MUSCULO SKELTETAL SYSTEM
Types of Bone
• 1. According to shape
o Long bone
o short bone
o irregular bone
o flat bone
• 2. According to tissue
o spongy bone ( inner portion)
o compact bone (outer portion)
Functions of Bone
• Maintain shape.
• Support and protect structure of the body.
• Provide attachments for muscles, tendons, and ligaments.
• Assist in regulating calcium and phosphate level.
• Bone marrow which is the centre of bone produces the blood cells.
• The length of bone growth is a result of the ossification of epiphyseal cartilage at the ends of bones.
• It stops between 18 to 25 years.
• The width of the bone growth is a result of the activity of osteoblasts and occurs throughout the life bout slow down with the aging process.
Nature of a joints
• Surfaces are covered with cartilage.
• Enclosed in a capsule and covered with a membrane called synovial membrane.
• Contain a cavity filled with synovial fluid.
• Ligaments hold the bone and joint in the correct position.
Function of synovial fluid
• Lubricates the cartilage and joint cavity.
• Cushion for shock.
Type of joints
• 1. Synarthrosis
Fibrous or fixed joints, No movement associated with these joints.
• 2. Amphiarthosis
Cartilaginous joints, slightly movable joints.
• 3. Diarthrosis
Synovial joints, Ball and Socket joints. Condyloids joints Freely movable joints. Allow frictionless, painless movement.
• white fibrous shiny tissue which connect bone to bone and hold the bone and joint in a correct position.
• It is a commonly used procedure to diagnose disorders of the muscular skeletal system.
• Remove any jewelry in the body.
• Handle injured area carefully.
• Administer analgesics.
• Inform the client that exposure to radiation is minimal.
• Health care provider should wear a lead apron.
• Removal of synovial fluid from the joint and instillation of medication in the joint cavity.
• Obtain a consent.
• Apply a compress bandage after procedure.
• Provide joint rest for 24 hours.
• If fever or swelling should be report to doctor.
• A radiographic examination of the soft tissues of the joint structure to diagnosis the trauma to the joint capsule or ligaments after administering air or contrast medium into the joint cavity.
• NPO for 8 hours.
• Written consent .
• Assess allergy to iodine or seafood.
• Minimize the joint use for 12 hours after the procedure.
• Instruct the client that joints may be edematous and tender for 1 to 2 days after the procedure. If more than two days inform the doctor.
• Apply ice packs.
• Apply ace wrap over the joint for 3 to 4 days.
• If air was used for injection crepitus may be felt in the joint for up to 2 days.
• A endoscopic examination of various joint to assess.
o Articular cartilage abnormality.
o Loose bodies can be removed.
o Cartilage can be trimmed.
o Biopsy may be performing during the procedure.
• NPO for 8 to 12 hr.
• Written consent.
• The Ace wrap should be worn for 2 to 4 days.
• Administer pain medication.
• Walk without weight bearing.
• Limit activity for 1 to 4 days.
• Elevate extremity for two days and place ice on the site for comfort.
• Use crutches for 5 to 7 day.
• If pain or edema persists more than 3 days inform doctor.
5. Bone scan
• Radioisotope is injected IV and will collect in area that indicate abnormal bone metabolism and some fracture, if they exist.
• From 1 to 3 hours after the injection, have the client void and then scanning procedure is performed.
• The isotope is excreted in the urine and feces within 48 hours and is not harmful to others.
• NPO 4 hours before procedure.
• Remove the jewelry and metal object.
• Increase the fluid intake.
• Patient need to lie supine during the procedure.
• Observe the injection site for redness, and swelling.
6. Bone or muscle biopsy
• May be done during surgery or through aspiration, or punch, or needle biopsy.
• Obtain consent.
• Monitor for bleeding, swelling, hematoma and pain.
• Elevate the site for 24 hours following the procedure to reduce edema.
• Apply ice pack to reduce hematoma.
• Monitor for infection.
• Inform the client that mild to moderate discomfort is normal following procedure.
• Measure electrical potential associated with skeletal muscle contractions.
• Needles are inserted into the muscle, and recording of muscular electrical activity are traced on recording paper through an oscilloscope.
• Informed consent.
• May feel discomfort because of needle prick.
• Should avoid stimulation and sedative for 24 hr prior to the procedure.
• May occur bruising at the needle insertion site.
• Injection of dye or air into the subarachnoid space to detect abnormalities of the spinal cord and vertebrae.
• Obtain consent.
• Provide hydration for at least 12 hours before the test.
• Assess for allergies to seafood.
• Pre medicate with sedation if prescribed.
• Seal the sight to prevent leaking.
• Access the vital signs and neurological signs.
• Provide comfortable position.
o If water base dye is used elevate the head 15 to 30 degrees for 8 hours.
o If oil based bye give flat position for 8 hours.
o If air based dye give head down from trunk.
• Force fluid to flush out the dye.
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