Jaelyn Harsh

Med-Surg II
Chapter 45
Musculoskeletal Function and Assessment
 Musculoskeletal System Anatomy and Physiology
o The skeleton is the framework of the body to which the voluntary muscles are attached
o The framework includes: the joints (articulations) between – TIP –
bones
o Voluntary muscles require nerve impulses to contract Another important
function of the muscular
(nervous system), a continuous blood supply (cardiovascular system is to aid in the
system), and oxygen (respiratory system) return of blood from the
 Musculoskeletal System Tissues and Their Functions legs through muscular
o Bone Tissue and Bone Growth compression on the leg
 Bone cells – osteocytes veins.
 Bone tissue is composed of: osteocytes, within a
strong nonliving matrix made of calcium salts and the protein collagen
 Compact bone – osteocytes and matrix are in precise densely structured
arrangements called osteons.
 Compact bone forms the shafts of long bones, covers the spongy bone of
the epiphyses of long bones, and covers the spongy bone that forms the
bulk of short, flat, and irregular bones
 Spongey bone – the arrangement of cells and matrix are more irregular and sparse
 OsteoBLASTS – produce bone matrix
 OsteoCLASTS – resorb bone matrix when more calcium is needed in the blood o
during repair
 Growth of bone depends on many factors…
 Proper nutrition – provides raw material to produce bone matrix,
comprising of calcium, phosphorus and protein
 Vitamin D is essential for the efficient absorption of calcium and
phosphorus
 Vitamins A and C are required for the production of bone matrix
 Hormones needed …
o Growth Hormone (GH) – from anterior pituitary gland. GH
increases mitosis and protein synthesis.
o Thyroxine – from thyroid gland. Thyroxine stimulates osteoblasts
and increases energy production.
o Insulin – from pancreas. Insulin is essential for the efficient use of
glucose to provide energy.
o If a child is lacking any of these hormones, growth is slower, and
the child may not reach his or her genetic potential for height.
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 Structure of the Skeleton
o 206 bones in the human skeleton
o Two Divisions: AXIAL and APPENDICULAR
 The axial bones are flat or irregular bones and contain red bone marrow
(hematopoietic tissue)
 The appendicular skeleton, the limbs consist of long bones (except the
carpals, tarsals, and patella)
 Long bones have a central diaphysis (Shaft), with two ends called
epiphyses
o Skull
 8 cranial bones
 14 facial bones
 3 auditory bones
 Immovable joints called sutures
o Vertebral Column
 33 vertebrae
 Atlas – the first of 7 cervical vertebra, forms a pivot with axis
 Axis – the second cervical vertebra
 12 thoracic vertebrae
 5 lumbar vertebrae
 5 fused in sacrum
 4 fused in coccyx
o Thoracic Cage
 12 pairs of ribs
 Sternum
 During breathing, the flexible thoracic cage is pulled upward and outward
by the external intercostal muscles to expand the chest cavity and bring
about inhalation.
o Synovial Joints
 Diarthroses – freely movable joints
 Bursae – small sacs of synovial fluid between the joints and structures that
cross over the joint
 Bursae lessen wear in areas of friction
o Muscle Structure and Arrangements
 When a muscle contracts, it shortens and exerts force on a bone.
 Muscles are anchored to bones by tendons, which are made of fibrous
connective tissue
 A muscle usually has at least 2 tendons
 There are approximately 700 skeletal muscles in the body
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