Musculoskeletal System -The human skeleton is a dynamic system comprised of
bones, joints, muscles, and supporting structures. All components work together to
produce movement and to supply structure and support to the body. Any
disturbance in this well-integrated system results in musculoskeletal dysfunction or
disorders.
Skeletal System – Skull, Maxilla, Mandible, Clavicle, Sternum, Humorous,
Ribs, Spine, Radius, Ulna, Femur, Pelvis, Patella, Tibia, Fibula,
• Functions
• Provides – shape & form of our bodies
• 206 bones form a rigid framework
• Supports
• Softer tissues & organs of the body are attached.
• Bones are connected by ligaments.
• Bones meet to form joints
• Protects
• Vital organs
• Brain – skull
• Heart/Lungs – sternum & rib cage.
• Allows bodily movement
• Interaction of muscular & skeletal system.
• Musculoskeletal system
• Produces blood for the body
• Stores minerals.
• The Bones
• Endoskeleton within the soft tissue of the body
• Living tissue capable of
• Growth
• Adaptation
• Repair
• 206 bones
• Axial (80)-skull, vertebral column,thorax
• Appendicular (126)-bones of extremities, shoulders,pelvis
• Short (metacarpals), Long (femur) , Flat (Sternum) , Irregular
(vertebrae)
• Osteoblasts – bone forming cells
• Osteoclasts – bone reabsorption cells
• Osteocytes – mature bone marrow
• Osteogenesis – bone formation
• Ossification – process in which minerals (calcium) are
deposited in the bone matrix
• Osteon – microscopic functional bone unit
• Neuromusclar junction:
• Stimulus (nerve impulse) travels to the junction; acetylcholine is
released from vesicles and stimulates muscle to contract.
• Hormones and Bones
• Calcitriol - ↑ amount of calcium in the blood by promoting absorption
from the GI tract; mineralization of osteoid tissue
• Vitamin D Deficient – bone mineralization deficit, deformity, and
fractures
, • PTH & Calcitonin – regulates calcium homeostasis; PTH regs calcium in
the blood, Calcitonin regs inhibits bone reabsorption & ↑ deposit of
calcium in bones
• Thyroid & Cortisol - ↑ thyroid in adults → ↑bone resorption and ↓
formation; ↑cortisol same as thyroid pts w/ long term synthetic
cortisol/corticosteroids → ↑risk for steroid induced Osteopenia
& Fractures
• Growth Hormone – stims liver & bones to produce insulin like growth
factor → ↑ bone modeling in children/adolescents
• Testosterone – skeletal growth in adolescents;
• Estrogen – stimulates osteoblasts & inhibits osetoclasts; ↑bone
formation and ↓reabsorption
Joints
Synathrosis – immovable (skull)
Amphiarthrosis – allow limited motion (vertebral joints/ symphis pubis
Diarthrosis – freely moveable
o Ball and socket – full freedom of movement (hip/shoulder
o Hinge – bending in one direction ( knee/elbow)
o Saddle – allow movement in 2 planes at right angles to each other
(thumb)
o Pivot – rotation for activities like turning doorknobs (radius/ulna)
o Gliding – limited movement in all directions (carpal bones in wrist)
Muscle
• Skeletal Muscle
• Attaches to bones of the skeleton
• Named according to properties
• Contraction exerts force on bones or skin & moves them
• Composed of individual muscle cells (muscles fibers)
• Cardiac Muscle
• Myocardium involuntary & exists only in the heart.
• Branched, striated muscle cells connected by gap junctions
• Controlled by intrinsic factors (amt. of venous return to right atrium;
hormones, signals from autonomic nervous system.
• Smooth Muscle
• No visible striations
• Contracts involuntarily
• Present in walls of hollow organs (digestive tract, blood vessels, urinary
bladder, & the eye.
Musculoskeletal Assessment
• Chief complaint
• Clinical manifestations
• Pain
• Joint stiffness
• Sensory changes
• Swelling
• Deformity
• Limited range of motion
• Infection
• Redness
, • Elevated temperature
• Pain
• Foul smelling drainage
• Swelling
• Inspection
• Joints in alignment; posture straight, gait smooth
• Extremities symmetrical & of equal length
• Muscle groups symmetrical, without atrophy or fasciculation
• Joints without erythema, swelling or deformities.
• Full range of motion (active & passive) in all major joints.
• Palpation
• Muscle groups firm, symmetrical, nontender; without masses or
spasms.
• Joints stable and nontender, without heat, crepitus (palpable or
audible), bogginess, or nodules.
• Muscle strength in all major muscle groups rated 5/5
(Black: chapter 25: pg. 466)
Neurovascular Early Assessment Parameters Client Teaching/Symptoms to
Components or Late Report
Sign
Pain Early Assess area involved ↑ing pain not relieved
using 0-10 scale w/meds or elevation
Paresthesia Early Assess numbness, Should be absent
tingling, pins or needles
sensation
Pallor Early Assess Capillary Refill >3sec/blue fingers or toes
[<3 sec]
Polar Late Assess skin temp by Cool/cold fingers or toes
touch
Paralysis Late Assess Mobility Unable to move area distal
to cast
Pulses Late Assess pulses distal to Weak pulses, unable to
injury [palpable and palpate pulses, pulse
strong] detected only with doppler
Deformities
A. Kyphosis –hump back
B. Scoliosis – curved spine
C. Lordosis – indent of spine towards lower back
D. Genu varum – knees outward
E. Genu valgum – knees inward
Diagnostic Tests
• Noninvasive
• Magnetic Resonance Imaging (MRI)
bones, joints, muscles, and supporting structures. All components work together to
produce movement and to supply structure and support to the body. Any
disturbance in this well-integrated system results in musculoskeletal dysfunction or
disorders.
