Key functions of the musculoskeletal system include
movement, structural support, protection of your internal
organs, blood cell production, and storage of minerals.
The components of the musculoskeletal system include
bones as well as joints. So this is where two or more bones
come together to allow for movement.
So an example of a joint would be your shoulder or your
knee, which are examples of synovial joints, which we will
be talking more about here in a minute.
Other components of the musculoskeletal system include
skeletal muscles, as well as tendons, which attach muscles
to bones, and ligaments, which attach bones to bones. So
if you could remember the phrase bones like bones, then
that will help you remember that bones are attached to
other bones through ligaments because L for likes and L
for ligaments. Here's an illustration of a long bone from
our medical-surgical nursing flashcard deck.
The outer layer of the bone is the cortex, which is made up
of dense, compact bone tissue.
The inner layer of the bone is comprised of spongy bone
tissue, and it contains bone marrow, which is where
hematopoiesis occurs, which is the formation of blood
cells.
So we have the red bone marrow here in the upper
epiphysis, and that contains stem cells that will become
red blood cells, white blood cells, or platelets.
Then we have the yellow bone marrow here in the
diaphysis, which contains stem cells that will become
cartilage, fat, or bone. So this line here that separates the
epiphysis from the diaphysis is the metaphysis, which
contains the epiphyseal plate or the growth plate.
Bone remodeling is a continuous process based on the
activity of osteoblast, which are bone-forming cells, and
osteoclast which are bone-destroying cells.
So we have a little cool chicken hint here on the card.
Osteoblast equals bone building. So when you see B for
blast, think bone building.
There are a number of minerals and hormones to be
familiar with that affect bone growth.
So calcium and phosphorus are essential minerals that are
needed for bone formation.
Vitamin D is needed for absorption of calcium. So if
someone's taking in enough calcium, if they don't have
enough vitamin D, then that calcium is not going to be
absorbed readily.
Parathyroid hormone or PTH is a hormone produced by
the parathyroid glands. And PTH will bring calcium out of
the bones and into the bloodstream. So it will increase
blood calcium levels.
Calcitonin is a hormone that counteracts the activity of
PTH. So calcitonin will tone down those blood calcium
levels, and it does this by inhibiting the activity of
osteoclast, which are those bone destroying cells. It also
decreases reabsorption of calcium at the kidneys. So again,
calcitonin is going to tone down blood calcium levels. And
PTH is going to increase those blood calcium levels.
And then growth hormone will increase bone formation.
So it will stimulate the activity of osteoblast, which are
those bone-building cells.
All right. Let's now take a look at a joint and talk about the
different components of a synovial joint. Here's an
illustration of a synovial joint from our medical-surgical
nursing flashcard deck. So a synovial joint is a freely
movable joint such as the elbow or the knee.
And you can see that we have the joint capsule, which
surrounds that synovial joint and is comprised of fibrous
connective tissue.
Then we have the synovium here, which is a membrane
that lines the joint capsule and secretes synovial fluid,
which helps to provide lubrication and shock absorption at
that joint.
The joint cavity here is fluid filled, and it is where the
articulating surfaces of the two bones come in contact
with each other.
And we have this articular cartilage, which lines the
surface of each of the bones in the synovial joint. The
purpose of this articular cartilage is to allow the bones to
glide smoothly against each other. We will be talking
about osteoarthritis in another video in this playlist, which
is caused by the wear and tear of this articular cartilage.
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First up, let's talk about an arthrocentesis, which is
aspiration of synovial fluid from the joint cavity. And we
may be removing some of the synovial fluid in order to
assist with diagnosis of an infection.
So for example, we'll take some of that synovial fluid and
run a culture on it to see if the patient has infection. We
may also be removing some synovial fluid to help with
pain control. So if a patient has severe swelling, removal of
some of that fluid can help to decrease their pain. We may
also do a arthrocentesis in preparation for the injection of
medications into that joint cavity, such as corticosteroids.
Another diagnostic procedure to know within the
musculoskeletal system is an arthroscopy. This is where
we insert a narrow tube with a camera on the end in order
to visualize the internal structure of a joint, and it also
allows for the collection of biopsies. If we are doing an
arthroscopy on a knee, the patient needs to be able to
bend their knee at least 40 degrees and there cannot be
any active infection present in that knee.
Then we have a DXA, which is a dual X-ray absorptiometry.
And this procedure uses low levels of X-rays to measure a
patient's bone mass.
So it is used to diagnose osteoporosis, which we will
definitely be talking more about later in this playlist.
Then we have nuclear scans, which are used to identify
fractures, bone cancer, as well as bone infections.
So for this procedure, a radioactive substance or isotope is
administered to the patient about four to six hours before
the procedure. And this radioactive material will gather in
places of chemical or physical changes in the bone. So if
the patient has bone cancer, for example, that's going to
cause rapidly replicating cells in the area of the bone
cancer. And this radioactive material will definitely be
attracted to that area and gather in the site of that bone
cancer. Then when we do the scan, the nuclear scan of the
patient, we will see this hot spot where this radioactive
material has gathered. So nuclear scans can be repeated at
24, 48, and 72 hours.
And then finally, we have something called an
electromyography, which is used to evaluate muscle
weakness.
For example, if we're trying to diagnose myasthenia gravis,
which we will be talking about in this playlist, then an
electromyography would definitely be helpful. So during
this procedure, we have needles that are inserted into the
muscles and the electrical activity of the muscle is
recorded. And my understanding is that this is not a
comfortable procedure. It's not like super painful, but it is
definitely not pleasant
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improve his pain with the RA. So, hopefully that will help
you remember that with RA, we get swan neck deformities
and boutonniere deformities. So think about that swan
with the boutonniere going to dance. Other deformities
are present as well that we talked about, like that ulnar
drift, etc.

And then, finally, when we run labs, a patient with

osteoarthritis will have a negative rheumatoid factor, as
opposed to a patient with rheumatoid arthritis who have a
positive rheumatoid factor.