Musculoskeletal System

Summary – Musculoskeletal System

The skeleton consists of 206 bones. For classification purposes, the human skeleton is divided into two sections named the axial and appendicular skeletons. Bones are made of dense connective tissue; bones of the human skeleton are further divided into long bones and short irregular bones. Upper extremity bones include the humerus, elbow, ulna, radius, carpal, metacarpal, and phalanx bones. The lower extremity bone structure is comprised of the hip, femur, patella, tibia, fibula, tarsal, metatarsal, and phalanges.

The vertebral column is also known as the spine column, composed of 24 vertebrae (each separated by a vertebral disc), plus the sacrum and the coccyx. The vertebrae are divided into three regions: cervical C1–C7 vertebrae, thoracic T1–T12 vertebrae, and lumbar L1–L5 vertebrae.

A joint is where two or more bones come together, some joints are movable, and some are not. There are a variety of joint movements that can occur: Abduction, adduction, pronation, supination, eversion, dorsiflexion, plantar flexion, flexion, extension, and elevation.

Tendons are made up of dense connective tissue; this connective tissue is how muscles and bone are connected. There are three primary classifications of muscle tissue: Skeletal, cardiac, and smooth muscle tissue.

Pain is one of the most common symptoms of MSK disorders. Symptom analysis of MSK pain is the same regardless of the region or joint involved. Other common signs and symptoms of MSK problems include deformity, weakness, joint pain, and backache. Joint pain is the most common presenting concern of patients with MSK problems. Joint pain can be classified as mechanical, soft tissue, inflammatory or noninflammatory (Goolsby & Grubbs, 2019). Mechanical joint pain refers to pain caused by damage to, in, and around joint structures; soft tissue joint pain is related to pain affecting the structures around the joint but not the joint itself, such as muscles, ligaments, or tendons. Inflammatory joint pain is the result of inflammation caused by an overactive immune system. In contrast, noninflammatory joint pain relates to pain without specific serologic inflammatory markers or visible signs of inflammation, such as redness or swelling. A common example is osteoarthritis of a joint (G. A. Pujalte & S. A. Albano-Aluquin, 2015).

Musculoskeletal Symptom Analysis
Questions to assess causes and/or relieving factors of the MSK pain:

1.      What has been done (if anything) to relieve the pain and what was the response?

2.      Is there any circumstance or activity that relieves or reduces the pain, does it change throughout the day, when is it work/better?

3.      Are there any circumstances that trigger the pain or make it worse?

Questions to identify the type or quality of pain:

1.      How would you describe the pain, is it burning, crampy, aching, or sharp?

2.      Is it constant, throbbing, shooting?

3.      How bad is the pain on a scale of 1-10?

Questions to determine location and radiation of pain:

1.      Where does it hurt the most, can you point to the area?

2.      Does the pain radiate anywhere, if yes, where?

3.      Do you have pain anywhere else?

Questions about associated symptoms:

1.      Have you noticed any other symptoms since this pain first started such as fever, malaise, or reduced energy?

2.      Have you noted any strange or different sensations or sounds such as tingling, numbness, grinding, or popping?

3.      Has there been any weakness, swelling, redness, or reduced ability to move

Questions about the temporal sequence of the symptoms:

1.      When did you first notice the pain and what were you doing at the time?

2.      Did the pain start suddenly or progress slowly over time?

3.      Is the pain persistent or intermittent, and has it gotten worse or stayed the same?

 

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Physical Assessment Essentials for Health Sciences Copyright © 2023 by Dr. Ivy Poulin NP, DNP, CDE is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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