Chapter 39 Assessment of Musculoskeletal Function

PTH regulates the

Concentration of Ca in the blood If low levels of Ca in blood, increased levels of PTH prompt mobilization of Ca

Circumduction

Cone like movement

Bones are constructed of ____ or ___ bone tissue

Cortical Cancellous

The shaft known as diaphysis, is primarily

Cortical bone ( compact bone)

Amphiarthrosis joints

Limited motion (Vertebral joints, symphysis pubis)

gliding joint

Limited movement in all directions and are represented by the joints of the carpel bones in the wrist

The periosteum contains

Nerves Blood vessels Lymphatics Provides for the attachment of tendons and ligaments

osteogenesis

bone formation

atrophy

decrease in the size of a muscle

Arthroscopy

direct visualization of the interior of a joint through the use of fiberoptic endoscope

epiphysis

end of long bone

hypertrophy

enlargement ; increase in size of a muscle

diarthrosis joint also known as synovial joints are freely movable and consist of

- ball and socket joints - hinge joints - saddle joints -pivot joints -gliding joints

The repair of a simple fracture occurs in four stages

1) hematoma formation 2)fibrocartaginous callus formation 3) bony callus formation (ossification) 4) remodeling

Three basic kinds of joints

1)synarthrosis 2) amphiarthrosis 3) diartheosis

Daily intake calcium for adults

1000-1200mg

There are ___ bones in the body

206

Vitamin D intake

600IU -young adults 800-1000- 50+

Excessive thyroid hormone production ( Graves' disease) results in

> bone resorption and < bone formation

The main source of energy for the muscle cells is

ATP

Short bones are the irregularly shaped bones located in

Ankle and hand (metacarpals)

___ is the chief cause of musculoskeletal disabilities in the US

Arthritis

Bone densitiometry is used to evaluate

BMD

Osteogenesis (bone formation) begins

Before birth

Flexion

Bending at joint

skeletal (striated) muscle are involved in

Body movement Posture Heat production functions

Bone xrays determine

Bone density Texture Erosion Change in bone relationship

Deficiency of Vitamin D results in

Bone mineralization deficit Deformity Fracture

Throughout the lifespan, a process known as ___ ___ occurs, which old bone is removed and new bone is added to the skeleton

Bone remodeling

Muscle and tendons hold ___ together and ___ allow the body to move

Bones Joints

More than 98% ____ is present in bone

Calcium

Bone pain is typically described as:

Dull Deel ache that is boring in nature

Calcitonin secreted by the thyroid gland in response to

Elevated blood Ca levels, inhibits bone resorption and increase the deposit of CA into bone

The ___ is a thin, vascular membrane that covers the marrow cavity of the long bones and the spaces in cancellous bone

Endosteum

During childhood there Is a layer of cartilage known as the epiphyseal plate ( growth plate) that speartes the ___ and ____

Epiphysis Diaphysis

The muscles of the body are composed of parallel groups of muscle cells because in fibrous tissue called

Fascia (epimysium)

Joint X-Ray reveal

Fluid, irregularity, spur formation, narrowing, change in structure

Cancellous bone is found where

Hematopoiesis and bone formation occur

Red mone marrow located mainly in the sternum, ilium, vertebrae, and ribs, is responsible for producing RBC, WBC, and platelets through a process called

Henatopoiesis

ball and socket joint

Hip and shoulder Full movement

musculoskeletal system serves as a reservoir for

Immature blood cells Essential minerals (calcium, phosphorus, magnesium and fluoride)

Calcitriol functions by ___ the amount of calcium in the blood by...

Increasing Promoting absorption of Ca from Gastro tract

The contraction of muscle fibers can result in either ___ or ___ contraction of muscle

Isometric Isotonic

Saddle joints

Only one pair exists and is between the thumb and wrist.

The cells that make up bone are

Osteoblast Osteocytes Osteoclasts

Estrogen stimulates ____ and inhibits ___

Osteoblasts Osteoclasts

Microsopic functioning unit of mature cortical bone is the

Osteon or haversian system

pt on long term synthetic cortisol or corticosteroids are at > risk for steroid induced

Osteopenia and fracture

___ and ___ are the major hormones regulators of ca homeostatsis

PTH calcitonin

Chart 39-2

Page. 1126

Covering the bone is a dense, fibrous membrane known as

Periosteum

Hinge joints

Permit bending in only one direction either flexion or extension ( elbow, knee)

The balance between bone resorption and formation is influenced by the following factors

Physical activity Dietary intake of certain nutrients (calcium) Several hormones including calcitriol, PTH, calcitonin, thyroid hormone, cortisol, growth hormone and sex hormones estrogen and testosterone

Pivot joints examples

Pivot joints allow rotation arround an axis. The neck and forearms have pivot joints. In the neck the occipital bone spins over the top of the axis. In the forearms the radius and ulna twist arround each other.

