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Musculoskeletal Functions
Support & Stand, Movement, Protect vital inner organs, Hematopoiesis, Resevoir (Calcium and Phosphorous)
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Musculoskeletal Components
- Bones/Cartilage
- Joints
- Ligaments
- Muscles - Smooth, Skeletal, Cardiac
- Tendons
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Movements
- Flexion / Extension
- Abduction / Adduction
- Pronation / Supination
- Circumduction
- Inversion / Eversion
- Elevation / Depression
- Plantar Flexion / Dorsiflexion
- Protraction / Retraction
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History (Subjective Data)
- A. Joint pain
- B. Joint stiffness
- C. Joint swelling, heat, redness
- D. Any limitation of movement
- E. Muscle pain/cramping
- F. Muscle weakness
- G. Bone pain
- H. Bone deformity, decreased ROM
- I. Hx of accidents or trauma, hx of fx(s), sprains, dislocation
- J. Functional assessment - any joint, muscle, bone problems that limit activities of
- daily living (ADLs).
- K. Self Care Behaviors - occupational hazards, chronic stress or repetitive motion to
- joints, heavy lifting
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Physical Exam/Assessment (Objective)
- A. Inspection - note the size and contour of the joint. Note color, swelling, masses,
- or any deformities
- B. Palpation - palpate joints for temperature, tenderness, heat, bony articulations,
- swelling or masses
- C. Range of motion - active and passive
- D. Muscle testing - resistant ROM, note strength by R and L - compare
- E. Temporomandibular joint
- F. Cervical spine
- G. Shoulders
- H. Elbow
- I. Wrist and Hand
- 1. Phalen’s test - pt to hold hands back to back while flexing the wrists 90
- degrees X 60 seconds
- 2. Tinel’s sign - direct percussion of the median nerve at the wrist
- J. Hip
- K. Knee
- 1. Bulge sign - mild fluid or effusion of the knee
- 2. Ballottement of the patella - not routinely done
- 3. McMurray’s test - pt supine, hold the heel and flex the knee and hip, place
- hand on medial side of knee, rotate the lef in and out, then rotate the leg
- and push on the knee, then slowly extend the knee - if you hear or feel a
- click this is a positive sign for a torn meniscus (special test/procedure)
- L. Ankle and foot
- M. Spine
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Rheumatoid Arthritis
- chronic, systemic inflammatory disease of joints and
- surrounding connective tissue; characterized by heat, redness, swelling, and painful motion of the affected joints
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Osteoarthritis
noninflammatory, localized, progressive disorder involving deterioration of articular cartilages and subchondral bone, and formation of new bone at joint surfaces; affected joints have stiffness, swelling with hard bony protuberances, pain with motion, and limitation of motion
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Osteoporosis
decrease in skeletal bone mass occurring when rate of bone resorption is greater than that of bone formation
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Atrophy
loss of muscle mass
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Dislocated Shoulder
anterior dislocation (95%) is exhibited as a hollow where it would normally look rounded
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Joint Effusion
swelling from excess fluid in the joint capsule
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Torn Rotator Cuff
characteristic “hunched” position and limited abduction of arm
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Gouty Arthritis
joint effusion or synovial thickening; characterized by redness, heat, soft, boggy or fluctuant fullness to palpation and limited ROM
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Epicondylitis
tennis elbow - chronic disabling pain at the lateral epicondyle of humerous, radiates down extensor surface of forearm
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Ganglion Cyst
round cystic, nontender nodule overlying a tendon sheath or joint capsule, usually on dorsum of wrist
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Carpal Tunnel Syndrome
atrophy occurs from interference with motor function due to compression of the median nerve inside the carpal tunnel, caused by chronic repetitive motion
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Syndactyly
webbed fingers, congenital deformity
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Osgood Schlatter Disease
- painful swelling of the tibial tubercle just below the
- knee, due to repeated stress on the patellar tendon
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Scoliosis
curvature of the spine
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Congenital Dislocated Hip
- head of the femur is displaced out of the cup shaped
- acetabulum
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Spina Bifida
incomplete closure of the posterior part of vertebrae results in a neural tube defect, usually occurs 4th week if gestation
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