| How many bones are there in an adult? | 206 bones |
| Functions of Skeletal System: 1 | Protects the internal tissue & organs |
| Functions of Skeletal System: 2 | Stabilizes and supports the body |
| Functions of Skeletal System: 3 | Provides surface for muscles, ligaments & tendon attachement |
| Functions of Skeletal System: 4 | Moves through level of action when contracted procedure process, hematopoiesis |
| Functions of Skeletal System: 5 | Stores minerals, 99% of the body's calcium |
| Functions of Skeletal System: 1-5 | congratulations |
| Produces RBG in the bone marrow | hematopoiesis |
| Functions of the muscles (three main) | Supports the body
Permits movement
Produces body heat |
| Techniques in doing Physical Examination in Musculoskeletal (3 common) | 1. Inspection
2. Palpation
3. Range of motion |
| basic equipments used in doing Physical Examination in Musculoskeletal: | 1. Tape measures
2. Goniometer |
| Common reason why patient seek medical help related to skeletal problems | occurrence of Physical Accident |
| Terms related to examining Skeletal S.: Refers to the angle | Angular |
| Terms related to examining Skeletal S.: Circle manner; round | Circular |
| Terms related to examining Skeletal S.: Crackling, grinding sound that can be heard or it can be felt when doing PE (commonly)
Sometimes heard in examining patient w/ fracture or some limitation of movements (palpation, ROM) | Crepitus |
| Terms related to examining Skeletal S.: Position of the limbs or of the body as a whole | Posture |
| Terms related to examining Skeletal S.: Total degree of motion of a joint
Movement of a joint | ROM Range of motion |
| Terms related to examining Skeletal S.: The equality of two sides of the body
very important in doing PR to check both arms or sides of the body
check for the equality of two sides | Symmetry |
| Gonio- angle; meter- instrument used to measure
Instrument used to measure an angle
mostly used by a PT to measure an angle especially in doing ROM
way of assessing if there is a limited ROM when a patient conducts or do simple ROM
"If there is limited ROM the therapist will be able to make some instructions or to assess properly, how to conduct the therapy base on the measurement of ROM | Goniometer |
| Clinical Manifestations: 1 | Signs of inflammation |
| Clinical Manifestations: 1: Signs of inflammation:
-facial expression; stated by the patient; painful if gunitan
-generalized redness
-
-feeling of warm especially on the injured site | pain/tenderness
Erythema
swelling
warmth |
| Clinical Manifestations: 2 | Stiffness or Limitation of Motion |
| Clinical Manifestations: 2: Stiffness or Limitation of Motion:
-check through doing ???
-ask patient to flex ??? ;but if the patient can only do until 45 degree= limited ang iyang ROM | -ROM;
-90 degree angle |
| Clinical Manifestations: 3: lining/ the shape: | Contour |
| Clinical Manifestations: 3: Contour:
pertaining to injury to the joint when there is already displacement in the normal relationship of the joints
-loss contact with two articular (2 articular between 2 joint) | Dislocation |
| Clinical Manifestations: 3: Contour:
minor injury
-incomplete or partial dislocation
-the bones are still in contact | Sublimation |
| Clinical Manifestations: 4
-any deviation from the normal shape, size, alignment resulting from an injury
-congenital or acquired injury | deformities |
| Clinical Manifestations:
-crepitatiou
-crackling/grinding sound
-heard/felt | crepitus |
| Musculoskeletal injury 5P's: 1:
-Location, severity and quality of it
