Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Timby/Smith : Introductory Medical-Surgical Nursing, 11/e Chapter 60: Introduction to the Musculoskeletal System
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Anatomy and Physiology Bones –There are 206 bones in the human body –Classification: short bones, long bones, flat bones, and irregular bones –Two types of bony tissue –Composition of bones –Types of bone cells –Bone marrow
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? There are two types of bones in the body.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer False Rationale: Bones are classified as short bones, long bones, flat bones, and irregular bones. There are two types of bony tissue in the body.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Anatomy and Physiology—(cont.) Muscles: skeletal, smooth, and cardiac Joints –The junction between two or more bones –Free-moving or diarthrodial joints Tendons –Cordlike structures that attach muscles to the periosteum of the bone –Attachments of the muscle Origin and insertion
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? Tendons attach bone-to-bone.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer False Rationale: Tendons are cordlike structures that attach muscles to the periosteum of the bone. Tendons connect muscles to their corresponding bone.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Anatomy and Physiology—(cont.) Ligaments: fibrous tissue connecting two adjacent, freely movable bones Cartilage –Firm, dense type of connective tissue –Types: hyaline or articular, costal, semilunar, fibrous, and elastic Bursae –Small sac filled with synovial fluid –Reduces friction between areas
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? Ligaments attach bone-to-bone.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer True Rationale: Ligaments attach bone-to-bone. The connection is of two adjacent, freely movable bones.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Assessment History –Chronic disorder: medical, drug, allergy; familial; occupational –Recent injury: occurrence of trauma –Open injury Date of last tetanus immunization –Compilation of list of symptoms –Determining the effect of activity on symptoms
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Assessment—(cont.) Physical Examination –Assessment: musculoskeletal Motor skills; muscle strength, wasting Symmetry, size, ROM, alignment Pain, tenderness; swelling; redness Spinal inspection: kyphosis, lordosis, scoliosis Neurovascular: spasms, tremors
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Assessment—(cont.) Physical Examination—(cont.) –Assessment: traumatic injury Vital signs; swelling; external bleeding, bruising; open wounds, debris, protrusion of bone or tissue Peripheral circulation, sensation; malalignment of the injured limb Injury beyond the original area Pain: type and location
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Management Diagnostic Tests –Diagnostic examination protocols –Send specimens to the laboratory –Ensure safe recovery after procedure Chronic Disorder –General medical history –Current symptoms –Compile drug, allergy histories
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Management—(cont.) Invasive Joint Examination –Inspect: swelling, bleeding, or drainage –Change or reinforce dressings Traumatic Injury –Information regarding injury –Monitor: vital signs, neurovascular status –Provide comfort and support