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Textbook For Nursing
Assistants
Chapter 25 The Musculoskeletal System
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 1
Structure of the
Musculoskeletal System
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 2
The Skeletal System
Four major types of bones
Long bones
Short bones
Flat bones
Irregular bones
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 3
The Skeletal System
Joints: areas where two bones join together
Range of motion: the complete extent of
movement that a joint is normally capable of
Three main types of joints:
Fixed
Slightly moveable
Freely moveable
Ligaments cross over the joint capsule and
attach one bone to another
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 4
The Muscular System
Consists of the muscles
Skeletal muscle:
Attached to the bones by bands of connective
tissue called tendons
Occasionally, skeletal muscles are attached to
other muscles by a broad, flat sheet of tendon
called an aponeurosis
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 5
Function of the
Musculoskeletal System
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 6
Vital Functions
Protection
Support
Movement
Heat production
Calcium storage
Production of blood cells
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 7
The Effects of Aging on the
Musculoskeletal System
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 8
Age Related Changes
Age-related changes affecting the
musculoskeletal system are the leading
cause of disability in older adults
Age-related changes include:
Loss of bone tissue
Loss of muscle mass
Wear and tear on joints
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 9
Disorders of the
Musculoskeletal System
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 10
Types of Disorders
Osteoporosis
Arthritis
Muscular dystrophy
Fractures
Amputation
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 11
Osteoporosis
Excessive loss of bone tissue
Commonly affects the bones of the spine and
pelvis, and the long bones in the arms and legs
Most common in older women who have gone
through menopause
Painful, debilitating, and person is at increased
risk for fractures from minor trauma
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 12
Osteoporosis: Risk Factors
Smoking
Inactivity or immobility
A diet lacking in calcium, vitamin D
Certain drugs, such as steroids
Diseases of the thyroid and adrenal glands
White race
Small bones
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 13
Osteoporosis
Can be prevented by exercising regularly and
eating a diet rich in calcium, protein, and vitamin
D, starting early in life
Some treatments are available: medication that
helps to slow progression, hormone replacement
therapy, calcium and vitamin D supplements,
weight-bearing exercise
When caring for a person with osteoporosis, be
gentle, encourage proper nutrition and
hydration, encourage light exercise, and be
observant for loss of function, swelling, or pain
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 14
Arthritis
Inflammation of the joints
Types of arthritis:
Osteoarthritis: degenerative disease
Rheumatoid arthritis: autoimmune disease
Gout: metabolic disease
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 15
Joint Replacement Surgery: Post Care
Use an abduction pillow to keep the legs in the
proper position when the person is in the supine
or lateral position
When out of bed, have the person sit in a
straight-backed chair with his hips flexed no
more than 90 degrees
Help the person with ambulation and transferring
Ask the nurse for any specific instructions or
restrictions that are specific to your patient or
resident
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 16
Muscular Dystrophy
A group of disorders that cause the
skeletal muscles to become more and
more weak over time
Types of muscular dystrophy
Myasthenia gravis
Duchenne’s muscular dystrophy
Person will need more and more help with
ADLs as the disease progresses
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 17
Fractures
Broken bone caused by trauma
Older people are at a high risk
Types of fractures
Closed fracture
Open fracture
Greenstick fracture
Impacted fracture
Comminuted fracture
Spiral fracture
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 18
Fractures: Treatment Methods
Treatments for fractures
Reduction and fixation
Reduction may be closed or open
Fixation may be external (cast) or internal (metal
plates, screws, pin, wires, or rods)
Traction: used to keep the ends of the bone in
alignment until the fracture can be
permanently repaired by casting or surgery
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 19
Amputation
The removal of all or part of an arm or a leg
May be necessary as a result of trauma or
disease
Adjusting to the amputation can be emotionally
difficult for the person
A prosthetic device may be fitted; allows the
person to regain function and a more normal
appearance
Phantom pain is the feeling that the amputated
body part is still present after it has been
removed
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 20
General Care Measures
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 21
Different Techniques
Techniques to prevent complications of
immobility, relieve musculoskeletal
discomfort, and maintain or restore
musculoskeletal function
Range-of-motion exercises
Application of heat or cold
Rehabilitation
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 22
Range-of-motion Exercises
Usually performed at least twice a day,
often along with other personal care
activities, such as bathing or dressing
May be active, passive, or active-assistive
Used to help prevent complications of
immobility, such as contractures, muscle
weakness, and brittle bones
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 23
Guidelines for Assisting with Range-of-Motion Exercises
Always follow the care plan or the instructions
that you are given exactly
Move through the exercises in a systematic way
Unless instructed otherwise, perform the same
exercise on each corresponding body part
Watch the person’s face for signs of discomfort
or pain
Do not move the joint past its natural range of
motion
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 24
Heat and Cold Applications
Used to reduce or prevent tissue swelling,
promote healing, ease pain, and promote
comfort
Risk factors for injury from heat and cold
applications
Very old or very young age
Chronic illness
Very fair skin
Impaired sensation
Disorientation (e.g., dementia, use of pain
medications)
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 25
Cold Applications
Used for people who have musculoskeletal
injuries resulting from trauma, such as sprains
and fractures
Application of cold reduces pain and swelling
and decreases bleeding
Cold applications can be either moist or dry
Cold applications should not be left in place for
longer than 20 minutes, and skin should be
checked every 10 minutes
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 26
Heat Applications
Relaxes the muscles, relieves pain, and
promotes blood flow to the area
Can be either moist or dry
Should not be left in place for longer than 20
minutes, and the skin should be checked every 5
minutes
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 27
Rehabilitation
Person with a musculoskeletal disorder
may need physical, emotional, or
vocational rehabilitation, or a combination
of the three
Role of nursing assistant:
reassurance and encouragement
active listener and an attentive observer
familiarity with the supportive, assistive and
prosthetic devices in use
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 28
End of Presentation
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 29