-varies from every person
-??? rating scale | Pain |
| Musculoskeletal injury 5P's: 2:
-A feeling o pins and needles
-prick the distal phalangeal/portion of the hand or feet or try to hold it and ask the patient if he/she feel the touch
-paresthesia is the numbness feeling | Paresthesia |
| Musculoskeletal injury 5P's: 3
-weakness in movement especially in the injured site/side | paralysis |
| Musculoskeletal injury 5P's:
-naturally the injured site is pale in color | pallor |
| Musculoskeletal injury 5P's:
-if there is injury there is a decrease rhythmic dilation in the artery
-sa injured site, ??? is faint or weak | Pulse
... pulsation is faint and weak |
| Distance and direction of movement of a specific joint
-consider the limitation of the ??? and the pain in movement | ROM Range of Motion |
| -Passive ROM
-movement is assisted by external force
-assisted by PT because the patient can't move that specific part of her/his body | PROM |
| -Active ROM
-Patient can voluntarily move or do motion w/out assistance | AROM |
| closing an angle in a joint
-bending movement | Flexion |
| increasing or opening an angle of a joint | extension |
| -extension beyond 180 degree angle
-overextension; superextension
-increasing a size or extension of a limb or part of the body beyond the normal limit of the ROM | Hyperextension |
| upward movement or extension of a foot or a toe | Dorsiflexion |
| bending a sole of foot towards the plantar
kinto (ambot ****) | Plantarflexion |
| away from the median (body) | Abduction |
| Movement toward the median plane (body) | Adduction |
| Turning of a structure around it's long axis
-??? of head is moving it to the left and right manner | Rotation |
| Circular movement from a central point of the body
-occurs at freely movable joint
-ask patient to stretch an arm then try to make a circular movement | Circumduction |
| Turning upward
-palm faces up | Supination |
| Turning down
-palm is down | Pronation |
| Turning of the sole of the foot upward | Eversion |
| Turning of the foot inward | Inversion |
| Moving a part forward
-move head forward/upward w/out moving the body | protraction |
| Moving a part of the body backward
-balik ang ulo sa position niya | Retraction |
| upward movement
-shrug shoulder | Elevation |
| Downward movement
-put shoulder back | Depression |
| is a common source of pain in the shoulder (inflammation?) common affected area is shoulder | The rotator cuff |
| Rotator cuff (a common source of pain in the shoulder): pain can be a result of: 1:
-invokes/affects the tendon and the muscles of the shoulder joint
-common sa athlete of sports in frequent used of shoulders | Rotator Cuff Tendonitis or Tendonitis |
| Is attached to the muscles and muscles to bones
-serves to move a bone | Tendons |
| Rotator cuff (a common source of pain in the shoulder): pain can be a result of: 2:
-inflammation of the bursa
-usually involves the patellar, elbow, hips, heels | Bursitis |
| Is a sac that has fluid found in the joints
-reduces friction everytime joints move | Bursa |
| Rotator cuff (a common source of pain in the shoulder): pain can be a result of: 2: Bursitis: patellar | Prolong kneeling, bending, infection bursitis |
| Rotator cuff (a common source of pain in the shoulder): pain can be a result of: 2: Bursitis:
elbow | -frequent gout
-increase uric crystals that build up in the body usually sa area
-frequent resting of part involved sa hard surface
-infection |
| Rotator cuff (a common source of pain in the shoulder): pain can be a result of: 2: Bursitis:
