Assessment of the Musculoskeletal System

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Assessment of the Musculoskeletal System
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Skeletal System

• Bone types
• Long bones, such as the femur, are cylindric with
  rounded ends they often bear weight.
• Short bones, such as the phalanges, are small and
  bear little or no weight.
• Flat bones, such as the scapula, protect vital
  organs and often contain blood-forming cells.
• Bones that have unique shapes are known as
  irregular bones (e.g., the carpal bones in the
  wrist).
• The sesamoid bone is the least common type and
  develops within a tendon the patella is a
  typical example.

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Skeletal System

• Bone structure

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Skeletal System

• Bone function
• Provides a framework for the body
• Supports the surrounding tissues (e.g., muscle
  andtendons)
• Assists in movement through muscle attachment
  andjoint formation
• Protects vital organs, such as the heart and
  lungs
• Manufactures blood cells in red bone
  marrowProvides storage for mineral salts (e.g.,
  calcium andphosphorus)

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Skeletal System

• After puberty, bone reaches its maturity and
  maximal growth. Bone is a dynamic tissue,
  however, that undergoes a continuous process of
  formation and resorption, or destruction, at
  equal rates until the age of 35 years. In later
  years, bone resorption accelerates, decreasing
  bone mass and predisposing clients to injury.
• Bone growth and metabolism affected by calcium
  and phosphorous, calcitonin, vitamin D,
  parathyroid hormone, growth hormone,
  glucocorticoids, estrogens and androgens,
  thyroxine, and insulin

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Joints

• Types include synarthrodial, amphiarthrodial,
  diarthrodial
• Structure and function of the diarthrodial or
  synovial joint
• Subtyped by anatomic structure
• Ball-and-socket
• Hinge
• Condylar
• Biaxial
• Pivot

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Muscular System

• Structure
• Function
• Supporting structures
• Musculoskeletal changes associated with aging
• Cultural considerations

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Assessments

• Family history and genetic risk
• Personal history
• Dietary history
• Socioeconomic status and ability to afford food
• Current health problems including obesity

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Physical Assessment

• General inspection
• Posture
• Abnormality in gait such as antalgic gait or
  lurch
• Goniometer, which provides a measure of ROM
  (range of movement)
• Head and neck evaluate the temporomandibular
  joints
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Physical Assessment (Continued)

• Spine lordosis, scoliosis
• Upper extremities
• Lower extremities

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Diagnostic Assessement

• Laboratory tests serum calcium and phosphorus,
  alkaline phosphatase, serum muscle enzymes
• Radiographic examinations standard radiography,
  tomography and xeroradiography, myelography,
  arthrography, and CT
• Other diagnostic tests bone and muscle biopsy

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Electromyography

• EMG aids in the diagnosis of neuromuscular, lower
  motor neuron, and peripheral nerve disorders
  usually with nerve conduction studies.
• Low electrical currents are passed through flat
  electrodes placed along the nerve.
• If needles are used, inspect needle sites for
  hematoma formation.

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Arthroscopy

• Fiberoptic tube is inserted into a joint for
  direct visualization.
• Client must be able to flex the knee exercises
  are prescribed for ROM.
• Evaluate the neurovascular status of the affected
  limb frequently.
• Analgesics are prescribed.
• Monitor for complications.

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Other Tests

• Bone scan
• Gallium or thallium scan
• Magnetic resonance imaging
• Ultrasonography