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109 ch. 66

Assessment of Musculoskeletal Fx

What fx does the musculoskeletal system provide protection, framework(support), mobility, produce heat, hematopoiesis, mineral bank (ca/P0), energy storage(adipose)
What do tendons attach? What do ligaments attach? Tendons: muscles to bones, limited blood supply(slow healing),Achilles Ligaments: bone to bone, elastic,easily torn
what types of bones are in the body and how many? 206, long(femur)- wt bearing/mvmt short(metacarpalsm sliding)- cancellous covered by compact flat(sternum, pelvis, cranium)- hematopoiesis, protect vital organs irregular(vertebrae, scapula, mandible)
what is cancellous bone? trabecular, lattice-like, less strength ends on long bones- epiphyses filled with bone marrow in irregular bones
what is cortical bone? compact, organized, shafts of long bones- diaphysis
what is the epiphysis separated by epiphyseal plate, growth plate. Calcified in adults
Structure of the bone epiphysis, diaphysis, medullary cavity(bone marrow), articular cartilage(cover ends of long bones), periosteum, endosteum, epiphyseal plate
What is periosteum nourishes/ facilitates growth and is flooded with blood cells, dense, fibrous membrane. Provides attachment of tendons and ligaments.
what is endosteum covers bone marrow cavity of long bones and spaces in cancellous bone. Osteoclasts are near endosteum
what is bone marrow vascular tissue in medullary of long and flat bones
What are the two types of bone marrow red- hematopoiesis in sternum, ilium, vertebrae, ribs yellow - has fat in adult located in femur, humerus, ulna, radius, tibia, fibia(long bones)
what is hematopoiesis? produce RBC, WBC, platelets
how is blood carried to compact bone? thru Volkmann's canals and periostal vessels
During osteogenesis, what term is used in bone growth for adults and children adults- remodeling- maintains bone structure and fx thru reabsorption child- modeling
what are three types of bone cells osteoblasts- secret bone matrix, form bone from mainly CA and P osteocytes- mature bone cells in lacunae(bone matrix units) osteoclasts- dissolve and resorb bone
what keeps balance of bone formation and resorbtion physical activity, nutrients(Ca & P), hormones(calcitriol/Vit D, PTH calcitonin, thyroid hormone, cortisol, GH, sex),
How much Ca is essentially needed 1000-1200 mg
what does calcitriol do absorbs Ca from gastro tract
What does PTH do with Ca regulates concentrations of Ca in blood, promote mvmt of Ca from bone
what does calcitonin do secreted by thyroid gland in response to elevated Ca, inhibits bone resorbtion, incr bone deposits in bone
GH and sex hormones do what in relation to Ca stimulate growth and remodeling and bone formation
where does bone fracture healing take place in the bone marrow in three phases
what are the three phases of healing for bone phase 1- reactive phase: hematoma 72 hrs from bleeding and granulation forms in clot 3-14 days Phase II: Reparative: callus(procallus)from 3wk to 6mos. Consolidation determined by Xray Phase III: Remodeling: years, bone removed and streamlined
what are three kinds of joints synarthorsis: immovable(skull) amphiarthrosis: limited motion(vertebral, symphysis pubis) and joined by cartilage Diarthrosis: freely moveable
what is the junction of two or more bones a joint (articulation)
what are five kinds of diarthrosis joints? synovial joints: ball/socket, hinge, saddle(thumb), pivot(radium/ulna), gliding(wrist)
how does the medial meniscus help the knee joint cartilage that provides shock absorption and lied between joint surfaces in synovial cavity
what are three types of cartilage elastin- ear lobes, stretch hyalin- end of nose, ends of articulating bones fibrocartilage- disks b/n vertebrae
what is the fx of a bursa sac filled wtih synovial fluid, cushions mvmt of tendons, ligaments, bones; elbow, shoulder, hip, knee
what is fascia encase muscle fibers, nerves and blood in compartments, limited stretch, allows sliding of adjacent structures
what is difference in isometric and isotonic contractions isometric: length of muscle remains same, force incr(push against a wall) isotonic: muscle shortens, no incr in tension (flex forearm)
flaccid vs spastic vs atonic hypertrophy/atrophy flaccid: limp muscle w/o tone spastic: > than normal tone atonic: soft/flabby hypertrophy: enlargment of muscle atrophy: decr size of muscle
effects of aging on musculoskeletal system osteopenia leads to osteoporosis loss of bone mass, incr collagen, atrophy, thinning cartilage, week ligaments
what is difference in bone pain, muscle pain, fracture pain, osteomyelitis(bone infection) pain bone pain: dull, deep ache, "boring" muscle pain: soreness, cramps fracture pain: sharp/piercing osteomyelitis: incr, sharp,
paresthesia burning, tingling, numbness
kyphosis, lordosis, scoliosis curvature of spine kyphosis: incr forward of thoracic spine (huncback), elderly w/ osteoporosis lordosis: swayback, in pregnancy scoliosis: lateral curve of spine, idiopathic
some abnormal gaits spastic hemiparesis gait (stroke), step-page gait (lower motor neuron disease), shuffling gait (Parkinson's disease)
the joint system is evaluated by noting ROM, deformity, stability, nodular formation ( from RA, gout, OA
what is joint effusion? swollen with fluid in capsule, incr temp. (knee)
Assessment of neurovascular status is to asses what? CMS: circulation, motion, sensation Five P's: pain, pallor, pulselessness, paresthesia, paralysis
Imaging of bone density is done mainly by what? Imaging of soft tissue is done best with? Arthrography id's what? Electromyography? DEXA MRI arthrography: tears of joint capsule or ligaments w/ contrast Electromyography: test muscle weakness, pain, disability and nerve problems
What should the nurse look for before any imaging? Nurse look for allergies to contrast and special considerations
Blood lab studies for alkaline phosphatase alkaline phosphatase: elevated in early fracture healing and bone tumors Ca & P: inverse relationship,
Created by: palmerag