Hips | -lying down laterally/side-lying for a long period of time
-improper posture
-prolong sitting/standing |
| Rotator cuff (a common source of pain in the shoulder): pain can be a result of: 2: Bursitis:
heel | repetitive activities like jumping, running
-wearing tight footwear |
| Special tests Upper extremities:
-to determine if patient has a fracture or pain in the shoulder
-tell patient to abduct both arms sideways; alternately; 90 degree angle then tell patient to slowly lower the arm of the affected shoulder
-positive if fail to slowly lower arm or smoothly lower arm or severe pain and may indicate rotator cuff tear
-positive if patient will abruptly lower the arm because of pain | Drop-Arm Test |
| Special tests Upper extremities:
-Pain w/ rotator cuff tendonitis or
-done by PE maneuvers | Impingement Test (Rotator Cuff) |
| Special tests Upper extremities: Impingement Test (Rotator cuff):
pain is produce by forcefully maximum forward elevation of the arm of (2) extremities | Neer sign |
| Special tests Upper extremities: Impingement Test (Rotator cuff):
flexing the arm towards the chest the examiner will internally rotate the humerus into 90 degree angle (abduction)
-Positive if there is pain | Hawkin's sign |
| Special tests Vascular & Neurologic Test: 1:
-radial/ulnar arteries
-checking the patency of the radial and ulnar artery
-examiner will press both artery at the same time and patient will be ask to make a clench fist
-There will be deprivation of circulation of blood
-patient will be asked to open the fist and examiner will release the hold/press and it will be checked if there is a proper return of blood flow
-Failure to return pink or red there is a problem on either of the artery. | Allen test |
| pulse aligned w/ thumb | Radial artery |
| Pulse aligned w/ pinky finger | Ulnar artery |
| Special tests Vascular & Neurologic Test: 2:
-median nerve
-patient is asked to make an inverted prayer hand or volar flexion
-to be done for 1 min/60 secs
-if patient experience tingling sensation, numbness, pain or paresthesia there is an indicative that the distribution of the median nerve may indicate carpal tunnel syndrome | Phallen's test |
| Special tests Vascular & Neurologic Test: 3:
-median nerve
-tapping on the superficial nerve
-distally related to radiating pain or numbness paresthesia due to tapping on the site of superficial nerve
-indicative that there is inflammation or irritation of the nerve
-carpal tunnel syndrome | Tinel's Sign |
| DIP | Distal Interphalangeal Joint |
| PIP
Use for gripping | Proximal interphalangeal Joint |
| MCP
knuckles | metacarpophalangeal Joint |
| hand bone
-fingers meet the handle | metacarpal |
| wrist | Carpal |
| Deformities on the fingers: 1: deformity of a finger caused by a certain finger particularly the extensor flexor is damage
-force causes the damage sa finger
-unable to strengthen the fingers | Mallet Finger (Baseball Finger) |
| Deformities on the fingers: 1: Mallet Finger (Baseball Finger): Symptoms: | 1. Pain
2. Swollen
3. Bruising
4. Drooping |
| Deformities on the fingers: 1: Mallet Finger (Baseball Finger): Treatment:
1. Immobilize damage finger
-removed if healed
2. | Finger splint
Surgery use of pins and wires |
| Deformities on the fingers: 2:
-a traumatic injury in the finger
-especially patient w/ rheumatoid immune disease (arthritis)
-flexed dip joint
-hyperextended dip joint
cause: due to rheumatoid arthritis
treatment: ring splint | Swan-neck deformity |
| Deformities on the fingers: 3:
-Caused by injury to tendons/middle joints
-rheumatoid A.
