vital organs
    • often contain blood-forming cells
    • ex. scapula
  4. Irregular Bones
    • unique shapes
    • ex. carpal bones of wrist, small bones of inner ear
  5. Sesamoid Bone
    • least common type
    • develops within a tendon
    • ex. patella
  6. Cortex (Bone)
    • outer layer of bone
    • dense, compact bone tissue
  7. Medulla (Bone)
    • inner layer of bone
    • spongy, cancellous tissue
  8. Diaphysis
    the shaft (elongated cylindrical portion) between the ends of a long bone
  9. Epiphyses
    the two knoblike ends of a long bone
  10. Haversian System
    • complex canal network containing microscopic blood vessels that supply nutrients and oxygen to bone and lacunae
    • canals run vertically within the hard, cortical bone tissue
  11. Lacunae
    small cavities that house osteocytes (bone cells)
  12. Cancellous
    the softer tissue inside bones that contains large spaces (trabeculae) that are filled with red and yellow marrow
  13. Hematopoiesis
    • production of blood cells
    • occurs in red marrow of bones
  14. Volkmann's Canals
    connect bone marrow vessels with the haversian system and periosteum
  15. Osteoblast
    • bone-forming cells
    • (type of osteogenic cell)
  16. Osteoclast
    • bone-destroying cells
    • (type of osteogenic cell)
  17. Matrix ("Osteoid")
    • collagen, mucopolysaccharides, lipids
    • deposits of inorganic calium salts (carbonate & phosphate) provide hardness of bone
  18. Some Facts about Bone
    • very vascular tissue
    • blood flow 200-400 mL/min
    • main nutrient arterty, branches into ascending/descending vessels, supplies cortex/marrow/haversian system
    • few nerve fibers
    • Sympathetic Nerve Fibers: dilation of blood vessels
    • Sensory Nerve Fibers: pain signals
  19. Function of Skeletal System:
    • Framework: allows body to be weight-bearing, upright
    • Support Surrounding Tissues: (ex. muscle, tendon)
    • Assists in Movement: thru muscle attachment, joint formation
    • Protects Vital Organs: (ex. heart, lungs)
    • Makes Blood Cells: in red bone marrow
    • Stores Mineral Salts: (ex. calcium, phosphorous)
  20. Resorption (Bone)
    • loss of bone minerals and density
    • release of free calcium from bone storage sites directly into the ECF
  21. Calcitonin
    • produced by thyroid gland
    • decreases serum Ca concentration
    • inhibits bone resorption
    • increases renal excretion of Ca and PO as needed to maintain balance
  22. Vitamin D
    • produced in body, transported in blood
    • promotes absorption of Ca and PO from small intestine
    • enhance PTH activity to release calcium from bone
    • deficiency can cause osteomalacia (softening of bone)
  23. Parathyroid Hormone (PTH)
    • (feedback loop system)
    • Low Serum Calcium:
    • ↑secretion, stimulates bone to promote osteoclastic activity, release Ca into blood
    • ↓ renal excretion of Ca, facilitates absorption from intestine
    • High Serum Calcium:
    • ↓ secretion to preserve bone Ca supply
  24. Growth Hormone
    • secreted by anterior lobe of pituitary gland
    • increases bone length, determines amt of bone matrix before puberty
    • Childhood Increase: gigantism
    • Childhood Decrease: dwarfism
    • Adult Increase: acromegaly (bone & soft tissue deformities)
  25. Adrenal Glucocorticoids
    • regulate protein metabloism
    • ↑ or ↓ catabolism to reduce or intensify the organic matrix of bone
    • aid regulation of intestinal Ca/PO absorption
  26. Estrogens & Androgens
    • Estrogen: stimulates osteoblastic (bone-building) activity, inhibits PTH
    • Androgen: [ex. testosterone] promotes anabolism (body tissue building), increase bone mass
  27. Thyroxine & Insulin
    • Thyroxine: secreted by thyroid gland to increase rate of protein synthesis in all types of tissue
    • Insulin: works w/growth hormone to build & maintain healthy bone tissue
  28. Distinguish these joints and provide examples of each: Synarthrodial, Amphiarthrodial, Diarthrodial (Synovial)
    • Synarthrodial: completely immovable [ex. in the cranium]
    • Ampiarthrodial: slightly movable [ex. in the pelvis]
    • Diarthrodial (Synovial): freely movable [ex. elbow & knee]
  29. Synovial Joint (Diarthrodial): Ball-and-Socket, Hinge, Condylar, Biaxial, Pivot
    • most common type in body
    • most commonly affected by disease
    • lined with synovium [membrane secretes fluid for lubrication & shock absorption]
    • Ball-and-Socket: [shoulder, hip] movement in any direction
    • Hinge: [elbow] motion in one plane, flexion, extension
    • Condylar: [knee] flexion, extension, rotates slightly
    • Biaxial: [wrist] gliding movement
    • Pivot: [radioulna] rotation only
  30. Bursae
    • small sacs lined w/synovial membrane
    • located at joints & bony prominences
    • prevent friction btwn bone & surrounding structures
  31. Types of muscle: Smooth, Cardiac, Skeletal
    • Smooth: non-striated, involuntary, autonomic nervous system, contracts organs & blood vessels
    • Cardiac: striated, involuntary, autonomic nervous system
    • Skeletal: striated, voluntary, central & peripheral NS, fxn is movement
  32. Motor End Plate
    junction of a peripheral motor nerve and the muscle cells that it supplies
  33. Fascia
    • dense, fibrous tissue that surrounds the entire muscle
    • contains the muscle's blood, lymph, and nerve supply
  34. Tendons vs. Ligaments
    • Tendons: bands of tough, fibrous tissue that attach muscles to bones
    • Ligaments: attach bones to other bones at joints
  35. Musculoskeletal Changes Assoc. w/ Aging
    • Osteopenia: decreased bone density (bone loss), osteoporosis is severe osteopenia
    • Synovial Joint Cartilage: less elastic and compressible, damaged cartilage leads to OA
    • Muscle Tissue Atrophy: decreased coordination, loss of muscle strength, gait changes, risk for falls w/injury
  36. Assessment:
    Patient History
    • Any traumatic injuries & sports activities, no matter when they occurred
    • Previous or current illness or disease (ex. diabetes slows healing process)
    • Previos hospitalizations & illnesses or complications
    • Current lifestyle (weight-bearing or high-impact activities, tobacco or alcohol use)
    • Occupation or work life (predisposed to certain injuries)
    • Allergies (dairy = decr. Ca intake)
    • Previous/Current drug use (prescription, OTC, illicit)
    • Herbs, Vit&Min Supplements, Biologic Compounds (glucosamine, chondroitin)
    • Complementary & Alternative Therapies
    • Typical day of Food Intake (identify deficiencies & excesses in nutrients)
    • Family Hx (identify disorders w/familial or genetic tendency)
    • Current Health Problems (most commonly pain & weakness)