Musculoskeletal

• Musculoskeletal system


  Three main parts: muscles, bones and joints
• Muscles


  • Groups of contractile cells or fibers that affect movement of an organ or another part of the body
  • Skeletal muscles contract and produce skeletal movement when they receive a stimulus from the central nervous system (CNS)
• Tendons


  • Tough fibrous portions of muscle that attach the muscles to bone
• Bursae


  • Sacs filled with friction reducing synovial fluid that are located in areas of high friction such as the knee
• Bones


  • The 206 bones of the skeleton form the body's framework, supporting and protecting organs and tissues
  • Storage of minerals
  • RBC production
• Joints


  The junction of two or more bones
• Joints


  • Stabilize the bones and allow a specific type of movement
  • Two types: nonsynovial and synovial
• Musculoskeletal assessment


  1. Begin with general observation

  2. Systematically assess the whole body, working from head to toe and from proximal to distal structures
• Assessing bones and joints

  1. Perform head-to-toe evaluation using inspection and palpation

  2. Perform passive range-of-motion (ROM) exercises
• Evaluating the temporomandibular joint (TMJ)

  1. Place index fingers in front of middle of each ear

  2. Ask patient to open and close mouth

  3. Check for clicking, swelling, crepitus, or pain
• Assessing the neck


  1. Inspect front, back, and sides

  2. Palpate spinous processes of cervical vertebrae and supraclavicular fossae
• Assessing the spine


  1. Assess spinal position and curvature

  2. Palpate spinal processes and areas lateral to spine
• Normal spinal curvature


  • Cervical concavity
  • Thoracic convexity
  • Lumbar concavity
• Assessing the shoulders and elbows

  1. Observe shoulders for asymmetry, muscle atrophy, or deformity

  2. Palpate shoulders and shoulder muscles
• Assessing shoulder and elbow range of motion

  1. Shoulder flexion and extension

  2. Shoulder external and internal rotation

  3. Shoulder abduction and adduction

  4. Elbow flexion and extension

  5. Elbow pronation and supination
• Assessing the wrists, hands and fingers

  1. Inspect for contour, symmetry, nodules, redness, swelling, deformities, and webbing

  2. Palpate wrists and finger joints

  3. Assess range of motion
• Testing for carpal tunnel syndrome

  Lightly percuss the transverse carpal ligament over the median nerve
• Assessing the hips and knees

  1. Inspect for contour and symmetry

  2. Palpate hips and knees
• Assessing the ankles and feet

  1. Inspect for swelling, redness, nodules, deformities, calluses, bunions, corns, ingrown toenails, plantar warts, trophic ulcers, hair loss, or unusual pigmentation

  2. Palpate bony and muscular structures

  3. Assess range of motion
• Assessing the muscles


  1. Inspect all major muscle groups for symmetry

  2. Note contracture and abnormal movements
• Muscle tone


  Muscular resistance to passive stretching
• Muscle strength


  Graded on a scale of 0 to 5
• Tendons


  Tough fibrous portions of muscle
• 3 mains parts


  • muscle
  • bones
  • Joints
• Muscles


  Group of contractive cells that affect movement of an organ!
• Skeletal muscles


  • Contract to produce skeletal movement
• Ball-and-socket joint


  • Shoulders tip
  • Flexion, extension, abduction, adduction
  • Rotate in their sockets
• Hinge Joints


  • Knees & elbows
  • Flexion, extension
• Types Of JOINT motion

  • Retraction
  • Traction
  • Flexion
  • Extension
  • Circumduction
  • Abduction
  • Adduction
  • Pronation
  • Supination
  • Internal rotation
  • External rotation
  • Eversion
  • Inversion
• Tinel's signs


  • Produces numbness & tingling shooting into the palm & Finger
  • Indicates patient may have carpal tunnel syndrome