Unit One: Mobility

Objectives

• Describe the basic function and structure of themusculoskeletal system.

• Select significant subjective and objective data related to the musculoskeletal system which should be obtained during patient assessment.

• Relate normal from abnormal findings related to a musculoskeletal assessment.

• Specify diagnostic tools used for assessment ofmusculoskeletal function.

Anatomic and Physiologic Overview

• Function of bone:Microscopic structure http://www.youtube.c

om/watch?v=d9owEvYdoukOsteo –blasts, cytes and clastsOsteons = Haversian System

Cancellous = trabecular = spongy bone Cortical = compact bone

Lamellae Caniculi Volkman’s Canal

Bone Maintenance

• Calcium 1200-1500 mg / day• Vitamin D• Parathormone• Calcitonin• Thyroid• Cortisol• Estrogen• Testosterone

Bone Healing

• Hematoma and inflammation• Granulation tissue• Callus formation• Ossification• Consolidation• Remodeling

206 Bones

• Long

• Short

• Flat

• Irregular

Joints

• Synarthrotid• Amphiarthrotic• Diarthroidal

– Types of diarthrosis joints/synovial joints

• Joint Capsule• Bursa

Body Movements• Adbuction• Adduction• Protraction• Retraction• Circumduction• Pronation• Supination• Extension• Flexion• Rotation• Inversion• Eversion

Health History using Functional HealthPatterns (Gordon)

• Begin with past health history/surgery• Medications• Family history

Health Perception-Health Management Pattern Nutritional Metabolic PatternElimination Pattern Activity-Exercise Pattern Sleep-Rest PatternCognitive-Perceptual PatternSelf Perception-Self Concept PatternRole-Relationship Pattern Sexuality PatternCoping-Stress Tolerance PatternValue-Belief Pattern

Physical Assessment

• Inspection• Palpation• Motion

– Active and Passive

• Muscle Strength 0 to 5• Spine curvatures

Diagnostic Studies

• Xray• CT• MRI• Myelogram• Bone Density• Bone Scan• Arthroscopy/

Arthrocentesis• EMG

Laboratory Diagnostics• Alkaline Phosphatase• Calcium• Phosphorus• R F• ESR• ANA• Complement• Uric Acid• CRP• CK• Potassium