Assessment and Management of Musculoskeletal Disorders PDF

Assessment and Management of Patients with Musculoskeletal Disorders LEARNING OBJECTIVES ▪ Describe the anatomy and physiology of the musculoskeletal system. ▪ Describe physical assessment of the musculoskeletal system. ▪ Explain the pathophysiology of musculoskeletal disorders. ▪ Recognize the re...

Assessment and Management of Patients with Musculoskeletal Disorders LEARNING OBJECTIVES ▪ Describe the anatomy and physiology of the musculoskeletal system. ▪ Describe physical assessment of the musculoskeletal system. ▪ Explain the pathophysiology of musculoskeletal disorders. ▪ Recognize the related medical management of musculoskeletal disorders. 2 Anatomic and Physiologic Overview There are 206 bones in the human body, divided into four categories: ▪ Long bones (eg, femur) ▪ Short bones (eg, metacarpals) ▪ Flat bones (eg, sternum) ▪ Irregular bones (eg, vertebrae) 3 Anatomic and Physiologic Overview ▪ Bone is composed of cells, protein matrix, and mineral deposits. The cells are of three basic types: osteoblasts, osteocytes, and osteoclasts. 4 Physical Assessment ▪ Common deformities of the spine include kyphosis, an increased forward curvature of the thoracic spine; lordosis, or swayback, an exaggerated curvature of the lumbar spine; and scoliosis, a lateral curving deviation of the spine. 5 Diagnostic Evaluation ▪ X-ray Studies ▪ Computed Tomography ▪ Magnetic Resonance Imaging ▪ Bone Densitometry ▪ Bone Scan 6 BURSITIS AND TENDINITIS ▪ Bursitis and tendinitis are painful inflammatory conditions that commonly occur in the shoulder. Bursae are fluid-filled sacs that prevent friction between joint structures during joint activity. ▪ Conservative treatment includes rest of the extremity, intermittent ice and heat to the joint, and nonsteroidal anti- inflammatory drugs (NSAIDs) to control the inflammation and pain. Arthroscopic synovectomy may be considered if shoulder pain and weakness persist. 7 CARPAL TUNNEL SYNDROME ▪ Is an entrapment neuropathy that occurs when the median nerve at the wrist is compressed by a thickened flexor tendon sheath, skeletal encroachment, edema, or a soft tissue mass. ▪ The patient experiences pain, numbness, paresthesia, and possibly weakness along the median nerve (thumb and first two fingers). Tinel’s sign and phalen’s sign may be used to help identify carpal tunnel syndrome. 8 CARPAL TUNNEL SYNDROME 9 CARPAL TUNNEL SYNDROME ▪ Rest splints to prevent hyperextension and prolonged flexion of the wrist, avoidance of repetitive flexion of the wrist (eg, use of ergonomic changes at work to reduce wrist strain), NSAIDs, and carpal canal cortisone injections may relieve the symptoms. 10 OSTEOPOROSIS ▪ Characteristics of osteoporosis include a reduction of bone density and a change in bone structure, both of which increase susceptibility to fracture. 11