The more fascicule contained in the muscle the more

Precise the movement

A bone scan is performed to detect

Primary bone tumors Osteomyelitis Some fracture Aseptic necrosis Monitor progression of degenerative bone disease

Retraction

Pulling backward

Protraction

Pushing forward

Movements facilitates the return of deoxygenated blood to the _____ side of the heart by massaging the venous vasculature

Right

Long bones are shaped like

Rods or shafts with rounded ends

Osteoclasts are located in

Shallow Howships lacunae ( small pits), involved in dissolving and resorbing bone

Fracture pain is

Sharp and piercing and is relieved by immobilization

Muscular pain is described as

Soreness Aching " muscle cramps"

Extension

Straightening at a joint

Cortical bones exists in areas where

Support is needed

Rotation

Turning around a specific axis

Pronation

Turning downward

Inversion

Turning inward

Supination

Turning upward

Eversion

Turnjng outward

Arthrograohy is used to identify the cause of

Unexplained joint pain and progression of joint disease

Long bones are found in the:

Upper and lower extremities (Ex. Femur)

Vitamin D food sources are

Vitamin D fortified milk & cereals Egg yolks Saltwater fishes Liver

Flat bones are located

Where extensive protection of underlying structures is needed ( sternum or skull)

joint capsule

fibrous tissue that encloses bone ends and other joint surfaces

bursa

fluid filled sac found in connective tissue, usually in the area of the joints

crepitus

grating or crackling sound or sensation; may occur with movement of ends of a broken bone or irregular joint surface

spastic

having greater-than-normal muscle tone

Synarthrosis joints

immovable joints ( skull structure)

lordosis

increase in concave curvature of the lumbar spine

kyphosis

increase in the convex curvature of the thoracic spine

fasciculation

involuntary twitch of muscle fibers

Arthrocentesis

joint aspiration

scoliosis

lateral curvature of the spine

trabeculae

latticelike bone structure; cancellous bone

cancellous bone

latticelike bone structure; trabecular bone

flaccid

limp; without muscle tone

osteocyte

mature bone cell

lamellae

mature compact bone structures that form concentric rings of bone matrix lamellar bone

synovium

membrane in joint that secretes lubricating fluid

osteon

microscopic functional bone unit

The ends of the long bones, called epiphyses, are primarily

Cancellous bone (trabecular bone)

Osteoblasts function in bone formation by secreting bone matrix. The matrix consist of

Collagen and ground substances ( glycoproteins and proteoglycans)

Bones are divided into four categories classified by their shape:

Long Short Flat Irregular

Osteocytes are mature bone cells involved in bone maintenance; located in the

Lucunae ( bone matrix units)

Abduction

Movement away from the midline of the body

Adduction

Movement toward the midline of the body

endosteum

a thin, vascular membrane covering the marrow cavity of long bones and the spaces in cencellous bone

paresthesia

abnormal sensation (burning, tingling, numbness)

contracture

abnormal shortening of muscle, joint, o both; fibrosis

Joint

area where bone ends meet; provides for motion and flexibility

osteoblast

bone forming cell

osteoclast

bone resorption cell

Bone is composed of

cells, protein matrix, and mineral deposits

cortical bone

compact bone

tendon

cord of fibrous tissue connecting muscle to bone

effusion i

excess fluid in joint

periosteum

fibrous connective tissue covering bone

fascia (epimysium)

fibrous tissue that covers, supports, and separates muscles

isotonic contraction

muscle is shortened without a change in tension; a joint is moved as a result

isometric contraction

muscle tension is increased without changing its length; there is no associated joint motion

tone (tonus)

normal tension (resistance to stretch) in resting muscle

ossification

process in which minerals (calcium) are deposited in bone matrix

remodeling

process that ensures bone maintenance through simultaneous bone resorption and formation

osteopenic

refers to a reduction in bone mass to below normal levels

resorption

removal/destruction of tissue, such as bone

X-ray study of the cortex of the bone

reveals any widening, narrowing, or signs of irregularity

clonus

rhythmic contractions of a muscle

ligament

ropelike bundles of collagen fibrils connecting bones

disphysis

shaft of long bone

cartilage

tough, elastic, avascular tissue at ends of bone

Irregular bones include

vertebrae, pelvic bones, and certain facial bones

Atonic

without tone; denervated muscle that atrophies