-Dip hyperextended
-Dip joint is flexed
treatment: splint- applied o the middle joint | Boutonniere deformity |
| Deformities on the fingers: 1-3 | Mallet finger (baseball finger)
Swan-neck deformity
Boutonniere deformity |
| nodes of the hand: 1,2 | Heberden's Nodes
Bouchard's Nodes |
| nodes of the hand: 1 (do not interchange w/ callus)
-bony projection arising from the bone that develops from a cartilage
-no longer than a "pea"
-commonly seen as "DIP" joint
-and pt w/ osteoarthritis | heberden's Nodes |
| nodes of the hand:
-bony projection
-common sa osteoarthritis
-seen as "DIP" joint | Bouchard's Nodes |
| Spinal column:
C
T
L
S
C | Cervical
Thoracic
Lumbar
Sacral if fused
Coccyx if fused |
| Spinal column: Cervical | 7 bones |
| Spinal column: Thoracic | 12 bones |
| Spinal column: Lumbar | 5 bones |
| Spinal column: Sacral if fused | 5 |
| Spinal column: Coccyx if fused | 4 |
| Curvature: | Lordosis
Kyphosis
Scoliosis |
| Curvature:
-inward curve of the lumbar spine (just above the buttocks)
-sway back | Lordosis |
| Curvature: Lordosis: Causes: | Poor posture
Obesity
Osteoporosis |
| Curvature: Lordosis: Treatment: | medication for pain and swelling
PT
weight loss
braces
surgery (last option) |
| Outward curvature of t he thoracic spine (bako)
-"hunchback" or slouching posture | Kyphotic (kyphosis) |
| Causes of Kyphosis or kyphotic: | -poor posture
-aging
-muscle weakness of the upper back
-slipped discs- injury to spine |
| Treatment for Kyphosis is: | Same as Lordosis:
medication for pain and swelling
PT
weight loss
braces
surgery (last option) |
| Curvature:
-abnormal sideways curvature of the spine
-lateral curvature of spine
-S or C shape
-to examine, ask patient to bend forward, examiner stay at the back and check deformities
-mishaped ribcage, shoulder back protrude | Scoliosis |
| Curvature: Scoliosis: Treatment: | -Most people don't need treatment
-If curvature worsens on orthopedic brace may be used |
| Hips and Knees: | -inspection and palpation
-check contour, symmetry, check deformitie |
| Is located in the proximal end of femur | Hip |
| Palpation of the Hip: | -check for tenderness
-palpate both knees for any swelling
normal is soft if palpated and solid tissues |
| ROM (hip?) | hip flexion, abduction, extension internal and external rotation
knees- flexion & extension |
| Example of Leg deformities:
-used measuring tape
-there is a distance 2.5 cm between your knees
-Knees wide apart, feet ankles are almost together when standing straight | Genovarum (bowleg) |
| Example of Leg deformities: Genovarum: causes: | -position inside mothers womb
-abnormal bone development
-fracture
-rickets disease |
| Example of Leg deformities:
-opposite ra sa isa
-knees are near
-feet or ankle 2.5 cm apart | genovalgum (knock knee) |
| Example of Leg deformities: Genovalgum (knock knee): cause: | -injury to the shin bone
-osteomlyelities- inflammation of the bone
-overweight or obesity
-rickets disease |
| Ankles and feet: check for: | -swelling, redness, and nodules
-edema by pinching or pressing skin
-callus
-
-localized swelling
-clavus, ingrowned toe nails and plantar warts |
| ROM of Ankle: Dorsiflexion: | 20 degree angle normal |
| ROM of Ankle: Plantarflexion: | 45 degree angle normal |
| ROM sa feet: Inversion: | 45 degree angle (normal) |
| ROM sa feet: eversion: | 40 degree angle (normal) |
| measure the leg incase you see the patient or suspect that one leg is ???
-difference of more than ??? or ??? is abnormal | ... one leg is longer;
3/8 or 1 cm |
| abbreviation: ADL | Activities of Daily Living |
| abbreviation: AE | Above Elbow |
| abbreviation: AK | Above Knee |
| abbreviation: BK | Below knee |
| abbreviation: C | Cervical Vertebra (C1-C7) |
| abbreviation: DJD | Degenerative Joint Disease |
| abbreviation: EMG: | Electromyography (recording of the muscles) |
| abbreviation: Fx | Fracture |
| abbreviation: NSAID | nonsteroidal Anti-Inflammatory Drugs |
| abbreviation: OA | osteoarthritis |
| abbreviation: ORIF | Open Reduction and Internal Fixation (a procedure) of the bone |
| abbreviation: OT | occupational therapy |
| abbreviation: RA | rheumatoid arthritis |
| abbreviation: T | Thoracic vertebrae (1-12) |
| abbreviation: THA | Total Hip Arthroplasty- total hip surgical repair of the joint |
| abbreviation: TKA | total knee arthroplasty |
| abbreviation: TMS | temperomandibular joint |
| abbreviation: Tx | treatment |
