1. Chapter 40 Assessment of Musculoskeletal Function

2. Question What is atrophy?
Shrinkage-like decrease in the size of the muscle
Fluid-filled sac found in connective tissue
Rhythmic contraction of muscle
Grating or crackling sound or sensation

3. Shrinkage-like decrease in the size of the muscle.
Answer
Shrinkage-like decrease in the size of the muscle.
Atrophy is shrinkage-like decrease in the size of the muscle. Bursa is a fluid-filled sac found in connective tissue. Clonus is rhythmic contraction of muscle. Crepitus is a grating or crackling sound or sensation.

4. Functions of the Musculoskeletal System
Protection of vital organs
Mobility and movement
Facilitate return of blood to the heart
Production of blood cells (hematopoiesis)
Reservoir for immature blood cells
Reservoir for vital minerals

5. Structure 206 bones in the body Long bones Short bones Flat bones
Irregular bones
Joints
Muscles

6. Structure of a Long Bone; Composition of Compact Bone

7. Bone Cells Osteoblasts Function in bone formation Osteocytes
Mature bone cells that function in bone maintenance
Located in the lacunae
Osteoclasts
Multinuclear cells function in destroying, resorbing, and remodeling bone
Located in Howship’s lacunae

8. Bone Formation and Maintenance
Osteogenesis: process of bone formation
Ossification: the process of formation of the bone matrix and deposition of minerals
Bone is in constant state of turnover
Regulating factors
Stress and weight bearing
Vitamin D
Parathyroid hormone and calcitonin
Blood supply
Role of calcium

9. Bone Healing Hematoma and inflammation
Angiogenesis and cartilage formation
Cartilage calcification
Cartilage removal
Bone formation
Remodeling

10. Question
Is the following statement true or false? Epiphysis is the bone-forming cell.

11. Answer
False Epiphysis is the end of a long bone. Osteoblast is a bone- forming cell.

12. Joints (Articulation): Junction of Two or More Bones
Synarthrosis: immovable joints
Amphiarthrosis: allow limited movement
Diarthrosis: freely movable
Ball and socket
Hinge
Saddle
Pivot
Gliding

13. Hinge Joint of the Knee

14. Muscles Attached to bones and other structures by tendons
Encased in a fibrous tissue—fascia
Contraction of muscle causes movement
Sarcomere: the contractile unit of skeletal muscle that contains actin and myosin
Muscle cell fibers react to electrical stimulation
Contraction uses energy in the form of ATP
Anaerobic pathways using glucose metabolized from stored glycogen provide energy for more strenuous muscle activity

15. Muscle Maintenance Muscle tone Muscle actions
Exercise, disuse, and repair

16. Question Is the following statement true or false?
Bone is in a constant state of turnover.

17. True Bone is in a constant state of turnover.
Answer
True Bone is in a constant state of turnover.

18. Assessment of the Musculoskeletal System
Include data related to function ability; ADLs, IADLS, and ability to perform various activities; note any problems related to mobility
Health history: family history, general health maintenance, nutrition, occupation, learning needs, socioeconomic factors, and medications (include OTC)
Assessment of pain and altered sensations
Physical assessment: posture, gait, bone integrity, joint function, muscle strength and size, skin, neurovascular status

19. Normal Spine and Three Abnormalities

20. Detecting Fluid in the Knee

21. Rheumatoid Arthritis—Ulnar Deviation and “Swan-Neck” Deformity

22. Diagnostic Evaluation
Radiographs
Computed tomography
MRI
Arthrography
Bone densitometry
Bone scan
Arthroscopy
Arthrocentesis
Electromyography
Biopsy
Laboratory studies

23. Which statement is false about magnetic resonance imaging?
Question
Which statement is false about magnetic resonance imaging?
Credit cards with magnetic strips may be erased.
Nonremovable cochlear implant devices can become inoperable.
Transdermal patches that have a thin layer of aluminized back must be covered with gauze.
Jewelry and hair clips must be removed before the MRI is performed.

24. Answer
Transdermal patches that have a thin layer of aluminized back must be covered with gauze.
True statements are credit cards with magnetic strips may be erased. Nonremovable cochlear implant devices can become inoperable. Jewelry and hair clips must be removed before the MRI is performed.
Transdermal patches that have a thin layer of aluminized back must be covered with gauze is false. Transdermal patches that have a thin layer of aluminized back must be removed before the MRI is performed because they can cause burns.