Lecture on the Musculoskeletal System

Overview

• The musculoskeletal system is composed of bones, joints, and muscles.
• Functions include:
  • Support and movement
  • Protection of vital organs
  • Production of red and white blood cells, platelets (in bone marrow)
  • Storage of minerals (e.g., calcium and phosphorus)

Bones and Joints

• Bones: Hard, rigid, dense structures.
• Joints (Articulations): Union of two or more bones, functional units permitting mobility needed for activities of daily living (ADLs).
  • Surrounded by a fibrous capsule, supported by ligaments.
  • Ligaments: Fibrous strands connecting bone to bone, preventing undesirable movement.
  • Tendons: Connect muscle to bone, facilitating movement.

Skeletal Muscles

• Composed of bundles of muscle fibers attached to bones by tendons.
• Muscle movements include:
  • Flexion, Extension, Abduction, Adduction
  • Pronation, Supination, Circumduction
  • Inversion, Eversion, Rotation
  • Protraction, Retraction, Elevation, Depression

Osteoporosis

• Gradual loss of bone density leading to porous bones and increased fracture risk.
• More prevalent in aging women due to decreased estrogen levels.
• Prevention strategies:
  • Regular physical activity and strength training
  • Balance training and fast walking
  • Maintaining a healthy body weight
  • Adequate calcium and vitamin D intake

Aging and the Musculoskeletal System

• Height decrease: Due to shortening of bones, particularly the vertebral column.
• Kyphosis: Thoracic curvature causing a backward head tilt.
• Loss of subcutaneous fat, leading to more pronounced bony prominences.
• Decreased muscle mass and atrophy, resulting in overall weakness.

Assessment of the Musculoskeletal System

Subjective Data

• Pain Assessment:
  • Rheumatoid arthritis (RA): Pain worse in the morning.
  • Osteoarthritis (OA): Pain worse later in the day.
  • Tendonitis: Pain worse in the morning.
• Functionality in ADLs: Bathing, toileting, dressing, grooming, eating, mobility, communication.
• Environmental and Lifestyle Factors:
  • Occupational hazards, exercise habits, weight changes, diet.
  • Smoking, alcohol consumption, medication use.

Objective Data

• Joint Inspection: Size, contour, color, swelling, masses, deformities.
• Joint Palpation: Noting any heat, tenderness, swelling, or masses.
• Neurovascular Checks:
  • Sensation, tingling, numbness in extremities.
  • Pulse checks, capillary refill for vascular assessment.
• Range of Motion (ROM): Active vs. passive, strength grading (0-5 scale).

Rheumatoid Arthritis (RA)

• Autoimmune disease with chronic inflammation and pain.
• More common in women, peaks between ages 30-60.
• Symptoms include joint pain, stiffness, fatigue, weight loss, fever.
• Symmetrical and bilateral joint involvement.

Osteoarthritis (OA)

• Non-inflammatory, localized deterioration of articular cartilage.
• Risk factors: Age, obesity, genetics, joint injury.
• Affects hands, knees, hips, lumbar and cervical spine.
• Symptoms include joint stiffening, pain with motion, limited motion.

Conclusion

• Review specific range of motions for the head-to-toe exam.
• Focus on the practical application of concepts in lab sessions.
• Review tables and figures in the textbook for additional details.