1 / 20

Chapter 66

Chapter 66. Assessment of Musculoskeletal Function. Orthopedics. The branch of medicine that deals with the prevention and correction of the disorders and diseases of the musculo-skeletal system.

giacomo-bradley
Download Presentation

Chapter 66

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Chapter 66 Assessment of Musculoskeletal Function

  2. Orthopedics • The branch of medicine that deals with the prevention and correction of the disorders and diseases of the musculo-skeletal system. • The primary goal of the nurse caring for a client with locomotor disorders is the prevention of contractures (permanent shortening of a muscle) or deformities.

  3. Skeletal Functions • To provide the body with a structural framework. • To act as a protective casing for internal organs ( the brain, heart, lungs, etc.). • To allow movement by muscles attached to the skeleton. • To store calcium, phosphorus, and magnesium. • To manufacture blood cells in the red bone marrow.

  4. Structure • 206 Bones in the body • Long bones • Short bones • Flat bones • Irregular bones • Joints • Muscles

  5. Bone Cells • Osteoblasts • Function in bone formation • Osteocytes • Mature bone cells that function in bone maintenance • Osteoclasts • Multinuclear cells function in destroying, resorbing, and remodeling bone

  6. Bone Formation and Maintenance • Osteogenesis: process of bone formation • Ossification: the process of formation of the bone matrix and deposition of minerals • Bone is in constant state of turnover • Regulating factors • Stress and weight-bearing • Vitamin D • Parathyroid hormone and calcitonin • Blood supply • Role of calcium

  7. Bone Healing • Hematoma and inflammation • Angiogenesis and cartilage formation • Cartilage calcification • Cartilage removal • Bone formation • Remodeling

  8. Joints • A joint is a junction of two or more bones. • Three types: • Diarthosis: freely movable such as hinge (elbow, knee); ball and socket (hip, shoulder), pivot (skull, first vertebrae), gliding (wrist) and saddle (thumb). • Synarthosis: joints are immovable (skull sutures). • Amphiarthosis: slightly movable (vertebrae and pelvic bones).

  9. Hinge Joint of the Knee

  10. Muscles • Attached to bones and other structures by tendons • Encased in a fibrous tissue—fascia • Contraction of muscle causes movement • Contraction utilizes energy in the form of ATP • Anaerobic pathways using glucose metabolized from stored glycogen provide energy for more strenuous muscle activity • Movement of the muscles may be voluntary or involuntary.

  11. Assessment of the Musculoskeletal System • Include data related to function ability; ADLs and ability to perform various activities. Note any problems related to mobility. • Health history: family history, general health maintenance, nutrition, occupation, learning needs, socioeconomic factors, and medications—include OTC • Assessment of painand altered sensations • Physical assessment: posture, gait, bone integrity, joint function, muscle strength and size, skin, neurovascular status

  12. Assessment of the Bony Skeleton • Notation on any deformities. • Body alignment. • Abnormal growths due to bone tumors. • Shortened extremities, symetry. • Amputations. • Abnormal angulation other than at joints. • Crepitus (a grating or crackling sensation or sound). • posture

  13. Assessment of Spine Three common spinal curvatures: • Scoliosis (crooked back; lateral curving deviation). • Kyphosis (hump back; increased roundness of the thoracic spinal curve). • Lordosis (sway back; exaggeration of the lumbar spine curvature as seen in pregnancy).

  14. Normal Spine and 3 Abnormalities

  15. Range of Motion (ROM) • Active • person does the moving • Have person move joint through each of its various ROM movements • Note the angle of each joint movement • Note any pain, tenderness, or crepitus

  16. Range of Motion (ROM) • Passive • person relaxes and allows you to move the joints • Done if person is unable to do active ROM • ALWAYS stop if the person complains of pain • NEVER push a joint beyond its anatomic angle

  17. Muscle Strength • As you are testing ROM • Test muscle strength • Ability to perform the ROM against resistance • Symmetry • Involuntary movements

  18. Detecting Fluid in the Knee

  19. Rheumatoid Arthritis—Ulnar Deviation and “Swan-Neck” Deformity

  20. Diagnostic Evaluation • X-rays • Computed tomography • MRI • Arthrography • Bone densitometry • Bone scan • Arthroscopy • Arthrocentesis • Electromyography • Biopsy • Laboratory studies

More Related