copyright © 2008 delmar learning. all rights reserved. unit 41 musculoskeletal system

Copyright © 2008 Delmar Learning. All rights reserved.

Unit 41

Musculoskeletal System


Objectives

• Spell and define terms.• Describe the location and functions of

the musculoskeletal system.• Describe some common conditions of

the musculoskeletal system.


Objectives

• Describe the nursing assistant actions related to the care of patients with conditions and diseases of the musculoskeletal system.

• List seven specific diagnostic tests for musculoskeletal conditions.


The Musculoskeletal System

• Skeleton – Bony frame of the body

• Muscles– Tissues made up of contractile fibers or

cells that produce movement– Together, the skeleton and muscles are

termed the musculoskeletal system


• Review the parts of the human skeleton

Structure and Function


• Review the major muscles of the body

Structure and Function


Common Conditions

• Many conditions can affect the bones, muscles, tendons, ligaments, and joints

• Often, when one of these structures is diseased or injured:– Surrounding tissues are also involved


Range of Motion

• Patients who have been ill or confined to bed are not as active as usual– Their joints may not move through the

normal range of motion daily

• Atrophy– Weakness and muscle wasting from lack of

use


Range of Motion

• Over time– Muscles become rigid– Joints do not move as freely as they once

did– Joint movement may be painful because

the muscles have shortened from lack of use


Range of Motion

• When the joint moves– Muscles stretch

• This causes discomfort or pain– As a result the patient may move even less


• Abduction – Moving away from midline• Adduction – Moving toward the midline• Flexion- Decreasing the angle between

two bones• Extension – Increasing the angle

between two bones


• Bursitis – Inflammation of the bursae (small sacs of fluid around joints)

• Treatment – use heat to promote healing


Arthritis

• Rheumatoid – autoimmune response can occur with any age

• Osteoarthritis – affects the cartilage covering the ends of the bones that form a joint . Most common symptom is Pain


• Gout – The great toe is usually first affected. Caused by uric acid not metabolized correctly. It may go into remission


osteoporosis

• Metabolic disorder of the bones• Most common in women• The first sign is a fracture• Treatment is to prevent fractures and

control pain


Fibromyalgia

• Chronic pain syndrome. Not sure of cause

• Affects more women than men• Criteria for dx:• Pain on both sides of the body, pain

above and below the waist, and pain upon palpatation in at least 11 of 18 body sites


Fractures

• See pg 709


Signs/Sx of fracture

• Edema, Pain, Limited movement, ecchymosis – Bruising

• Treatment – Keep immobile , in most cases will not exercise the fractured extremity


Cast

• Elevated the casted extremity on a pillow

• Turn the patient frequently using the palms of your hands

• Observe the uncasted area of the extremity for signs off decreased circulation. Report coldness, cyanosis, swelling, increased pain, numbnessor tingling


Signs of infection under cast

• Odor and drainage


Traction

• It is designed to pull two body areas slightly apart. Do Not disturb the weights

• Check under straps for pressure areas• Keep bed covers off of ropes and

pulleys


Hip fractures

• most common with elderly• The leg on the affected side may be

shortened and in a position of external rotation

• At risk of pressure ulcers on the heels therefore a pressure relieving mattress may be ordered


THA total hp arthroplasty

• (Insertion of a hip prosthesis)• Care: Anti embolism stockings• trapeze bar• Use an abduction pillow to keep legs

apart• Avoid flexion of the hip and legs• Bed is not elevated more than 45

degrees (see pg 715)

•


Total Joint Replacement

• Goal is to relieve pain.• Most common is hip and knee


CPM (Continuous Passive Motion)

• CPM therapy prevents stiffness by delivering a form of passive ROM so the joint is moved without the patient’s muscles being used. CPM therapy is effortless for the patients


Compartment syndrome

• Painful condition that occurs when pressure within the muscles builds up, preventing blood and oxygen from reaching muscles and nerves, This is a serious complication that may develop following an injury or surgical procedure

• Report to nurse immediately this is surgical emergency.


Amputation

• Phantom pain - this is a real pain• Avoid abduction• Avoid flexion of the knee• Avoid placing pillow under the

amputated extremity• Avoid elevating HOB• Keep legs in adduction


Range of Motion

• Prevents contractures (disfigurement caused by muscle shortening)

• Easier to prevent than reverse


• EMG – measure the effectiveness of muscle/nerve interaction

copyright © 2008 delmar learning. all rights reserved. unit 41 musculoskeletal system

Documents

delmar learning

pain copyright

musculoskeletal conditions

bones copyright

remission copyright

lack of use copyright

bonesmost common

common symptom