Musculoskeletal System

MUSCULOSKELETAL SYSTEM

Anatomy Three Divisions Ω muscles Ω bones Ω joints

Anatomy of the Muscular System

Anatomy Functions of the Muscular System – Body movement – Maintenance of Posture – Respiration – Production of body heat – Communication – Constriction of organs and vessels – Heartbeat

Anatomy Four major functional characteristics – Contractility – Excitability – Extensibility – Elasticity

Anatomy of the Skeletal System

Anatomy Functions of the Skeletal System – Support – Protection – Movement – Storage – Blood cell production

Anatomy Functional classification of joints ♦ Synarthroses ♦ Amphiarthrosis ♦ Diarthrosis

Assessment Focus Muscle strength Tone Size Muscle development ▓ fasciculation ▓ tremors ■intention tremor ■resting tremor

Assessment Equipment ►Goniometer

Implementation 

Explain the procedure.

3. Wash hands and observe appropriate infection control procedures. 5. Provide for client privacy. 7. History taking.

History Inquire with the client the following: presence of muscle pain : onset, location, character, associated phenomena, aggravating and alleviating factors any limitations to movement previous sports injuries any loss of function without pain

Muscle Assessment 5. Inspect the muscles for size. 6. Inspect the muscles and tendons. 7. Inspect the muscles for fasciculations and tremors. > by having the client hold the arms out in front of the body

Muscle Assessment 8. Palpate muscles at rest to determine muscle tonicity. 9. Palpate the muscles while the client is active and passive for flaccidity, spasticity, and smoothness of movement. 10. Test muscle strength.

Testing Muscle Strength Sternocleidomastoid Trapezius Deltoid Biceps Triceps Wrist and finger muscles Grip Strength

Hip Muscles Hip abduction Hip adduction Harmstrings Quadriceps Muscles of the ankle and feet

Grading Muscle Strength 0: 1: 2: 3: 4: 5:

0% of normal strength 10% of normal strength 25% of normal strength 50% of normal strength 75% of normal strength 100% of normal strength

Bone Assessment 11. Inspect the skeleton for normal structure and deformities. 12. Palpate the bones to locate any areas of edema or tenderness.

Joint Assessment

13. Inspect the joint for swelling. Palpate each joint for tenderness, smoothness of movement, swelling, crepitation, and presence of nodules. 14. Assess joint range of motion >Ask the client to move a selected body parts. The amount of movement can be measured by a goniometer. 15. Document findings.

Types of Joint Movements Movement >Flexion

Action >Decreasing the angle of the joint

>Extension

>Increasing the angle of the joint

>Hyperextension

>Further extension or straightening of the joint

>Abduction

>Movement of the bone away from the midline of the body

Types of Joint Movements >Adduction

>Movement of the bone toward the midline of the body

Types of Joint Movements >Pronation

>Moving the bones of the forearm so that the palm of the hand faces downward when held in the front of the body

>Supination

>Moving the bones of the forearm so that the palm of the hand faces downward when held in the front of the body

Types of Joint Movements

>Circumduction

>Movement of the distal part of the bone in a circle while the proximal end remains fixed

>Rotation

>Movement of the bone around its axis

Types of Joint Movements >Eversion

>Inversion

>Turning the sole of the foot outward by moving the ankle joint.

>Turning the sole of the foot inward by moving the ankle joint

Lifespan Considerations

Infants Palpate the clavicles of newborns. A mass of crepitus may indicate a fracture experienced during vaginal delivery. Newborns naturally return their arms and legs to the fetal position when extended and released. Check muscle strength by holding the infant lightly under the arms. Check infants for developmental dysplasia of hip.

Lifespan Considerations Children Should be able to sit without support 8 months of age. Pronation of the feet is common in children between 12 and 30 months of age. Genu varum is normal in children for 1 year aftter beginning to walk. Lordosis is common in children before age 5.

Lifespan Considerations Elders Muscle mass decreases with age. The bones become fragile and osteoporosis leads to a total bone mass. Osteoathritic changes in the joints can be observed.