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