In adults, what type of bone produces RBCs?
What are 2 examples of minerals taht can be stored in bones and joints?
calcium and iron
What are nonmobile joints called?
What are moveable joints called?
What do synovial joints have in them?
Cartilage, Ligaments, bursa, muscles attached, tendons and fasiculi
What does cartilage do?
covers the surface of bone
What do ligaments do?
- Connects bone to bone
- provides joint stability
What is bursa?
sac of viscous synovial fluid for friction free movement of joint
What is bursitis?
- inflammation of bursa
- may be caused by overuse or infection
What are fasculi?
bundles of muscle fibers
what are tendons?
attach muscle to bone
what is tendonitis?
inflammation of tendon
What is flexion?
forward or lateral bending
What is abduction?
away from midline
what is pronation?
what is inversion?
what is protraction?
body part forward
where can you internally rotate?
shoulder and hip
what is radial deviation?
move hand inward
what is rotation?
moving head around central point
what is extension?
what is adduction?
what is supination?
what is eversion?
what is retraction?
body part backward
what part of the body can you externally rotate?
what is ulnar deviation?
move hand outward
What is RA? What are the symptoms?
Rheumatoid arthritis. It is inflammation of synovium (lining of the joint)
- symmetric joint involvement
- worse in the am
- movement decreases pain
What is DJD? What are th charicteristics of it?
Osteoarthritis, Degenerative Joint Disease. The cartilage wears away.
- may affect unilateral joint
- worse in pm (wear and tear disease)
What is MOI?
Method of Injury
What is HNP? What are the sensory and motor changes that come with it?
Herniated Nucleus Pulposus ("herniated intervetebral disc")
- Sensory changes: numbness of LE (lower extremities), tingling
- motor changes: weakness
what may preclude independent living?
decreased functional ability
What are the 4 things you will do to examine each joint?
- test ROM
- test muscle strength
What techniques will you use while examining?
- cephlocaudal (head to toe)
- proximal to distal
- support each joint
- compare corresponding joint (examine unaffected joint first)
What are the signs of inflammation or infection of a joint?
redness, heat, swelling, pain
What are the 2 causes of joint swelling?
- effusion (excess joint fluid)
- inflammation of surrounding soft tissue (bursa tendon)
What is a dislocation?
bone out of joint position
what is a subluxation
parital dislocation, bone moves in and out of position
what is a contracture?
shortening of muscle leading to limited ROM
associated with BR and immobility
What is crepitation? (in conjunction with ROM?)
noise adn palpable crunching with motion
What are the 5 grades on the ROM scale?
- 5- FROM against full resistance- normal
- 4- FROM against some resistance- slight weakness
- 3- FROM without resistance- moderate weakness (can move against gravity- over head, but not resistance)
- 2- Full passive ROM- severe weakness, can only roll extremity- cant raise arms over head
- 1- slight muscle contraction- can not move extremity
- 0- no muscle contraction
How wide should one be able to open their TMJ?
How far should one be able to move their TMJ side to side?
What nerve are you assessing when palpating the masseter muscle?
What bones are considered art of the shoulder?
scapula, humerus and clavicle
What is the subacromial bursa?
- cushioning pad
- allows humerus to move under the acromion process of the scapula during abduction of the arm.
What four muscles are part of the rotator cuff?
- teres minor
(and tendons that stabilize the joint)
What are the palpable landmarks of the shoulder?
- acromian process of the scapula
- greater tublercle of the humerus
- coracoid process of the scapula
What is the arm drop test for? What are the components of the test?
tests for rotator cuff tears
- abduct arms past 90 degrees adn ask to lower slowly
- at about 90 degrees, if the arm suddenly drops, there is a supraspinatus muscle weakness, may see the deltoid attempting to compensate
What are the bone of the elbow?
articulation of teh humerus, radius and ulna
Where is the olecranon bursa?
between olecranon process and skin
What is the "funny bone" nerve?
- ulnar nerve, olecranon nerve
- between medial epicondyle and olecranon process.
What is epicondylitis
- occurs with repetitive movement
- assess for pain with flexion and extension
What would pain over the medial epicondyle suggest?
medial epicondylitis or golfer's elbow
What would pain over the lateral epicondyle suggest?
lateral epicondylitis or tennis elbow (from backhand swing movement)
Whar are characteristics of Osteoarthritis or DJD?
hard tender nodules on fingers:
- Heberden's nodes: DIP joint
- Bouchards nodes: PIP joint
What is common with RA?
- Flexion contracture of MCP
- called Swan's neck or boutonniere deformity
When do we commonly see carpel tunnel syndrome?
