What are the major functions of the musculoskeletal system?
1) Locomotion
2) Activities of daily living
3) Provide structure and form for soft tissue
4) Protect vital organs
5) Hematopoesis
6) Storage reservoir for calcium and phosphorus
How do synovial joints move? What are some examples?
Freely movable
Knee, shoulder
How do cartilaginous joints move? What are some examples?
Slightly moveable (symphysis) Vertebral bodies of the spine
Slightly moveable (symphysis) Vertebral bodies of the spine
Slightly moveable (symphysis) Vertebral bodies of the spine
Define synarhrosis (firbous) joints?
Two bones connected by fibrous tissue that are immovable
Skull, hard palate
Define amphiarthrosis (fibrocartilaginous) joints?
Joints connected by fibrocartilage with no joint cavity between them
Joints are slightly moveable
Vetebral joints, symphysis pubis, ascroiliac joints, costochondral junction
Define diarthrosis (synovial) joints?
Joints that are freely moveable
Articulating portion of each bone is covered iwth a thing layer of articular (hyaline) cartilage
Allows free, low-friction, painless gliding of bones on each other
Separated by a fluid containing cavity
How far can ligaments stretch before they snap?
6%
What three joins have fibrocartilagnious discs (menisci) between the articulating bones?
Knee
Temporomandibular
Ulna-carpal joints
What is the range of motion for a uniaxial joint?
Moves in one plane, two opposite directions
What is the range of motion for a biaxial joint?
Moves in two planes at right angles to each other
What is the range of motion for a multiaxial joint?
Moves in multiple directions
What are the characteristics of a hinge joint?
Morphology: configuration of the opposing articular surfaces, the presence of strong collateral ligaments, restricts motion
Uniaxial - flexion and extension
Ex: elbow, knee, interphalangeal joints of the fingers
What are the characteristics of a gliding joint?
Morphology: flat articular surface allows gliding over eachother
Uniaxial - moves in flexion and extension
Ex: Patello-femoral joint
What are the characteristics of a pivot joint?
Morphology: bony pivot with an osteoligamentous ring. Allows circular rotation
Uniaxial - head nodding, supination, pronation
Ex: Atlas and axis, proximal radioulnar joint
What are the characteristics of a saddle joint?
Morphology: surface of both bones are convex in one direction and concave in the other direction
Biaxial - flexion, extension, adduction, abduction
Ex: carpometacarpal join of the thumb
What are the characteristics of a condyloid joint?
Morphology: One articulating surface is convex and the other is concave. Allows no rotation
Biaxial - flexion/extension; adduction/abduction
Ex: Carpometacarpal join of the fingers, radiocarpal joint, temporomandibular joint (which is also a hinge joint)
What are the characteristics of a ball and socket joint?
Morphology: one articulating surface is a hemispheric head and the other surface is cup shaped
Multiaxial - flexion/extension, adduction/abduction, external rotation/internal rotation, circumduction
Ex: Hip joint (deep cup) and shoulder (shallow cup)
What types of joints does a TMJ function as?
Condyloid joint
Gliding joint
Hinge joint
What determines the stability of a synovial joint?
The shape and depth of the articulating surface
Ligaments
Associated muscles and muscle tone
Define antalgic (Trendelenberg) gait?
Stance phase of gait is abnormally shortened compared to the swing phase on the affected side
More rapid transfer of weight form one foot (affected side) to the other (opposite) side
Associated with pain on weight bearing side
Define a waddling gait?
Duck like walk
Proximal muscle weakness of the hip
Seen in congenital hip dislocation
What can limit active range of motion?
Pain (bursitis, arthritis)
Swelling
Reduction of forces acting on the joint (muscle weakness)
Structural changes in the soft tissue (ligaments, muscles)
Changes in the boy compartment
Muscle bulk
How do we test C5?
Abduction at the glenohumeral joint
How do we test C6?
Flexion at the elbow joint
How do we test C7?
Extension at the elbow
How do we test C8?
Flexion at the finger joints
How do we test T1?
Abduction and adduction of index, middle and ring fingers
How do we test L1, L2?
Flexion of the hip
How do we test L3, L4?
Extension of the knee
How do we test L5, S2?
Flexion of the knee
How do we test S1, S2?
Plantar flexion of the toes
Where do you do a spinal puncture?
L3/L4 or L4/L5
What are the special tests for sciatic nerve root irritation or entrapment?
Lasegue’s or straight leg raising tests
Bowstring maneuver
What is the special test for sacroiliac joint?
Sacroiliac joint stress maneuver
What are the special tests for the rotator cuff tears?
The shoulder drop test
What are the special tests for the elbow?
Cozen’s test (Lateral epicondylitis - “tennis elbow”)
Medial epicondylitis - “golfer’s elbow”
What are the special tests for carpal tunnel syndrome?
Phalen’s test
Tinel’s test
What do the muscles of the legs anterior compartment do?
Dorsiflex and invert the foot, invert and extend the toes
What do the muscles of the lateral compartment do?
Evert the foot
What do the muscles of the posterior compartment do?
Plantarflex the foot
Flexes the lateral four toes
Flexes the great toe
Laterally rotates the femur on a fixed tibia
Plantarflexes the foot
What are the special tests for the hip and gluteal muscles?
Trendelenburg sign
Thomas’ test (fixed flexion contracture)
What are the special tests for joint effusion of the knee?
Bulge sign Ballotment sign (patellar tap)
What are the special tests for ligament integrity of the knee?
Medial ligament
Lateral ligament
Anterior draw sign
Posterior draw sign
What are the special tests for cartilaginous injury of the knee?
McMurray’s test
Medial meniscus - Fouche’s sign
