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Musculoskeletal System

Musculoskeletal System. Chapter 41-43. Musculoskeletal System FUNCTION!. Protection Framework Mobility Reservoir Blood cells Minerals Ca Ph. Anatomy & Physiology SKELETAL SYSTEM. How many bones are in the human body? 206 1,245 847 145 666. Bone Types. Long bones Short bones

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Musculoskeletal System

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  1. Musculoskeletal System Chapter 41-43

  2. Musculoskeletal SystemFUNCTION! • Protection • Framework • Mobility • Reservoir • Blood cells • Minerals • Ca • Ph

  3. Anatomy & PhysiologySKELETAL SYSTEM How many bones are in the human body? • 206 • 1,245 • 847 • 145 • 666

  4. Bone Types • Long bones • Short bones • Flat bones • Irregular bones

  5. Which of the following are formed in the bone marrow? • Red blood cells • White blood cells • Platelets • Hemoglobin • All of the above

  6. Bone structure • Types of bone tissue • Compact bone • Dense • Spongy bone • Bone marrow

  7. Bone Marrow Red Yellow Location Long bones Contents Fat • Locations • Flat bones • Contents • RBC • WBC • Platelets • Hgb

  8. Bone Cells • Osteoblasts • Form matrix • Osteocytes • Maintenance • Osteoclasts • Dissolving & resorbing

  9. Bone Maintenance • Modeling • Childhood • Remodeling • Adulthood

  10. Cool Fact! Complete skeletal turnover occurs every 10 years

  11. Joints • AKA: • Articulations • Defined • Where two or more bones meet

  12. Synovial joints • Cavity filled with synovial fluid

  13. Ligaments • Defined • Connects bones to bones • Function • Joint stability

  14. Tendon • Define • Connects muscles to bone • Function • Joint movement

  15. Muscles • Types of muscles • Skeletal muscles • Voluntary movement • Smooth muscles • Internal organs • Involuntary • Cardiac muscles • Heart muscle • Involuntary

  16. Muscle structure • Muscle thick bundles of parallel fibers

  17. Muscle contraction • EACH muscle cell is “excitable” • Receive and respond to stimuli • Skeletal muscle cells contract when motor neurons release acetylcholine (neurotransmitter)

  18. Muscle contraction • Motor neuron  • Acetylcholine  • Muscle cells  • Contraction

  19. Muscle extension • Muscles extend when they relax

  20. Muscle Tone • Nerve impulses maintain muscle tone. • Lack of muscle use  atrophy • Muscle wasting

  21. M/S system of the older adult • i in bone mass • Joint & disc dehydrate  iheight • i flexibility • Hips & knees flex • Head tilted backward  • Alt. center of gravity  • h risk of falls

  22. Assessment • Chief complaint • Pain • Limited mobility

  23. Physical assessment • Gait • Movements • Posture

  24. Physical Examination • Posture • What is this? • Kyphosis • h curve of the thoracic spine

  25. Physical Examination • Posture • What is this? • Lordosis • h Curve of the lumbar spine

  26. Physical Examination • Posture • What is this? • Scoliosis • Lateral curve of the spine

  27. Physical assessment • Inspect & palpate

  28. Physical assessment • Crepitus • Grating sound or sensation during ROM

  29. Neurovascular status • CMS • Circulation • Color • Temp • Cap. refill • Motion • Weak / paralysis • Sensation • Paresthesia • Pain

  30. Range of Motion • Flexion • Bend a joint • Extension • Straighten joint • Abduction • Move away from midline • Adduction • Move towards midline

  31. Range of Motion Passive Active Independent • Total assist

  32. Clinical Alert! • Never attempt to move a joint past its normal range of motion for the client or past the point at which pain is experienced.

  33. Erythrocyte Sedimentation Rate (ESR) • What does an elevated ESR indicate? • Bone cancer • Osteoporosis • Inflammation • Anemia • Auto-immune disease

  34. C-reactive Protein • What does an positive CRP indicate? • Bone cancer • Osteoporosis • Inflammation • Anemia • Auto-immune disease

  35. Dx Tests • Ca+ • Calcium • Ph • Phosphate

  36. Dx Test - imaging • X-ray • No special prep • CT – scan • No special prep • CT-scan with contrast • Assess for allergies • MRI

  37. Dx tests • Bone density scan • Used to diagnosis osteoporosis • No special prep

  38. Dx Test • Arthroscopy • Flexible fiberoptic endoscope to visualize joint

  39. Arthroscopy • Pre-procedure • √ Consent • NPO 8 hours • Post-procedure • Assess neurovascular status

  40. Arthroscopy • Pain management • Assess bleeding, swelling • Elevated • Ice

  41. Dr Behl show – Knee arthroscopy • http://video.search.yahoo.com/search/video;_ylt=A2KJkIdUcqhOFU0ARt2JzbkF?p=knee+arthroscopy&fr=&fr=moz2-ytff-&fr2=tab-web

  42. Shoulder Arthroscopy • http://video.search.yahoo.com/search/video;_ylt=A2KJke5zc6hOyQsANouJzbkF?p=shoulder+arthroscopy+surgery&fr=&fr2=sg-gac

  43. Soft Tissue Injury: Sprain • Ligament injury

  44. Soft Tissue injury: Strain • Tear in the muscle

  45. IDT care: Sprain / Strain • X-ray • To rule out fx

  46. IDT care: Sprain / Strain • Rest • Ice • First 48 hours • Compression dressing • Elevate • Above level of the heart

  47. Crutches • Requirement for use • Good balance • Strong upper body • Erect posture

  48. Crutches: Adjust • Length • 5 cm below axilla • Hand grip • 20 – 30o elbow flexion

  49. Crutches • Down Stairs • Crutches • Affected leg • Unaffected leg

  50. Crutches • Up stairs • Unaffected leg • Crutches & affected

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