What are the median nerve distribution tests for Carpel tunnel syndrome? and the results?
- Phalen's- positive (paresthesia of fingers with median nerve distribution
- Tinel's sign- positive (numbness and tingling over median nerve distribution)
- Thenar eminence atrophy
What are the Ulnar nerve distribution tests for carpel tunnel syndrome?
- Phalen's- positive (paraesthesia of fingers with ulnar nerve distribution)
- Hypothenar atrophy
What is Phalen's?
(a test for CTS)
90 degree flexion of wrist x 60 sec
will cause paraesthesia of fingers if t has CTS
What is tinel's sign?
(a test for CTS)
percuss median nerve
will cause numbness and tingling if pt has CTS
seen in median nerve distribution
What is Hypothenar atrophy?
(a test for CTS)
palmar area distal to wrist on ulnar side
seen in ulnar nerve distribution
What is thenar emience atrophy?
(a test for CTS)
- round mound proximal to thumb
- seen in median nerve distribution
What comprises the hip?
acetabulum and head of femur.
Do you inspect the hip while standing or sitting?s
What are palpable landmarks of the hip?
- anterior superior ilian crests
- ischial tuberosity (what you sit on)
- greater trochanter
What are the 3 bones that comprise teh knee?
femur, tibia and patella
What is the largest joint in the body?
What does the medial and lateral menisci do?
cushions tibia and femur (it is cartilage)
What are the ligaments of the knee?
medial and lateral collateral (med and lat stability)
anterior adn posterior cruciate (post and ant cushions)
Palpate the knee while the pt is.........
What are things that we will inspect for in the knee?
- shape and contour (note hollows on either side of patella)
- note inflammation and deformities
- assess quads for atrophy
What comprises the tibiotalor joint?
articulation of tibia, fibula nad talus
What are the landmarks of the ankle?
- medial malleolus
- lateral malleolus
- most feet have a longitudinal arch
What should you have the pt do while you are inspecting the ankle- sit, stand, or walk?
Findings with the toes:
- Toes should lie flat
- hammer toes are more common with a high arch (hyerextension od MTP and flexion of PIP)
- claw toes
- hallux valgus (bunion)- lateral deviation of toes
Where should weight bear on the foot?
Weight should fall in the middle of the foot
What are the characteristics of a supinated foot?
strike of heel on ground is concentrated on outsid eof foot; ankles appear to turn outward
What are the characteristics of a pronated foot?
strike of heel on ground is concentrated on inside of foot; ankles appear to turn inward
What is the technical name for a foot drop?
Wherer are the 4 major landmarks of the spine?
- C7- at vetebral prominens
- T7- inferior angle of scapula
- L4- crosses the highest point on each iliac crest
- S2- crosses two symmetric dimples over posterior superior iliac spines
What are the 4 curves of the spine?
What is scoliosis?
lateral curvature of thoracic adn lumbar spine- note asymmetry of shoulders, scapular, and iliac crests when bending forward.
What is kyphosis?
enhanced thoracic curve
what is lordosis?
enhanced lumbar curve
How do we measure leg length?
anterior iliac spine to medial malleolus
What are the 4 landmarks that we inspect for the back?
symmetry of shoulders, scapulae, iliac crests, and gluteal folds with knees and feet together.
What indicates a herniated nucleus pulposus?
pain shoots down buttocks and leg past knee
When does long bone growth end?
until about age 20
Where do children grow? (place on bone, name for growth plate)
What are common sightings in preschool aged children?
- lordosis is common
- normally may apear flat footed (fat pad along arch until age 3)
- walks with broad stance until age 3
- toeing in common until age 3
- Not so normal things::
- oberve for bow legs or knock knees
- check for trendelenburg sign
What is genu varum?
what is genu valgum?
What age should you start scoliosis screening?
What does pregnancy do to the spine?
- progressive lordosis
- anterior cervical flexion, kyphosis, adn slumping of the shoulder girdle by 3rd trimester (may cause median and ulnar nerve impingement in upper extremities)
What are common findings in older adults?
- height decreses (up to 2 inches)
- loss of sq fat from bony prominences
- loss of muscle mass
What are the characteristics of the height decreses in older adults?
- discs thing and collapse (6th adn 7th decade)
- kyphosis of spine occurs with backward head tilt
- hips and knees flex
- up to 2 in of loss
What is osteoporosis?
- loss of bone matrix
- more in females than males
- more in whites than blacks
What are the advantages of blacks in consideration of their bones?
longer and denser long bones (less osteoporosis)
Asians and Eskimos have a lower _______ thank whites and blacks