121 Week 10 Musculoskeletal


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  • Add Dem Bones illiac crest and greater trochanter of femur (acromion process)
  • Use of boney prominences to identify/locate muscles for IM injection points: Dorsogluteal (illiac crest and greater trochanter of femur) Ventrogluteal (illiac crest and greater trochanter of femur) Deltoid (acromion process) Vastus lateralis
  • Tenderness and swelling: osteomyelitis, rheumatoid arthritis, strains & sprains, bursitis, tendonitis, Malaise, weakness, fatigue: Lordosis, Kyphosis, Scoliosis, osteomyelitis, rheumatoid arthritis, rheumatoid arthritis, carpel tunnel syndrome, myasthenia gravis, polymyositis, systemic lupus erythematosus, Duchenne’s muscular dystrophy Fever: Osteomyelitis, rheumatoid arthritis, gout, systemic lupus erythematosus Bone deformation: scoliosis, osteoporosis, Paget’s; fractures, osteoarthritis, systemic lupus erythematosus, Duchenne’s muscular dystrophy Inflammation Osteomyelitis, osteoarthritis, sprains & strains, bursitis & tendonitis, Stiffness: osteoarthritis, Weight and height loss Kyphosis, osteoporosis, rheumatoid arthritis Pain: herniated Intervertebral disc, osteoporosis, Paget’s, osteoarthritis, rheumatoid arthritis, gout, sprains & strains, bursitis & tendonitis, carpel tunnel, systemic lupus erythematosus Bone pain: Living with constant pain becomes a part of everyday life. Sometimes the pain becomes severe, and any chance for relief is greatly appreciated. In fact, most bone cancer patients that die are folks that have given up on living because the pain has become just too great. When cancer invades the bone it can cause the bone to deteriorate or build up too quickly. Although the mechanism is not fully understood, it is theorized that bone pain occurs due to stretching of the tissue around the bone, which can have an inflammatory effect. It also may result from pressure on nerve roots or muscle spasms
  • There are several types of bone fracture , including: Oblique - a fracture which goes at an angle to the axis Comminuted - a fracture of many relatively small fragments (splinters) Spiral - a fracture which runs around the axis of the bone Compound - a fracture (also called open) which breaks the skin Bones are rigid, but they do bend, or "give" somewhat when an outside force is applied to them. When this force stops, bone returns to its original shape. For example, if you fall forward and land on your outstretched hand, there's an impact on the bones and connective tissue of your wrist as you hit the ground. The bones of the hand, wrist and arm can usually absorb this shock by giving slightly and then returning to their original shape and position. If the force is too great, however, bones will break, just as a plastic ruler breaks after being bent too far. The severity of a fracture usually depends on the force that caused the fracture. If the bone's breaking point has been exceeded only slightly, then the bone may crack rather than breaking all the way through. If the force is extreme, such as in an automobile collision or a gunshot, the bone may shatter. If the bone breaks in such a way that bone fragments stick out through the skin or a wound penetrates down to the broken bone, the fracture is called an "open" fracture. This type of fracture is particularly serious because once the skin is broken, infection in both the wound and the bone can occur.
  • Kyphosis : excessive curving of the spine, producing a rounded or "humped" upper back, a type of spinal disorder often associated with scoliosis or lordosis; once popularly called humpback. In adults often related to osteoporosis (bone weakening from calcium loss), in children kyphosis more often results from injury, a tumor on the spine, or a genetic disorder, such as Hunter syndrome, or spina bifida. Lordosis (hyperlordosis) : excessive curving of the lower spine, a type of spinal disorder often associated with scoliosis and/or kyphosis; sometimes popularly called swayback. In adults often related to osteoporosis (bone weakening from calcium loss), in children kyphosis more often results from injury, a tumor on the spine, or a genetic disorder, and can be exaggerated by poor posture. Scoliosis: abnormal sideways curvature of the spine, in excessive cases becoming almost S-shaped, a type of spinal disorder commonly associated with lordosis and/or kyphosis. Most people have some amount of irregular curvature in the spine; perhaps one in ten has a curvature of at least 10 degrees. if unrecognized and untreated, may progress to severe and painful deformity, and cause increasing pulmonary problems as the lungs are restricted. Scoliosis often appears in childhood or adolescence, in infancy in more boys than girls, but by school age in both sexes. Scoliosis can result from unequal leg length, which causes tilting of the body; from tumors or injuries; or from diseases such as muscular dystrophy or polio; but is often a genetic disorder. If detected early, scoliosis can be treated simply by exercises or orthopedic devices, such as shoe lifts to even the leg lengths. Where curvature is between 25 and 40 degrees, braces are often prescribed in an attempt to halt progression of the curvature, especially during the growth years of adolescence, which is successful in nearly 80 percent of patients in recent studies. Serious or worsening cases may require surgery, in which bone grafts are used to help force and fuse the spinal vertebrae into a straight line. Good posture and exercise such as swimming, especially the sidestroke and the backstroke, can ease the pain associated with scoliosis, though it will not stop progression. People with the condition should avoid being sedentary and overweight, as that may aggravate the condition. Electrical stimulation was for some years tried as a treatment, but studies showed no beneficial effect. Children should be checked for scoliosis from early childhood, and if it is detected, the degree of curvature should be checked annually to see that measures being taken are keeping the condition from worsening. Preteens and teens, in particular, since curves often markedly worsen during periods of rapid growth, in young girls especially in the year or two before their first menstrual period.