Skeletal System – Skull, Maxilla, Mandible, Clavicle, Sternum, Humorous,
Ribs, Spine, Radius, Ulna, Femur, Pelvis, Patella, Tibia, Fibula,
• Functions
• Provides – shape & form of our bodies
• 206 bones form a rigid framework
• Supports
• Softer tissues & organs of the body are attached.
• Bones are connected by ligaments.
• Bones meet to form joints
• Protects
• Vital organs
• Brain – skull
• Heart/Lungs – sternum & rib cage.
• Allows bodily movement
• Interaction of muscular & skeletal system.
• Musculoskeletal system
• Produces blood for the body
• Stores minerals.
• The Bones
• Endoskeleton within the soft tissue of the body
• Living tissue capable of
• Growth
• Adaptation
• Repair
• 206 bones
• Axial (80)-skull, vertebral column,thorax
• Appendicular (126)-bones of extremities, shoulders,pelvis
• Short (metacarpals), Long (femur) , Flat (Sternum) , Irregular
(vertebrae)
• Osteoblasts – bone forming cells
• Osteoclasts – bone reabsorption cells
• Osteocytes – mature bone marrow
• Osteogenesis – bone formation
• Ossification – process in which minerals (calcium) are
deposited in the bone matrix
• Osteon – microscopic functional bone unit
• Neuromusclar junction:
• Stimulus (nerve impulse) travels to the junction; acetylcholine is
released from vesicles and stimulates muscle to contract.
• Hormones and Bones
• Calcitriol - ↑ amount of calcium in the blood by promoting absorption
from the GI tract; mineralization of osteoid tissue
• Vitamin D Deficient – bone mineralization deficit, deformity, and
fractures
, • PTH & Calcitonin – regulates calcium homeostasis; PTH regs calcium in
the blood, Calcitonin regs inhibits bone reabsorption & ↑ deposit of
calcium in bones
• Thyroid & Cortisol - ↑ thyroid in adults → ↑bone resorption and ↓
formation; ↑cortisol same as thyroid pts w/ long term synthetic
cortisol/corticosteroids → ↑risk for steroid induced Osteopenia
& Fractures
• Growth Hormone – stims liver & bones to produce insulin like growth
factor → ↑ bone modeling in children/adolescents
• Testosterone – skeletal growth in adolescents;
• Estrogen – stimulates osteoblasts & inhibits osetoclasts; ↑bone
formation and ↓reabsorption
Joints
Synathrosis – immovable (skull)
Amphiarthrosis – allow limited motion (vertebral joints/ symphis pubis
Diarthrosis – freely moveable
o Ball and socket – full freedom of movement (hip/shoulder
o Hinge – bending in one direction ( knee/elbow)
o Saddle – allow movement in 2 planes at right angles to each other
(thumb)
o Pivot – rotation for activities like turning doorknobs (radius/ulna)
o Gliding – limited movement in all directions (carpal bones in wrist)
Muscle
• Skeletal Muscle
• Attaches to bones of the skeleton
• Named according to properties
• Contraction exerts force on bones or skin & moves them
• Composed of individual muscle cells (muscles fibers)
• Cardiac Muscle
• Myocardium involuntary & exists only in the heart.
• Branched, striated muscle cells connected by gap junctions
• Controlled by intrinsic factors (amt. of venous return to right atrium;
hormones, signals from autonomic nervous system.
• Smooth Muscle
• No visible striations
• Contracts involuntarily
• Present in walls of hollow organs (digestive tract, blood vessels, urinary
bladder, & the eye.
Musculoskeletal Assessment
• Chief complaint
• Clinical manifestations
• Pain
• Joint stiffness
• Sensory changes
• Swelling
• Deformity
• Limited range of motion
• Infection
• Redness
, • Elevated temperature
• Pain
• Foul smelling drainage
• Swelling
• Inspection
• Joints in alignment; posture straight, gait smooth
• Extremities symmetrical & of equal length
• Muscle groups symmetrical, without atrophy or fasciculation
• Joints without erythema, swelling or deformities.
• Full range of motion (active & passive) in all major joints.
• Palpation
• Muscle groups firm, symmetrical, nontender; without masses or
spasms.
• Joints stable and nontender, without heat, crepitus (palpable or
audible), bogginess, or nodules.
• Muscle strength in all major muscle groups rated 5/5
(Black: chapter 25: pg. 466)
Neurovascular Early Assessment Parameters Client Teaching/Symptoms to
Components or Late Report
Sign
Pain Early Assess area involved ↑ing pain not relieved
using 0-10 scale w/meds or elevation
Paresthesia Early Assess numbness, Should be absent
tingling, pins or needles
sensation
Pallor Early Assess Capillary Refill >3sec/blue fingers or toes
[<3 sec]
Polar Late Assess skin temp by Cool/cold fingers or toes
touch
Paralysis Late Assess Mobility Unable to move area distal
to cast
Pulses Late Assess pulses distal to Weak pulses, unable to
injury [palpable and palpate pulses, pulse
strong] detected only with doppler
Deformities
A. Kyphosis –hump back
B. Scoliosis – curved spine
C. Lordosis – indent of spine towards lower back
D. Genu varum – knees outward
E. Genu valgum – knees inward
Diagnostic Tests
• Noninvasive
• Magnetic Resonance Imaging (MRI)
