Musculoskeletal And Neurologic Systems

The musculoskeletal and energy system. The musculoskeletal system is made up of muscles, bones, ligaments, tendons and cartilage. Each part of the musculoskeletal system is controlled by the nervous system, an impulse from the nervous system results in a contraction of muscle, shortening it, causing the bone to which it is attached to move. The musculoskeletal system aids movement of the body, as well as helping to maintain posture as well as the production of heat

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If an Athlete takes part in acute exercise, the musculoskeletal system responds in a number of ways. The muscles increase in temperature and metabolic activity as a short-term response to acute exercise and this accordingly increases the demand for oxygen, a demand that is met through capillary dilation to increase blood supply.Musculoskeletal And Neurologic Systems The muscles warm during any form of exercise as to make them more pliable and so to reduce any risks of injury; this is known as an increase in muscle pliability. Movement of the joints causes the secretion of synovial fluid; the synovial fluid becomes less viscous and the range of movement at the join increases. Looking particularly at the effects of exercise on your skeletal system, during exercise the muscles are put under enough stress for small tears to be inflicted on the muscle fibres that swell and then put pressure on nerve endings causing the Athlete to suffer pain. These minor tears can only be repaired if the body has an adequate amount of rest and fuel as to strengthen…

Based on your research and understanding, respond to one of the following scenarios:
1. A 58-year-old female is admitted for a work up for a complaint of neck and low back pain.Musculoskeletal And Neurologic Systems During admission, you discover that she underwent a renal transplant six years ago. The patient also had blood work collected. When you review the findings, you notice that her serum calcium is elevated at 13.9 (Normal values range from 8.5 to 10.2 mg/dl), her CBC shows a hematocrit of 33%, and hemoglobin of 11.1 g/dl (normal adult female hematocrit Range: 37-47%, normal adult female hemoglobin range: 12-16 g/dl).
o What does this mean and what could be the underlying cause of her pain and her abnormal lab values?
o What other assessments would be helpful?
2. A 12-year-old female is admitted with severe pain in her spine. While checking history, the patient and her mother state that several weeks ago the patient was treated for an upper respiratory infection. The infection subsided after several days of taking antibiotics. However, several days later, the child complained of joint swelling and pain in her right elbow, which subsided, but then seemed to migrate to her left knee. A week later, today, the child began to complain of worsening back pain. The mother has been treating the pain with over the counter pain medication and heat and ice packs, but this did not seem to help.

• What are the possible causes of the pain and how you would proceed?Musculoskeletal And Neurologic Systems
A 33-year-old Hispanic male is admitted and complains of a tingling sensation in his left leg, vertigo, and loss of balance. When you begin to perform intake history, you notice that his speech is slurred, his teeth are in need of repair, and he seems to be very drowsy.
• What other findings may you find in this individual?
• What would you think is the underlying cause of this patient’s complaint?
• How would you proceed with your assessment specifically for this patient?
A patient is admitted to the unit. He is a diabetic on chronic hemodialysis. He has an Arteriovenous (A-V) graft, which is annulated each time he undergoes dialysis treatments. You notice an area on his graft arm that is red and warm to the touch. He states that he has had this on his arm for several weeks. He asked the dialysis staff about the area, but they told him to apply warm compresses to the site. The staff at the dialysis center continues to use the graft, but they are careful to avoid the area when they cannulate for his treatments. Now the patient presents with extreme low back pain, fever, nausea, and swelling of his lower extremities. On checking his fasting serum glucose, you notice that the reading is 159 (Normal fasting blood glucose range 64 to 110 mg/dl), and his white blood cell count is 36,000 (normal range is 4,500-10,000 white blood cells/mcl). He states that his sugars were normally well controlled, but in the past ten days he seems to be requiring more insulin.Musculoskeletal And Neurologic Systems
• How would you proceed with this patient?
• What could be the underlying problem?

Both of these can reveal levels of various minerals and other substances indicating disease or a musculoskeletal disorder. The levels of certain protein in the blood may also help diagnose a disease. Blood and Urine samples are the most common tests used to diagnose problems within the musculoskeletal system. Also, prior to surgery, blood samples are used to detect bleeding tendencies. Urinary N-telopeptide of type 1 collagen or N-Tx and deoxypyridinoline (Dpd) both reflects increased osteoclast activity and increased bone resorption.

b. Nerve Conduction Studies

It is used to measure the electrical activity of muscles when a muscle fiber contracts to determine if the muscles and nerves are working properly. It is performed by stimulating a peripheral nerve at several points along its course and recording the muscle action potential or the sensory action potential that results. Usually, surface or needle electrodes are used. It is placed on the skin over the nerve to stimulate the nerve fibers. A technique called truax biography will show nerve conduction patterns, which changes in various muscle and nerve diseases.Musculoskeletal And Neurologic Systems

c. Imaging Procedures

X-Ray Studies

Bone X-Rays determines the bone density, erosion, and changes in bone relationships. It is used to diagnose broken bones or joint dislocations, guide orthopaedic surgery such as spine repair or infusion, assist in detection and diagnose of bone cancer, and locate foreign objects around soft tissues and in bones. Joint X-Rays reveal fluid irregularity, spur formation, narrowing and changes in joint structure. It is used to detect degenerative conditions on the joints, fractures, and tumors. Multiple X-Rays with multiple views are also needed for full assessment of the structure being examined.

Computed Tomography

It is used to identify the location and extent of fractures in areas that are difficult to evaluate such as acetabulum.Musculoskeletal And Neurologic Systems It can be performed with or without the use of contrast agents and can illustrate a detailed specific plane of involved bone and can also reveal tumors of the soft tissues or injuries to the ligaments or tendons.

Magnetic Resonance Imaging

It can demonstrate abnormalities such as tumors and narrowing of tissue pathways through the bone. It is a noninvasive procedure and electromagnets are used that is why patients with any metal implants, clips or pacemakers cannot have an MRI. IV contrast agent are used to enhance visualization.

Arthrography

It identifies acute or chronic tears of the joint capsule or supporting ligaments of the knee, shoulder, ankle, hip, or wrist. A radiopaque contrast agent or air is used. It is injected into the joint cavity to visualize the irregular surfaces. The joint will be put through its ROM to distribute the contrast agent accompanied by a series of X-Rays. If the contrast agent leaks, it means a tear is present. Musculoskeletal And Neurologic Systems