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Linda S. Williams / Paula D. Hopper Copyright © 2011. F.A. Davis Company Understanding Medical Surgical Nursing, 4th Edition Chapter 45 Musculoskeletal Function and Assessment

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Page 1: Musculoskeletal Function and Assessment

Linda S. Williams / Paula D. Hopper

Copyright © 2011. F.A. Davis Company

Understanding Medical Surgical Nursing, 4th Edition

Chapter 45

Musculoskeletal Function and Assessment

Page 2: Musculoskeletal Function and Assessment

Copyright © 2011. F.A. Davis Company

Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition

Skeletal System Tissues � Bone � Cartilage � Fibrous Connective Tissue (Ligaments)

Page 3: Musculoskeletal Function and Assessment

Copyright © 2011. F.A. Davis Company

Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition

Skeletal System Functions � Movement � Protection � Stores Calcium

Page 4: Musculoskeletal Function and Assessment

Copyright © 2011. F.A. Davis Company

Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition

Muscular System Tissues � Skeletal Muscle � Fibrous Connective Tissue (Tendons) � Fasciae

Page 5: Musculoskeletal Function and Assessment

Copyright © 2011. F.A. Davis Company

Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition

Muscular System Functions � Movement � Heat Production � Returns Blood from Legs

Page 6: Musculoskeletal Function and Assessment

Copyright © 2011. F.A. Davis Company

Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition

Bone Tissue � Osteocytes � Calcium Salts � Collagen � Periosteum

Page 7: Musculoskeletal Function and Assessment

Copyright © 2011. F.A. Davis Company

Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition

Growth of Bone Osteoblasts Produce Bone Growth and

Repair Bone

Page 8: Musculoskeletal Function and Assessment

Copyright © 2011. F.A. Davis Company

Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition

Anterior Full Skeleton

Page 9: Musculoskeletal Function and Assessment

Copyright © 2011. F.A. Davis Company

Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition

Structure of Skeleton � 206 Bones � Axial Skeleton

� Skull, Hyoid, Vertebral Column, Rib Cage � Appendicular Skeleton

� Arms/Legs, Shoulder, Pelvic Girdles

Page 10: Musculoskeletal Function and Assessment

Copyright © 2011. F.A. Davis Company

Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition

Anterior and Lateral Skull

Page 11: Musculoskeletal Function and Assessment

Copyright © 2011. F.A. Davis Company

Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition

Typical Synovial Joint

Page 12: Musculoskeletal Function and Assessment

Copyright © 2011. F.A. Davis Company

Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition

Appendicular Skeleton Structure of Synovial Joints

Page 13: Musculoskeletal Function and Assessment

Copyright © 2011. F.A. Davis Company

Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition

Major Muscles

Page 14: Musculoskeletal Function and Assessment

Copyright © 2011. F.A. Davis Company

Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition

Muscle Structure and Arrangements

� Over 600 Muscles � Anchored to Bones by Tendons � Antagonistic Muscles � Synergistic Muscles

Page 15: Musculoskeletal Function and Assessment

Copyright © 2011. F.A. Davis Company

Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition

Role of Nervous System � Skeletal Muscles are Voluntary Muscles � Require Nerve Impulses for Contraction

Page 16: Musculoskeletal Function and Assessment

Copyright © 2011. F.A. Davis Company

Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition

Neuromuscular Junction � Termination of Motor Neuron on Muscle

Fiber � Contains Neurotransmitter Acetylcholine

Page 17: Musculoskeletal Function and Assessment

Copyright © 2011. F.A. Davis Company

Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition

Neuromuscular Junction (cont’d) � Nerve Impulse Arrives at Terminal

� Release of Acetylcholine across Synaptic Cleft

� Acetylcholine Bonds to Acetylcholine Receptors

� Sarcomere Shortens

Page 18: Musculoskeletal Function and Assessment

Copyright © 2011. F.A. Davis Company

Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition

Aging and the

Musculoskeletal System

Page 19: Musculoskeletal Function and Assessment

Copyright © 2011. F.A. Davis Company

Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition

Aging and the Musculoskeletal System (cont’d)

� Decreased Muscle Mass/Strength � Decreased Elasticity of Ligaments,

Tendons, Cartilage � Decrease in Intervertebral Space � Changes in Posture and Gait Changes

Page 20: Musculoskeletal Function and Assessment

Copyright © 2011. F.A. Davis Company

Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition

Aging and the Musculoskeletal System (cont’d)

� Impaired Mobility � Increased Risk for Falls � Pain

Page 21: Musculoskeletal Function and Assessment

Copyright © 2011. F.A. Davis Company

Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition

Assessment of the Musculoskeletal System

� Subjective Data � History

� Injury � Occupation � Family History � Current Health � Diet History

Page 22: Musculoskeletal Function and Assessment

Copyright © 2011. F.A. Davis Company

Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition

Assessment of the Musculoskeletal System (cont’d)

� Physical Assessment � Inspection, Palpation, Range of Motion

� Psychosocial Assessment � Deformities Affect Body Image

Page 23: Musculoskeletal Function and Assessment

Copyright © 2011. F.A. Davis Company

Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition

Diagnostic Tests � Laboratory Tests

� Serum Calcium � Serum Phosphorus � Alkaline Phosphatase � Myoglobin � Muscle Enzymes � Uric Acid

Page 24: Musculoskeletal Function and Assessment

Copyright © 2011. F.A. Davis Company

Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition

Diagnostic Tests (cont’d) � X-Rays � Computed Tomography � Dual Energy X-Ray Aborptiometry � Arthrography � Myelogram � Magnetic Resonance Imaging

Page 25: Musculoskeletal Function and Assessment

Copyright © 2011. F.A. Davis Company

Linda S. Williams / Paula D. Hopper Understanding Medical Surgical Nursing, 4th Edition

Diagnostic Tests (cont’d) � Gallium/Thallium Scan � Arthroscopy � Bone or Muscle Biopsy � Ultrasonography � Arthrocentesis � Electromyography