  • Fibromyalgia is an arthritis-related condition that is characterized by  generalized muscular pain and fatigue. The term "fibromyalgia" means pain in the muscles, ligaments and tendons. This condition is referred to as a "syndrome" because it's a set of signs and symptoms that occur together. Fibromyalgia is especially confusing and often misunderstood condition. Because its symptoms are quite common and laboratory  tests are generally normal, people with fibromyalgia were once told that their condition was "all in their head." However, medical studies have proven that fibromyalgia does indeed exist, and it is estimated to affect about 2 percent of the U.S. population today. It is diagnosed when the you display the following symptoms: A history of widespread pain (pain on both sides of the body and above and below the waist) that is present for at least three months Pain in at least 11 of 18 tender-point sites In general, drugs used to treat musculoskeletal pain, such as aspirin, non-steroidals (e.g. ibuprofen) and cortisone are not particularly helpful in this situation. As in any chronic pain condition, education is an essential component that helps patients understand what can or can't be done as well as teaching them to help themselves.
  • Throughout life, old bone is removed and new bone is added to the skeleton. During childhood and adolescence, new bone is added faster than old bone is removed. As a result, bones become stronger, larger, and denser. Peak bone mass is reached around age 30. This last for several years, and then more bone is lost than is replaced. If not treated, bone losses may lead to osteoporosis. The disease is more likely to occur if optimal bone mass was not achieved during the bone-building years. You can help ensure that bones stay strong throughout life by getting enough calcium and vitamin D and exercising regularly. Risk Factors Risk factors for osteoporosis or thin bones include: sex: female ,age: risk increases with age body size: small, underweight women race: caucasian and Asian women family members with osteoporosis post menopause abnormal cessation of menstrual periods (amenorrhea) due to anorexia nervosa and rigorous exercise low-calcium diet ,medications: immunosuppressants, such as prednisone and other steroids excess thyroid drugs anticonvulsants long-term heparin therapy drugs that lower sex steriod levels lithium low estrogen levels in women low testosterone levels in men inactive lifestyle too little sunlight early graying of hair anorexia cigarette smoking excessive use of alcohol, coffee, and tea diseases, including: liver disease ( cirrhosis ) h yperthyroidism low vitamin D a lcoholism Marfan's and Ehler-Danlos syndromes Cushing's syndrome hyperparathyroidism cancer (including lymphoma ) gastrointestinal disorders
  • Tendinitis is inflammation or irritation of a tendon — any one of the thick fibrous cords that attach muscles to bone. The condition, which causes pain and tenderness just outside a joint, is most common around your shoulders, elbows and knees. But tendinitis can also occur in your hips, heels and wrists. Some common names for tendinitis are tennis elbow, golfer's elbow, pitcher's shoulder, swimmer's shoulder and jumper's knee. If tendinitis is severe and leads to the rupture of a tendon, you may need surgical repair. But many times, rest and medications to reduce the pain and inflammation of tendinitis may be the only treatments you need. You can also take preventive measures to reduce your chance of developing tendinitis or to keep tendinitis from affecting your normal range of motion in joints such as your shoulder. Tendinitis produces the following signs and symptoms near a joint that is aggravated by movement: Pain Tenderness Mild swelling, in some cases Tendinitis in various locations in your body produces these specific types of pain: Tennis elbow. This type causes pain on the outer side of your forearm near your elbow when you rotate your forearm or grip an object. Achilles tendinitis. This form causes pain just above your heel. Adductor tendinitis. This type leads to pain in your groin. Patellar tendinitis. In this type, you experience pain just below your kneecap. Rotator cuff tendinitis. This form leads to shoulder pain. If the sheath of tissue that surrounds the tendon becomes scarred and narrowed in small joints, such as the finger, it may cause the tendon to lock in one position, such as occurs in the condition called trigger finger. The pain of tendinitis is usually worse with activities that use the muscle that is attached to the involved tendon.
