Assessment of the
Musculoskeletal System
Skeletal System

Bone types
– Long bones, such as the femur, are cylindric
with rounded ends; they often bear weight.
– Short bones, such as the phalanges, are small
and bear little or no weight.
– Flat bones, such as the scapula, protect vital
organs and often contain blood-forming cells.
– Bones that have unique shapes are known as
irregular bones (e.g., the carpal bones in the
wrist).
– The sesamoid bone is the least common type
and develops within a tendon; the patella is a
typical example.
Skeletal System

Bone structure
Skeletal System
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Bone function
– Provides a framework for the body
– Supports the surrounding tissues (e.g., muscle and
tendons)
– Assists in movement through muscle attachment and
joint formation
– Protects vital organs, such as the heart and lungs
– Manufactures blood cells in red bone marrow
Provides storage for mineral salts (e.g., calcium and
phosphorus)
Skeletal System

After puberty, bone reaches its maturity and
maximal growth. Bone is a dynamic tissue,
however, that undergoes a continuous process of
formation and resorption, or destruction, at equal
rates until the age of 35 years. In later years,
bone resorption accelerates, decreasing bone
mass and predisposing clients to injury.

Bone growth and metabolism affected by calcium
and phosphorous, calcitonin, vitamin D,
parathyroid hormone, growth hormone,
glucocorticoids, estrogens and androgens,
thyroxine, and insulin
Joints
Types include synarthrodial,
amphiarthrodial, diarthrodial
 Structure and function of the
diarthrodial or synovial joint
 Subtyped by anatomic structure:

– Ball-and-socket
– Hinge
– Condylar
– Biaxial
– Pivot
Muscular System
Structure
 Function
 Supporting structures
 Musculoskeletal changes associated
with aging
 Cultural considerations

Assessments
Family history and genetic risk
 Personal history
 Dietary history
 Socioeconomic status and ability to
afford food
 Current health problems including
obesity

Physical Assessment





General inspection
Posture
Abnormality in gait such as antalgic gait or
lurch
Goniometer, which provides a measure of
ROM (range of movement)
Head and neck: evaluate the
temporomandibular joints
(Continued)
Physical Assessment
(Continued)
Spine: lordosis, scoliosis
 Upper extremities
 Lower extremities

Diagnostic Assessement
Laboratory tests: serum calcium and
phosphorus, alkaline phosphatase,
serum muscle enzymes
 Radiographic examinations: standard
radiography, tomography and
xeroradiography, myelography,
arthrography, and CT
 Other diagnostic tests: bone and
muscle biopsy

Electromyography
EMG aids in the diagnosis of
neuromuscular, lower motor neuron, and
peripheral nerve disorders; usually with
nerve conduction studies.
 Low electrical currents are passed through
flat electrodes placed along the nerve.
 If needles are used, inspect needle sites
for hematoma formation.

Arthroscopy
Fiberoptic tube is inserted into a joint
for direct visualization.
 Client must be able to flex the knee;
exercises are prescribed for ROM.
 Evaluate the neurovascular status of
the affected limb frequently.
 Analgesics are prescribed.
 Monitor for complications.

Other Tests
Bone scan
 Gallium or thallium scan
 Magnetic resonance imaging
 Ultrasonography
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