Musculoskeletal Anatomy and Physiology, Musculoskeletal Disorders

1. Musculoskeletal
Pathophysiology

2. Composition of the
Musculoskeletal System
1) Bone
2) Muscle
3) Joints
4) Ligaments
5) Tendons

3. Bones and Muscles Joints

5. Bone Functions
1) Body movement
2) Body position
3) Stabilize joints
4) Maintain body temperature

6. Bone Shape
Short
Long
Flat
Irregular

7. Bone Tissue
Intracellular Matrix – strong, rigid structure of fibers and
calcium phosphate
Compact Bone – outer bone covering
Spongy Bone – interior bone

8. Bone Cells
Osteocytes – mature bone cells
Osteoblasts – producing cells that make collagen and
matrix proteins
Osteoclasts – resorption cells that secrete collagenase

10. Functions of Muscles
1) Produce body movement
2) Stabilize body position
3) Regulate organ volume
4) Move substances within the body
5) Generate heat

11. Smooth Muscle
Major Location – walls of hollow viscera, blood vessels
Major Function – movement of viscera, peristalsis,
vasoconstriction
Cellular Characteristics – no striations, single nucleus,
and lacks transverse tubules
Mode of Control - involuntary
Characteristics of Contractions – contracts and relaxes
slowly; self-exciting; rhythmic

13. Cardiac Muscle
Major Location – heart walls
Major Function – pumping action of the heart
Cellular Characteristics – has striations, single
nucleus, and well-developed transverse tubules;
intercalated discs separate adjacent cells
Mode of Control - involuntary
Characteristics of Contraction – network of cells
contracts as a unit; self-exciting; rhythmic

15. Skeletal Muscle
Major Location – muscles
Major Function – movement of bones at joints,
maintenance of posture
Cellular Characteristics – has striations, many nuclei,
and well-developed transverse tubules
Mode of Control – voluntary
Characteristics of Contraction – contracts and relaxes
rapidly

18. Joints
Functions
◦ Act as levers for complex movement
◦ Maintain body posture
Types
◦ 1) Synarthroses – immovable joints
◦ 2) Amphiarthroses – slightly moveable joints
◦ 3) Diarthroses – freely moving joints

20. Ligaments
Connect bone to bone

21. Tendons
Connect muscles to bone

22. Fractures
Present with bleeding, local inflammation, and necrosis of
tissue at the end of the broken bone.
Types of Fractures
◦ Complete – break ends across entire bone
◦ Incomplete – some of fracture components are still partially
joined
◦ Comminuted – crushed, small, crumbled bone fragments
near the fracture
◦ Pott’s Fracture – fracture of the lower tibia
◦ LeFort Fracture – fracture of the face and/or base of skull

24. Osteoporosis
Decrease in bone mass and bone density
Loss of bone matrix and bone mineralization
Predisposing Factors: 50+ y/o, sedentary, hormonal, low
BMI, diet, and Asian/European Ancestry
Treatment: dietary supplements like calcium and vitamin
D, weight-bearing activities, and PT

26. Rickets and Osteomalacia
Deficit of vitamin D and phosphates.
Weak bones in pediatrics
Soft bones in adults

27. Paget’s Disease
Excessive bone destruction with replacement by fibrous
tissue and abnormal bone

28. Tumors
Bone is a common area of secondary tumors.
Primary tumors are usually malignant.
Types
◦1) Osteosarcoma – cancerous tumor in bone
◦2) Chondrosarcoma – cartilage cells in adults
◦3) Ewing’s Sarcoma – shaft of long bone in adolescents

30. Muscular Dystrophy
Autosomal recessive disorder causing degeneration of
skeletal muscle
Signs/Symptoms in boys: dystrophin deficit, and
replacement of skeletal muscle by fat and fibrous
connective tissues
Diagnostic Tests: genetic abnormalities, elevated creatine
kinase levels, EMG, muscle biopsy, blood test
Treatment: no curative treatment, only supportive
treatment - moderate exercise, PT/OT, massage, assistive
device, or ventilator

32. Osteoarthritis
Degenerative wear and tear of bone
Cause: increased weight lifting or articular cartilage
damage.
Signs/Symptoms: bone spurs, inflammation, rough and
worn surface, lack of range of motion, pain, and falls
Treatment: assistive devices, NSAIDS, glucosamine-
chondroitin supplements, or joint replacement

34. Rheumatoid Arthritis
Autoimmune, chronic, systemic, and inflammatory disease.
Cause: unknown
Signs/Symptoms: synovitis, red and swollen joints,
pannus formation, cartilage erosion, fibrosis, muscle
atrophy, muscle spasms, muscle contractions
Systemic Signs/Symptoms: fatigue, anorexia, mild fever
Treatment: rest, limit activity, heat/cold therapy, NSAIDS,
glucocorticoids, analgesics, surgery, and drugs

36. Gout
Cause: deposits of uric acid in the joint
Signs/Symptoms: inflammation, redness, swelling, pain
Diagnosis: examination of synovial fluid, blood tests
Treatment: reduce uric acid levels by drugs and dietary
changes

38. Ankylosing Spondylitis
Cause: joint fixation, inflammation of spinal joint or
costovertebral joints, inflammation of intervertebral spaces
of axial skeleton, fibrosis, calcification of joints
Signs/Symptoms: low blood pressure, pain when supine,
rigid spine
Systemic Signs/Symptoms: fatigue, fever, weight loss,
iritis
Treatment: relieve pain, restore mobility, anti-inflammatory
drugs, analgesics, daily exercise, PT/OT