Musculoskeletal Nursing Care
movement that causes the top of the foot to elevate or tilt upward
dorsiflexion
frontal and trapezius
muscles of the head and neck
pectoralis major and biceps brachii
muscles that move upper extremities
Flexes and helps adduct upper arm
pectoralis major
movement that causes the bottom of the foot to be directed downward
plantar flexion
movement of the hand and forearm that causes the palm to face downward
pronation
movement of the hand and forearm that causes the palm to face upward
supination
Joints contain a cavity filled with
synovial fluid
-The meeting point of two or more bones. -They hold bone together to form the skeleton -They allow movement and flexibility of the skeleton
Articulation
appendicular skeleton consists of how many bones
126 bones
How many bones in the human body
206
Axial skeleton consists of how many bones
80 bones
Slightly movable joint
Amphiarthrosis
Composed of the upper extremities, lower extremities, shoulder girdle, and pelvic girdle
Appendicular Skeleton
-Arms, legs, pelvic and shoulder girdle -Key role in movement -Insertion of most muscle
Appendicular skeleton
endoscopic examination that enables direct visualization of joint to diagnose extent of injury patient may be given local or general anesthetic agent post procedure: assess neurovascular status of the affected limb after advise patient to limit activities for several days and educate family to provide assistance
Arthroscopy
-Spine, skull, rib cage -Protects internal structures -Origin of muscles
Axial Skeleton
Composed of the skull, hyoid bone in the neck, verbal column, and thorax
Axial Skeleton
The skeletal is divided into
Axial and the appendicular skeleton
-valuable in detecting metastatic and inflammatory bone disease ( osteomyelitis) -involves the IV administration of low radioactivity approximately 2-3 -(2-4) hrs before the test - no food and fluid restrictions -encouraged to drink fluids over the next 1-3 hours for renal clearance -a scanning camera reveals the degree of radionuclide uptake. areas of concentrated nuclide mat represent tumor or other abnormality -
Bone Scan
Joints are enclosed in a
Capsule (Synovial)
only found in the heart
Cardiac
-found only in the heart and at cardiac ends of main blood vessels -contract involuntarily -striated when viewed under a microscope -do not fatigue -contract rhythmically - can contract without signals due to "pacemaker" cells -have a good blood supply
Cardiac Muscles
DURING:will lie still and may feel warm dye injected AFTER: observe for delayed allergic reactions encourage fluid unless CI
Computed Tomography
used for more detailed assessments
Computed Tomography
-pt signed consent form authorizing the exam -ask allergies iodine and sea food -NPO (3-4) hrs -baseline VS -have the pt void
Computed Tomography PREP
Assists in return of venous blood and lymph to the right side of the heart
Contraction
Freely movable joints
Diarthrosis
used to evaluate the amount of inflammation present ESR is elevated in inflammatory arthritis
Erythrocyte Sedimentation Rate
increase the angle between two adjoining joints
Extension
Body's framework that supports internal tissues and organs
Support
Basic Functions of the Skeletal System
Support, Movement. Protection. Hematopoiesis, Mineral storage
Immovable joints
Synarthrosis
Types of joints
Synarthrosis, Amphiarthrosis, Diarthrosis
-Found in the joint capsule -Formed by the synovial membrane, which lines the joint capsule -Lubricates the cartillage -Provides a cushion against shock
Synovial Fluid
puncture of patient's joint with needle and withdrawal of synovial fluid for diagnostic purposes Dx- trauma, SLE, RA, OA, gout Also for instilling meds with trauma or disease- the synovial fluid appears cloudy, milky, sanguineous, yelllow, green or gray after procedure- placing it on a pillow and joint rest for 12 hrs apply ice 24-48 hrs unless otherwise order
Synovial Fluid Aspiration
Forms a firm. cavelike structure that protects our internal structures (ex. skull protects the brain)
Protection
used to determine the presence of skeletal fracture
Radiographic Examination
movement around its longitudinal axis
Rotation
Bones found in the hands and feet
Short bones
-aid in movement and locomotion -voluntarily activated -appear striped under microscopic, also called "striated" muscle -fatigue more quickly than smooth or cardiac muscle -able to stretch and resume original shape
Skeletal Muscles
-Muscles that move voluntarily -Aid in movement and locomotion -Appear striped under a microscope, called striated muscle -FAtigue more quickly than smooth or cardiac muscles -Are able to stretch and resume original shape
Skeletal muscles
Three types of Muscles found in the human body
Skeletal, Smooth. Cardiac
-get their name from their smooth appearance under a microscope - contract involuntarily -found in hair erectors, pupils,glands,ducts, esophagus, bronchi, intestines, stomach,and blood vessels. -contract slowly and rhytmically -fatigue slowly
Smooth Muscles
most efficient at determining injuries of hard structures
X-ray
moves away from the midline of the body
abduction
moves the extremity towards the axis of the body
adduction
Joints are also called
articulations
flexes lower arm
biceps brachii
Bones found in the skull and sternum
Flat bones
the movement decreases the angle between two adjoining joints
Flexion
raises eyebrow
Frontal
-Muscles are necessary for movement -Movement results from contraction and relaxation of the individual muscles -They usually act in groups to execute a body movement
Functions of the Muscular System
Blood cells are formed in the red bone marrow; the red bone marrow is a spongy bone found in the ends of the long bones
Hematopoiesis
bones and joints provide the framework the muscles are responsible for the powerhouse behind the movement tendon connect muscle to bone and skeletal muscles that are soft and fragile are arranged in opposing
How does bone and muscle work together
Bones that make up the vertebrae (backbone)
Irregular
-Involuntary muscles in organs -Found in walls o hollow structures, including veins, arteries, and intestines -Found in hair erectors, pupil, gland, ducts, esophagus, brunch, intestine, stomach, and blood vessels -Contract slowly and rhythmically -fatigue slowly -maintain flow of fluid along tissue walls
Smooth muscles
Hold the bone and joint in the correct position
Ligaments
Bones found in the extremities
Long Bone
Structures of Bones
Long, Short, Flat, Irregular
magnetic resonance imaging can determine the extent of soft tissue injury
MRI
- remove any metal - encourage to relax such as imagery during test -procedure, patient lie still for 45-60 mins
MRI PREP
many minerals, particularly calcium and phosphorus are stored in the bones. The bones release the minerals when we don't get enough of them in our diet
Mineral Storage
Muscles attached to the bones help them move. As the muscle contracts, it pulls on the bone and movement occurs
Movement
used to detect structural disorders such as herniated disk, tumors or presence of infection most common discomfort- HEADACHE
Myelogram
-hx of allergies to iodine and sea food -water soluble dye, semi-fowler's position for 8hrs to keep the dye in lower spine - fluid consumption to helps the body to absorbs dye -oil based flat position for 12 hrs
Myelogram Nursing Intervention
-Motion -Maintenance of posture -Production of heat
Three Vital functions muscles perform when they contract
extends head and neck
Trapezius