1. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Timby/Smith : Introductory Medical-Surgical Nursing, 11/e Chapter 60: Introduction to the Musculoskeletal System

2. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Anatomy and Physiology Bones –There are 206 bones in the human body –Classification: short bones, long bones, flat bones, and irregular bones –Two types of bony tissue –Composition of bones –Types of bone cells –Bone marrow

3. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? There are two types of bones in the body.

4. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer False Rationale: Bones are classified as short bones, long bones, flat bones, and irregular bones. There are two types of bony tissue in the body.

5. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Anatomy and Physiology—(cont.) Muscles: skeletal, smooth, and cardiac Joints –The junction between two or more bones –Free-moving or diarthrodial joints Tendons –Cordlike structures that attach muscles to the periosteum of the bone –Attachments of the muscle Origin and insertion

6. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? Tendons attach bone-to-bone.

7. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer False Rationale: Tendons are cordlike structures that attach muscles to the periosteum of the bone. Tendons connect muscles to their corresponding bone.

8. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Anatomy and Physiology—(cont.) Ligaments: fibrous tissue connecting two adjacent, freely movable bones Cartilage –Firm, dense type of connective tissue –Types: hyaline or articular, costal, semilunar, fibrous, and elastic Bursae –Small sac filled with synovial fluid –Reduces friction between areas

9. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? Ligaments attach bone-to-bone.

10. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer True Rationale: Ligaments attach bone-to-bone. The connection is of two adjacent, freely movable bones.

11. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Assessment History –Chronic disorder: medical, drug, allergy; familial; occupational –Recent injury: occurrence of trauma –Open injury Date of last tetanus immunization –Compilation of list of symptoms –Determining the effect of activity on symptoms

12. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Assessment—(cont.) Physical Examination –Assessment: musculoskeletal Motor skills; muscle strength, wasting Symmetry, size, ROM, alignment Pain, tenderness; swelling; redness Spinal inspection: kyphosis, lordosis, scoliosis Neurovascular: spasms, tremors

13. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Assessment—(cont.) Physical Examination—(cont.) –Assessment: traumatic injury Vital signs; swelling; external bleeding, bruising; open wounds, debris, protrusion of bone or tissue Peripheral circulation, sensation; malalignment of the injured limb Injury beyond the original area Pain: type and location

14. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Management Diagnostic Tests –Diagnostic examination protocols –Send specimens to the laboratory –Ensure safe recovery after procedure Chronic Disorder –General medical history –Current symptoms –Compile drug, allergy histories

15. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Management—(cont.) Invasive Joint Examination –Inspect: swelling, bleeding, or drainage –Change or reinforce dressings Traumatic Injury –Information regarding injury –Monitor: vital signs, neurovascular status –Provide comfort and support