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health assessment
musculoskeletal ch 24
| Question | Answer |
|---|---|
| bone function | structure/protection serve as lever calcium storage blood production |
| axial bones | head/trunk bones |
| appendicular bones | extremities shoulder hips |
| type of bones | compact bones spongy bones |
| type of bone cells | osteoblast osteoclasts |
| skeletal muscle types | skeletal voluntary muscles (650) smooth muscle cardiac muscle |
| types of muscle movements | abduction/adduction circumduction inversion/eversion extension/flexion protraction/retraction elevation/depression rotation |
| fasciculi | long muscle fibers (voluntary muscle) joined by connective tissue |
| skeletal muscles | attached to bone via tendon assist with posture body heat allow bodily movement |
| joint | where 2 or more bones meet provide ROM |
| joint classifications | fibrous cartilaginous synovial |
| fibrous joints | joined by fibrous connective tissue immovable ie skull bone sutures |
| cartilaginous joints | joints jointed by cartilage ie. vertebral joints |
| synovial joints | contain space between bones filled w/ synovial fluid bones are jointed by ligaments enclosed by fibrous capsule ie. shoulder/wrist/knees |
| synovial fluids | lubricant that promotes sliding movement at bone ends |
| ligaments | connective tissue joining synovial joints |
| articular cartilage | smooths and protects bones articulating iwht another |
| bursae | small sacs filled w/ synovial fluid (cushion joints) |
| different cartilaginous joints | cervical bones (7) thoracic bones (12) lumbar bones (5) sacral bones (5) coccygeal bones (3-4) |
| osteoporosis | low bone density d/t bone forming cells cannot keep pace with bone destroying cells |
| osteoporosis risk groups | white females age (65+) postmenopausal females underweight individuals Hx fractures malabsorption disease endocrine disease (hyperthyroidism/hypogonadism/hyperparathyroidism) smoking long term glucocorticoid use/PPI |
| osteoporosis clinical manifestations | loss of height over time stooped posture easy fracture back pain (fractured/collapsed vertebra) |
| why are postmenopausal women at higher risk | decreased estrogen level -> decrease bone density = elevated osteoporosis risk |
| osteoporosis tx | bisphosphonates (medication) diet (increase calcium) weight bearing exercise |
| osteoporosis client education | sufficient calcium intake + sufficient protein intake physical activity vitamin D smoking/EtOH avoidance |
| older adult physical exam considerations | some positions for exams may be uncomfortable with decreased flexibility |
| sternoclavicular joint | one of 4 joints in the shoulder where clavicle meets sternum |
| paravertebral muscles | muscles located along the spine |
| spinal processes | should be nontender, well developed, firm/smooth w/ nontender paraspinal muscles |
| ROM test of lumbar spine | bend forward and touch toes (check shoulder/scapula/hip symmetry) flexion and rotation |
| phalen test | holding dorsal side of hands together for 1 minute test for CTS |
| ganglion | nontender, round, enlarged/swollen fluid filled cyst commonly seen on the wrist |
| rheumatoid arthritis | autoimmune arthritis may be swelling in the wrist/finger joints |
| tenosynovitis | infection of flexor tendon sheathes cause painful extension of finger |
| wrist fracture signs | pain/tenderness/swelling inability to hold grip pain that improves and returns as dull ache extreme tenderness when pressure applied |
| tinel test | percuss radial side of wrist on the median nerve tingling/shocking sensation = positive test suggests CTS if positive |
| dupuytren contracture | condition where finger is permanently bent or flexed with inability to extend ring and little finger |
| signs of hip bursitis | pain when moving from standing to lying down pain on palpation of greater trochanter |
| decrease in hip rotation suggests | possible osteoarthritis femoral neck stress fracture |
| unequal leg length suggest | possible scoliosis abnormality in structure/position of hip or pelvis |
| plumb line inspection | front/side = ear -> shoulder -> hip lower extremities = iliac crest -> knee -> patella -> ankle -> toe should be aligned vertically |
| ballottement test | detects large amounts of fluid in knee (in supine position) firmly palpate patella on the top and bottom, if fluid wave or click noted = large amounts of joint effusion positive test in meniscal tears |
| older adult consideration for knee | may have bow legged appearance d/t decrease muscle control |
| lumbar curve flattening suggest | herniated lumbar disc ankylosing spondylitis |
| ankylosing spondylitis | type of spine arthritis, may see lumbar spine flattening |
| kyphosis | hunch back (thoracic spine rounding) common in older clients |
| lumbar lordosis | natural inward curvature of the lower back |
| scoliosis | curvature of spine in S shape laterally |
| thenar atrophy | atrophy of thenar prominence d/t pressure on median nerve seen in carpal tunnel |
| osteoarthritis | degenerative joint disease cartilage wears down with age joint pain |
| boutonniere deformities | flexion of proximal interphalangeal joint and hyperextension of distal interphalangeal joint common in rheumatoid arthritis |
| swan neck deformities | hyperextension of the proximal interphalangeal joint with flexion of the distal interphalangeal joint common in rheumatoid arthritis |
| acute rheumatoid arthritis | Tender, painful, swollen, stiff joints |
| chronic rheumatoid arthritis | chronic autoimmune inflammatory joint disorder of body joint linings -> painful swelling -> bone erosion + joint defromity severe cases attacks organs |
| chronic rheumatoid arthritis tx | no cure antirheumatic drugs slow progression pain medications |
| osteoarthritis tx | pain medications physical therapy surgery |
| RA vs OA | RA = systemic + rapid progression w/ classic signs of swelling OA = nonsystemic + slow progression w/o swelling |
| gout | urate crystals formation in joints d/t high uric acid content in blood inflammation/pain/swelling of joints |
| gout complications | recurrent gout attacks kidney stone advanced gout w/ tophi |
| gout risk factor | high purine food (increase uric acid) EtOH (decrease renal elimination) sugary drinks obesity/age/men genetics dehydration |
| flat feet | foot w/o arch -> cause pain/swelling on foot surface |
| acute gouty arthritis | metatarsophalangeal joint of great toe affected tender/painful/reddened/hot/swollen |
| callus | nonpainful thickened skin @ pressure points of feet |
| hallux valgus | great toe is deviated laterally and may overlap 2nd toe possible bunion formation @ medial side on great toe joint |
| corn | painful thickening of skin @ bony prominences/pressure points |
| plantar wart | painful warts occurring under callus -> appears as tiny dark spot |
| osteomalacia | SOFTENING of bones |
| osteomalacia vs osteoporosis | softening of bones vs decreased bone density |
| older client considerations | fall risk (proprioception issue or mechanical weakness) osteoporosis/osteomalacia risk -> fracture risk |
Created by:
sleepingbear