week 5: musculoskeletal sys

Question 1

how many bones for supporting the body

Answer 1

206!

Question 2

what is a joint

Answer 2

Place of union of 2+ bones; aids in mobility (activities of daily living; ADL’s)

Question 3

non synovial joints

Answer 3

Not freely moveable, slightly moveable (ex., skull, vertebrae)

Question 4

synovial joints

Answer 4

Freely moveable, bones are separated, has enclosed cavity
- Cavity has synovial fluid, covered with cartilage on bone surface
- Ligaments support joint: Fibrous bands from one bond to other, strengths the joint and prevents undesired movement

Question 5

developmental considerations for bones: infants/children

Answer 5

Has a single C-shaped curve to the spine at birth
Secondary anterior curves in cervical (3-4 months) and lumbar (12-18 months)
Bones lengthen at the epiphyses (growth plates); trauma or infection can deform
Longitudinal growth continues until closure at around 20 years

Question 6

developmental considerations for older adults

Answer 6

Resorption/Bone Loss happens more than Deposition/Bone Growth; osteoporosis happens, vertebral column shortens, calcium is lost
Postural changes: Kyphosis (humpback), backward head tilt, knee/hip flexion, balance
Losing subcutaneous fat: Bones get bonier; bony prominences seem sharper
Losing muscle mass = weakness
Lifestyle (exercise, weightlifting) can prevent, delay changes

Question 7

flexion

Answer 7

Bending limb at joint

Question 8

extension

Answer 8

Straightening a limb at joint

Question 9

abduction

Answer 9

Move limb away from midline

Question 10

adduction

Answer 10

Move limb towards midline

Question 11

pronation

Answer 11

Turning palms down

Question 12

supination

Answer 12

Turning palm up

Question 13

circumduction

Answer 13

Moving arm in a circle around shoulder

Question 14

inversion

Answer 14

Turning sole of foot in

Question 15

eversion

Answer 15

Turning sole of foot out

Question 16

rotation

Answer 16

Moving head around central axis

Question 17

protraction

Answer 17

Moving body part forward parallel to ground (ex., jaw forward)

Question 18

retraction

Answer 18

Moving body part backward parallel to ground

Question 19

elevation

Answer 19

Raising body part (ex., shoulders)

Question 20

depression

Answer 20

Lowering body part

Question 21

disorder examples

Answer 21

Arthritis, Osteoporosis, Gout, Lower Back DIsorders, Fractures/Dislocations, Joint replacements (hips and knees), amputations

Question 22

osteoporosis

Answer 22

Decrease in bone mass and density
Tested with bone mineral density for women/men over 65, those with fractures over 40 or a family history of osteoporotic fractures, or use of steroids for >3 months

Question 23

osteoporosis risk factors

Answer 23

Women moreso than men, the older you get, if you’re white/Asian, if you have a family history, if you’ve had a hip fracture, if you have a small frame (you have less overall bone mass)
Hormone levels (too much/little), lowered sex hormones, thyroid hormones or other gland issues (overactive parathyroid/adrenal)
DIET: Low calcium, vitamin D, eating disorders (less intake and therefore less calcium), GI surgery (less absorption), taking steroids, lifestyle choices

Question 24

osteoporosis prevention

Answer 24

Diet: Including milk, fish, greens, soy, onions, reducing caffeine
Exercise: Doing weight-bearing exercises (do you even lift bro)
Lifestyle: Reducing smoking and alcohol
Supplements: Calcium and Vitamin D

Question 25

hand problems

Answer 25

Rheumatoid Arthritis (thick knuckles): Bouchard (Proximal IP joint) nodes and Heberden’s (Distal IP joint) nodes Swan Neck deformity (knuckles “swan neck” inward) Ulnar Deviation (it’s like way up)

Question 26

subjective assessment: joints

Answer 26

Have you had any problems or pain with any of your joints? Where is it (both sides), how does it feel/strength, when did it start, when does it happen/how long does it last, what makes it better/worse? Indicative of arthritis, rheumatoid arthritis, osteoarthritis Is there any stiffness in your joints? Is there any swelling, redness, or heat? (acute inflammation) Any limitation of movement and in which joint?

Question 27

subjective assessment: muscles

Answer 27

Have you had muscle problems like pain or cramping? (myalgia = weakness/pain) Is there any weakness in the muscles? Where, how long? Claudication: Leg cramps, in calf, peripheral vascular disease, reduced O2

Question 28

subjective assessment: bones

Answer 28

Any bone pain? Is it affected by movement? Any deformities of bone/joint? What caused it? Does it affect your ROM? Any accidents/trauma to your bones like fractures, dislocations, sprain, joint strain?

Question 29

functional assessment

Answer 29

Do your problems affect any Activities of Daily Living? Which ones? Bathing, Toileting, Dressing, Grooming, Eating, Mobility, Communicating Assess for safety for independent living, if they need home healthcare services Instrumental Activities of Daily Living (IADL) - Activities for independent community life Shopping, meal prep, housekeeping, laundry, finances, transport, medications

Question 30

general: self-care behaviours

Answer 30

Do you have any occupational hazards like heavy lifting, repetitive motion, joint stress? What do you do to it better? What kind of exercise do you do? Do you warm up? Do you get pain during exercise? Weight gain, loss of independence, self-esteem, body image, role changes?

Question 31

subjective history for infants/children

Answer 31

Were you told about any birth trauma? (Ex., dislocations during birth) Did the child need to be resuscitated? (anoxia) Did the child reach the motor milestones at a normal age? Any bone injuries/dislocations? Any bone deformities? Like strange toes/feet, spinal curvature, when? Treatment?

Question 32

subjective history for adolescents

Answer 32

Are you involved in any athletics/sports? Do you use safety equipment? Warm up? What do you do if you get hurt? Any adult supervision? Time management(? The textbook is weird)

Question 33

subjective history for aging adults

Answer 33

Any changes in weakness over the past few months/years? Any increase in falls or stumbling or injuries? Do you use any mobility aids or anything to help you walk? Assess home environment, community resources, risk for elder abuse (dependence, impairments, social isolation)

Question 34

objective assignment things to note

Answer 34

- size/contour/colour - swelling/masses/deformities - effusion (fluid) - dislocation - subluxations (partial dislocations) - contracture (shortening of a muscle; therefore limited ROM of a joint) - ankylosis (stiffness/fixation of joint) - gait? - posture

Question 35

inspection and palpation

Answer 35

Note size and contour (bilaterally), any colour, swelling, masses, deformities Feel for skin temperature, bony articulations, any tenderness, heat, swelling, masses

Question 36

ROM

Answer 36

Generally, you model Active ROM and assist with passive if they can’t do it Passive ROM: Assisting them to do flexion/extension Active ROM: Them moving their joint themselves

Question 37

rating muscle strength

Answer 37

On a 5 point scale, where 5 is normal 0. No contraction Slight Contraction Full ROM, Passive Motion no Gravity Full ROM, with Gravity Full ROM, against Gravity, some Resistance Full ROM, against Gravity, full Resistance