Chapter 26
Nontraumatic
Musculoskeletal
Disorders
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26-1
Objectives
26-2
Review of the
Musculoskeletal System
26-3
Anatomy and Physiology Review
• Skeleton
– Provides support for
the body
– Provides a frame for
other parts of the
musculoskeletal system
to attach to
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Anatomy and Physiology Review
• Bones are living tissue
– Collagen
– Calcium
26-5
Anatomy and Physiology Review
• Skeletal muscles
– Move the skeleton
– Produce the heat that helps maintain a
constant body temperature
– Maintain posture
• Tendons
• Ligaments
26-6
Anatomy and Physiology Review
• Joints
– Immovable
(fibrous) joints
– Cartilaginous
joints
– Synovial joints
26-7
Nontraumatic Musculoskeletal
Conditions
26-8
Arthritis
• Osteoarthritis
– A chronic condition
characterized by the
breakdown of the joint’s
cartilage
– Commonly affects the
hands, wrists, elbows,
shoulders, spine, hips,
knees, and ankles
26-9
Arthritis
• Types of osteoarthritis
– Primary osteoarthritis
• Associated with aging
• Cause is unknown
– Secondary osteoarthritis
• Caused by another disease or condition
26-10
Arthritis
• Rheumatoid arthritis
– Lining of the joints is inflamed
– Initially
• Pain, warmth, stiffness, redness, and
swelling around the joint
– In later stages of the disease
• Affected joint becomes misaligned and
loses its shape, limiting joint movement
26-11
Osteoporosis
• Disease of progressive bone loss
• Bones become weak and brittle due to loss
of minerals in the bones
• Common cause of fractures in women after
menopause and older adults
– Fracture = a break in a bone
26-12
Fibromyalgia
• A disorder characterized by general fatigue
and widespread musculoskeletal pain and
stiffness
• Most often develops during early and middle
adulthood
• Women are affected more often than men
are.
• Cause is not known
26-13
Fibromyalgia
• Common assessment findings and symptoms
– Musculoskeletal aches,
– Bladder irritability
pain and stiffness
and spasms
– Soft tissue tenderness
– Painful menstruation
– Depression and anxiety
– General fatigue
– Impaired concentration
– Sleep disturbances
– Problems with short and
– Sensitivity to odors,
long-term memory
noises, bright lights,
and touch
– Headaches
26-14
Overuse Syndromes
• Overuse syndromes are a group of
conditions in which a part of the body is
injured from repeated motions performed in
the course of normal work or daily activities.
26-15
Overuse Syndromes
• Common assessment findings and symptoms
– Numbness
– Decreased joint
motion
– Swelling
– Burning
– Pain
– Aching
–
–
–
–
–
Redness
Weakness
Tingling
Clumsiness
Cracking or popping
of joints
26-16
Carpal Tunnel Syndrome
• Carpal tunnel
• Median nerve compression
– Pain, burning, tingling,
weakness, or numbness
26-17
Wrist Tendonitis
• Inflammation of one or more
of the tendons around the
wrist joint
• Overuse can result in pain,
tenderness, and swelling over
the area of inflammation.
26-18
Tennis Elbow
• Affects the tendons that
attach to the bone on the
lateral part of the elbow
• Exact cause unknown
• Overuse results in pain on
the outside of the arm at the
elbow joint
26-19
Golfer’s Elbow
• Similar to tennis elbow but involves pain
on the inside of the arm at the elbow joint
• Pain is usually triggered when gripping
an object
26-20
Snapping Hip Syndrome
• Also called dancer’s hip
• Audible noise and
snapping sensation when
the hip is moved from
flexion to extension
26-21
Hip Bursitis
• Pain and inflammation
over the outside of the
upper thigh
• Usually occurs in middleaged or older adults
• More common in women
than men
26-22
Shin Splints
• Medial tibial stress
syndrome
• Pain over the front
of the tibia
26-23
Kneecap Bursitis
• Swelling and pain on top of the kneecap
• Limited motion of the knee
26-24
Achilles Tendonitis
• Achilles tendon
– Largest and strongest
tendon in the body
– Attaches muscles of the
calf to heel bone
– Used when walking,
running, or jumping
– Overuse typically results
in pain over the back of
the heel
26-25
Patient Assessment
26-26
Patient Assessment
• Scene size-up and ensure your safety.
• Perform a primary survey
• Take the patient’s vital signs and gather the
patient’s medical history.
– Use OPQRST to identify the type and
location of the patient’s pain.
26-27
Physical Examination
• Use DCAP-BTLS to recall what to look and
feel for during the physical exam:
– Deformities
– Contusions (bruises)
– Abrasions (scrapes)
– Punctures/penetrations
– Burns
– Tenderness
– Lacerations (cuts)
– Swelling
26-28
Physical Examination
• Feel for deformities, tenderness, and
swelling.
• Feel and listen for crepitus.
• Check the pulse, movement, and sensation
in each extremity (PMS).
– Assess the dorsalis pedis pulse (on top of the
foot) in each lower extremity.
– Assess the radial pulse in each upper extremity.
– During your bilateral assessment, compare PMS
findings (left vs right)
26-29
Physical Examination
• Assess movement
– Lower extremities
– Upper extremities
• Assess sensation
– Lower extremities
– Upper extremities
26-30
Emergency Care
• In general, emergency care is supportive.
• Take appropriate standard precautions.
• Provide specific treatment based on the
patient’s signs and symptoms.
• Allow the patient to assume a position of
comfort.
• Maintain an open airway. Give oxygen if
indicated.
• Applying a splint may be indicated.
• Transport and reassess as often as
indicated.
26-31
Questions?
26-32