  • At the base of the palm is a tight canal or “tunnel” through which tendons and nerves must pass on their way from the forearm to the hand and fingers. The nerve that passes through this narrow tunnel to reach the hand is called the Median Nerve. This narrow passage between the forearm and hand is what is known as the "Carpal Tunnel". The Carpal Tunnel is normally quite snug and there is just barely enough room in it for the tendons and nerves that have to pass through it. If anything takes up extra room in the canal, things become too tight and the nerve in the canal becomes constricted or “pinched”. In actuality, the condition and its accompanying symptoms can be brought on by either a decrease in the size of the carpal tunnel OR an enlarging of the tissues inside the tunnel. Carpal Tunnel Syndrome has received a lot of attention in recent years because of suggestions that it may be linked with occupations that require repeated use of the hands, such as typing on a computer keyboard or doing assembly work. In reality, many people develop this condition regardless of the type of work they do.        What Causes Carpal Tunnel Syndrome? The most common cause of Carpal Tunnel Syndrome is inflammation of the tendons in the tunnel which can normally be attributed to repetitive use of the hand and/or wrist. Repetitive Strain Injuries (RSIs) can happen to anyone whose work calls for long periods of steady hand movement, from musicians & dental hygienists to meat cutters & cashiers. RSIs tend to come with work that demands repeated grasping, turning and twisting; they are especially likely if the work requires repeated twisting or involves repetitive vibration, as in hammering nails or operating a power tool. Stressful hand, arm and neck positions — whether from working at a desk, long-distance driving or waiting on tables — only aggravate the potential for damage. A number of sports can bring on repetitive stress injuries: Rowing, golf, tennis, downhill skiing, archery, competitive shooting and rock climbing are just a sampling of activities that stress the hand and wrist joints. Injuries and ailments that cause swelling or compression of soft tissue on nerves, such as sprains, leukemia, and rheumatoid arthritis, can lead to stress injuries. Diabetes, thyroid problems, and other systemic disorders are also associated with discomfort from stressed nerves, as is the fluid accumulation that sometimes accompanies pregnancy. Some authorities believe that a pyridoxine (vitamin B6) deficiency can also induce the symptoms. Fluid retention, a major contributor to CTS & RSI symptoms naturally occur with the usage of contraceptive pills. Post Menstrual Syndrome (PMS) also causes fluid retention as do many other medical conditions, all of which can result in Carpal Tunnel Syndrome symptoms. A tingling or numb feeling in the hand and/or fingers; • Shooting pains in the wrist or forearm, and sometimes extending to the shoulder, neck and chest, or foot; • Difficulty clenching the fist or grasping small objects; For many unfortunate sufferers, CTS has a pattern of flaring up through the night thereby making sleep difficult. CTS symptoms can also be expected to arise frequently while performing the activity that is the cause of the condition in the first place.
  • 121 Week 10 Musculoskeletal

    1. 1. Musculoskeletal System
    2. 2. Objectives <ul><li>Recognize major bones and muscles of the musculoskeletal system </li></ul><ul><li>Recognize common symptoms of musculoskeletal diseases </li></ul><ul><li>Recognize common laboratory and diagnostic tests of the musculoskeletal system </li></ul><ul><li>Differentiate different fracture types </li></ul><ul><li>Differentiate between lordosis, kyphosis and scoliosis </li></ul><ul><li>Differentiate various diseases of the musculoskeletal system Fibromyalgia Osteoporosis Tendinitis Carpel Tunnel Syndrome </li></ul>
    3. 4. cranium mandible clavicle scapula sternum rib radius ulna vertebrae carpels ilium sacrum ischium femur patella tibia fibula phlanges
    4. 5. Muscles
    5. 6. Recognize common symptoms of musculoskeletal diseases <ul><li>Pain </li></ul><ul><li>Tenderness and swelling </li></ul><ul><li>Malaise, weakness and fatigue </li></ul><ul><li>Fever </li></ul><ul><li>Obvious bone deformation </li></ul><ul><li>Inflammation </li></ul><ul><li>Stiffness </li></ul><ul><li>Weight and height loss </li></ul>
    6. 7. Fractures and bone healing
    7. 8. Differentiate between lordosis, kyphosis and scoliosis
    8. 9. Fibromyalgia <ul><li>Syndrome </li></ul><ul><li>Also known as Fibritis, chronic muscle pain syndrome, psychogenic rheumatism, tension myalgia </li></ul><ul><li>Chronic, body-wide pain that migrates </li></ul><ul><li>Pain in at least 11 of 18 tender spots </li></ul>
    9. 10. Osteoporosis <ul><li>Osteoporosis is a disease in which bones become weak and brittle. If left unchecked, osteoporosis can progress painlessly until a bone breaks (fracture). Any bone can be affected, but of special concern are fractures of the hip, spine, and wrist </li></ul>
    10. 11. Tendinitis <ul><li>Tendonitis is the inflammation, irritation, and swelling of a tendon. It can occur as a result of injury, overuse, or with aging </li></ul><ul><li>Any action that places prolonged repetitive strain on the forearm muscles can cause tendonitis. </li></ul><ul><li>Common symptom of tendonitis is pain, (tenderness, and the increase of pain with movement) </li></ul>
    11. 12. Carpel Tunnel Syndrome <ul><li>Pinching of the nerve causes numbness and tingling in the area of the hand that the nerve travels to. The condition that results when the Median Nerve is being pinched in The Carpal Tunnel is commonly referred to as Carpal Tunnel Syndrome or “CTS”. </li></ul>
    12. 13. Common laboratory and diagnostic tests <ul><li>Blood tests (rheumatoid factor, uric acid, serum enzymes) </li></ul><ul><li>X-ray </li></ul><ul><li>CT scan </li></ul><ul><li>MRI </li></ul><ul><li>Bone Density Scan </li></ul>
    13. 14. Bone Density Scan