Musculoskeletal system

Question 1

What are the two classifications of joints?

Answer 1

by the material between them (fibrous, cartilaginous, synovial)

OR

their degree of movement
(immovable: synarthrodial aka: skull suture, slightly moveable joints are amphiarthrodial aka: symphysis pubis, and freely movable joints are diarthrodial aka: the knee and distal interphalangeal DIP joint of distal fingers

Question 2

Flexion vs Extension (elbow, hips, neck)

Answer 2

Flexion: bicep show off
Extension: knife hands at sides

Question 3

Abduction vs Adduction (shoulder)

Answer 3

Abduction: Lift arms away from body
Adduction: Arms towards body

Question 4

Pronation vs Supination (elbow/wrist/hand)

Answer 4

Pronation: Palm down
Supination: Palm up

Question 5

Protraction vs Retraction (jaw)

Answer 5

Protraction: Chin out
Retraction: Chin tucked

Question 6

Circumduction (shoulder)

Answer 6

Softball toss (shoulder rotates 360)

Question 7

Rotation (head)

Answer 7

Turn head left and right

Question 8

Elevation vs Depression (shoulder)

Answer 8

Elevation: Shoulder shrug up
Depression: Shoulder shrug down

Question 9

Name the 8 important joints

Answer 9

Temporomandibular
Spine
Shoulder
Elbow
Wrist and Carpals
Hip
Knee
Ankle/Foot

Question 10

What are the 3 types of muscles?

Answer 10

Smooth, cardiac, and skeletal

Question 11

How many bones/cartilage in skeleton?

Answer 11

206

Question 12

How to inspect temporomandibular joint (TMJ)

Answer 12

Palpate for smooth movement (up and down) for Sounds (clicks) and tenderness. Observe jaw for ROM. Motion smooth, without pain. Protrude and retract chin without pain or difficulty.

Question 13

How to inspect the shoulder joint

Answer 13

Structures smooth, regular, bilaterally symmetrical; shoulders
level, rounded, firm, smooth contour, no bony prominences or
crepitus. Each shoulder equidistant from vertebral columns.

Hand behind head, hand on small of back, standing superman, shoulder shrug strength test

Question 14

How to inspect the elbow joint

Answer 14

Inspect size and contour in flexed and extended
positions. Palpate elbow flexed at ~ 70 degrees and relaxed.

Look for deformity, redness, or swelling. Note heat, swelling, tenderness, or nodules

Test muscle strength by stabilizing arm with one hand, flex elbow against resistance applied just proximal to wrist. Extend elbow against resistance

Question 15

How to inspect the wrists and hands

Answer 15

Inspect and palpate. “Skin appears smooth with knuckle
wrinkles present and no swelling or
lesions; muscles appear fully
developed”. “Joint surfaces feel
smooth, without swelling,
bogginess, nodules, or tenderness”

Test ROM and muscle strength. Bend hand up and down at wrist,
bend fingers up and down at joints,
spread fingers apart, make a fist,
touch thumb to each finger and
base of little finger, turn palms
outward and in while on a flat
surface. Position forearm palm up and
resting on a flat surface; stabilize at
midforearm; instruct to flex wrist
against resistance at palm

Question 16

How to inspect the Hip

Answer 16

inspect and palpate: STANDING Note symmetric levels of iliac crests, gluteal folds,
and equally sized buttocks
 Smooth, even gait reflects equal leg lengths and functional
hip motion
 Help person into supine position and palpate hip
joints
 joints should feel stable and symmetric, with no tenderness
or crepitation

Asses ROM: LYING DOWN leg up foot 90 degree to hip knee straight. Leg up knee bent move leg further than 90 degrees back. Both legs down legs together slide one leg as far to side as can. Reset legs together knee bent foot on floor lay knee on one leg and law it on outside of body.

Question 17

How to inspect the ankle and foot

Answer 17

INSPECT sitting, standing and walking
* Compare feet, noting contour of joints
and foot alignment
* Weight-bearing should fall on middle
of foot
* Toes point straight forward and lie flat;
note locations of calluses as they
reveal areas of abnormal friction

Support ankle and palpate joint
spaces; should feel smooth, with no
swelling or tenderness. Palpate metatarsophalangeal; note
swelling, inflammation or tenderness.

Instruct to point toes up and
down, soles of feet in and out. Ability to maintain
dorsiflexion and plantar
flexion against resistance

Question 18

What are the Activities of Daily Living, according to the Katz Index?

Answer 18

bathing, dressing, toileting, transferring, continence, and feeding

Question 19

What health history questions would you ask a person to determine if the individual is having a problem with the musculoskeletal system

Answer 19

Any chronic diseases?
 Loss of bone density or
osteoporosis?
Take medications? Pain meds?
Any changes in ability to move during
usual activities?
Changes in muscle strength? How did
you adapt to changes?
Accidents? Trauma? Surgery on bones or
joints?
* If yes, what was the outcome?

history of:
 Arthritis?
* Rheumatoid arthritis? Osteoarthritis?
* Gout?
 Curvature of spine?
 Back problems in your family?
 Muscular problems?

Do you exercise?
* How often?
* Sports?
* Which ones, and how often?
* Protect yourself from injury while
exercising or playing sports?
* Do you lift, push, pull, bend, or stoop
frequently as part of daily routine at
home or work?
* How do you protect yourself from
muscle strain or injury?

Question 20

What are common problems in musculoskeletal system?

Question 21

What are physical findings of RA and OA?

Answer 21

RA: Osteoporosis. >50 y.o.
Women
Caucasians and Asians have increased risk
Family hx
Smoking, alcohol, diet low in Ca++
Inadequate weight bearing
Low estrogen, testosterone

OA: Arthritis
Increases with age
Women > men
Overweight
Joint injury
Occupations/sports involving repeated knee bend or squatting
Family hx

Question 22

Identify the muscles for which strength testing is appropriate and describe how to conduct the test.

Answer 22

Upper and lower extremities. Ask person to flex the muscle being evaluated
and then to resist when you apply opposing
force against it

Question 23

How do you inspect the spine for scoliosis?

Answer 23

Inspect & Palpate shoulders and cervical,
thoracic, and lumbar spine for alignment and
symmetry and pain/tenderness

Question 24

How do you assess gait? balance? What are expected findings for each test, how do you document results if abnormal?

Answer 24

Observe gait for conformity,
symmetry, and rhythm.
* Expected: “Regular
smooth rhythm, leg
swing, length symmetry,
and smooth symmetric
arm swing.”

Abnormal: An nunstable.exaggerated gait, limp, irregular strdide length, arm swing unrealted to gait,

Question 25

Be able differentiate the subjective data from objective data for the musculoskeletal system.

Question 26

What health history questions are asked about the problems associated with the musculoskeletal system?