MUSCULOSKELETAL

SYSTEM
 Anatomy
Three
Divisions
Ω muscles
Ω bones
Ω joints
Anatomy of the Muscular System
 Anatomy
Functions of the Muscular System
– Body movement
– Maintenance of Posture
– Respiration
– Production of body heat
– Communication
– Constriction of organs and vessels
– Heartbeat
 Anatomy
Four major functional characteristics
– Contractility

– Excitability

– Extensibility

– Elasticity
Anatomy of the Skeletal System
 Anatomy
Functions of the Skeletal System
– Support

– Protection

– Movement

– Storage

– Blood cell production

 Anatomy
Functional classification of joints

♦ Synarthroses

♦ Amphiarthrosis

♦ Diarthrosis
 Assessment Focus
Muscle strength
Tone
Size
Muscle development
▓ fasciculation
▓ tremors
■intention tremor
■resting tremor
 Assessment

Equipment

►Goniometer
 Implementation
 Explain the procedure.

3. Wash hands and observe appropriate

infection control procedures.

5. Provide for client privacy.

7. History taking.
 History
Inquire with the client the following:
presence of muscle pain : onset,
location, character, associated
phenomena, aggravating and
alleviating factors
any limitations to movement
previous sports injuries
any loss of function without pain
 Muscle Assessment
5. Inspect the muscles for size.

6. Inspect the muscles and tendons.

7. Inspect the muscles for fasciculations and

tremors.
> by having the client hold the arms
out in front of the body
 Muscle Assessment
8. Palpate muscles at rest to determine
muscle tonicity.

9. Palpate the muscles while the client is

active and passive for flaccidity, spasticity,
and smoothness of movement.

10. Test muscle strength.

 Testing Muscle Strength
Sternocleidomastoid Hip Muscles
Trapezius Hip abduction
Deltoid Hip adduction
Biceps Harmstrings
Triceps Quadriceps
Wrist and finger Muscles of the ankle
muscles and feet
Grip Strength
Grading Muscle Strength
0: 0% of normal strength
1: 10% of normal strength
2: 25% of normal strength
3: 50% of normal strength
4: 75% of normal strength
5: 100% of normal strength
 Bone Assessment

11. Inspect the skeleton for normal

structure and deformities.

12. Palpate the bones to locate any

areas of edema or tenderness.
 Joint Assessment
13. Inspect the joint for swelling. Palpate
each joint for tenderness, smoothness of
movement, swelling, crepitation, and
presence of nodules.

14. Assess joint range of motion

>Ask the client to move a selected body
parts. The amount of movement can be
measured by a goniometer.

15. Document findings.

 Types of Joint Movements
Movement Action
>Flexion >Decreasing the angle of the joint

>Extension >Increasing the angle of the joint

>Hyperextension >Further extension or straightening of

the joint

>Abduction >Movement of the bone away from

the midline of the body
 Types of Joint Movements
>Adduction >Movement of the bone
toward the midline of the
body
 Types of Joint Movements
>Pronation >Moving the bones of the forearm
so that the palm of the hand
faces downward when held in
the front of the body

>Supination >Moving the bones of the forearm so

that the palm of the hand faces
downward when held in the front
of the body
 Types of Joint Movements
>Circumduction >Movement of the distal part of
the bone in a circle while the
proximal end remains fixed

>Movement of the bone around

>Rotation
its axis
 Types of Joint Movements
>Eversion >Turning the sole of the foot
outward by moving the ankle
joint.

>Inversion
>Turning the sole of the foot
inward by moving the ankle
joint
 Lifespan Considerations
Infants
Palpate the clavicles of newborns. A mass
of crepitus may indicate a fracture
experienced during vaginal delivery.
Newborns naturally return their arms and
legs to the fetal position when extended
and released.
Check muscle strength by holding the
infant lightly under the arms.
Check infants for developmental dysplasia
of hip.
 Lifespan Considerations
Children
Should be able to sit without support 8
months of age.
Pronation of the feet is common in children
between 12 and 30 months of age.
Genu varum is normal in children for 1
year aftter beginning to walk.
Lordosis is common in children before age
5.
 Lifespan Considerations
Elders
Muscle mass decreases with age.

The bones become fragile and osteoporosis

leads to a total bone mass.

Osteoathritic changes in the joints can be

observed.