MUSCULOSKELETAL SYSTEM

INTRODUCTION

Locomotion – a Latin word

Loco + motion
Movement or ability to move from one place
to another

Also called as Musculoskeletal system mainly involves

Bones, Muscles, joints.
Functions of the Musculoskeletal
System

• Gives the body shape

• Protects internal organs
• Facilitates for movement
History should consist

Pattern of joint involvement

Mode of onset
Character of pain – relieving & aggravating factors
Stiffness – early morning and after immobility
Family history
General medical history
Past medical history
History should determine

Condition is mechanical or inflammatory

Acute or chronic, persistent or intermittent
The distribution of joints involved
Treatments tried and their effectiveness
Gait:
Gait is the cyclical pattern of musculoskeletal motion
that carries the body forward.

Gait –stance & swing

Assessment of Gait:
Ask the patient to walk back and forth
across the room.
Observe for equality of arm swing,
balance and rapidity and ease of
turning.
Next, ask the patient to walk on his
tiptoes, then on heels.

Test patient's ability to stand with feet

together with eyes open and then
closed. (Romberg's test). Reassure
patient that you will support him, in
case if he becomes unsteady.

Normal : person can walk in balance

with the arms swinging at sides and
can turn smoothly. Person should be
able to stand with feet together
without falling with eyes open or
It may become altered because of

•Loss of muscle power

•Alteration of muscle tone
•In coordination of movement
•Pain during movement
TYPES OF GAIT
Some of the common patterns of gait are

• Hemiplegic gait
•Spastic gait
•Scissors gait
•High stepping gait
•Parkinson’s gait
• Antalgic gait
CONCERNING SYMTOMS

• Pain
• Stiffness
•Swelling
•Tenderness
•Warmth
• Redness
•Weakness
•Deformity
PAIN

It may originate from a joint (arthralgia),

muscle(myalgia) or other soft tissue structure.
Assessment of the muskuloskeletal pain done by..
 Site
 Onset
 Character
 Radiation
 Associated factor
 Timing
 Severity
STIFFNESS

Restricted range of movement

•Localized to particular joint-ankylosing
spondylitis
•Generalized-Rheumatoid arthritis.

If the stiffness predominate over pain, suspect

•Spasticity (increased muscle contraction)
•Tetany (involuntary contraction)
SWELLING

Swelling may be due to diffuse soft tissue

edema or caused by the collection of fluid in a
joint, bursa or tendon sheath.

Eg: swelling in knee joint-haemarthrosis

WEAKNESS

Suggests a joint disorder, peripheral nerve

lesion or muscular disease.
Eg: medial nerve compression in carpal tunnel
syndrome
Location of weakness-
• Proximal weakness-primary muscle disease
such as immune-mediated inflammatory
muscle disease.
Eg: dermatomyositis
• Distal weakness-neurological
Eg: peripheral neuropathy of thiamine
Redness

Seen in acute inflammatory arthritis

•Erythema is common in
infective ,traumatic and crystal-induced
condition.