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The Musculoskeletal System

Musculoskeletal System Anatomy

The musculoskeletal system provides humans with the ability to move and perform different tasks using their skeletal and muscular systems. Therefore, the body gets its form, movement capability, and overall stability from the strength of its muscular and skeletal formations. The musculoskeletal system (also known as the locomotor system) consists of the skeleton, muscles, and numerous connective tissues, joints, tendons, and ligaments (Boros and Freemont 205). In this way, vital human organs are protected and the body is recurrently supported. The skeleton serves as a reinforcement mechanism that ensures the stability of the body and also guarantees that muscles may keep bones in place. The motion becomes possible owing to the joints and cartilage that prevent bones from touching and destroying one another.

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Speaking of the skeletal system in detail, it may be important to mention that it serves as the key “reservoir” for phosphorus and calcium. The bloodstream is regulated by this storage, as excessive amounts of minerals are not fluctuating across the body but rather get stored in bones. The skeleton is also important because it is associated with the hematopoietic system that is responsible for blood production (Boros and Freemont 208). There are two types of bone marrow that are known to humans: red and yellow. The red marrow can be found only in some of the human bones, as it helps replace blood cells that are destroyed by the liver. Therefore, healthy blood circulation would not be possible without red marrow. As for its yellow counterpart, it is mostly addressed in times of starvation due to the fatty connective tissue that can be used by the organism to generate energy.

The muscular system includes all muscles that have the possibility to contract and move the respective bone that is attached to a certain joint. Each of the skeletal muscles is attached to a specific bone, with joints serving as a divider between the opposing groups of muscles (for example, biceps and triceps). Each of the muscles features nerves, as the latter conduct electrical currents that force muscles to contract when necessary (Boros and Freemont 209). Muscle tissue can be of three essential types: skeletal, smooth, and cardiac. Yet, the musculoskeletal system only includes the first two, as the cardiac muscles are not under conscious human control.

The last part of the human musculoskeletal system is a mix of ligaments, tendons, and joints. The main task of ligaments (bands of white elastic tissue) is to connect the ends of bones and ensure that joints are formed in an accurate manner. Joints, on the other hand, make human movement possible owing to bone articulations. A tendon is another flexible tissue required to connect bones and muscles (Boros and Freemont 211). All these issues are necessary for the musculoskeletal system to prevent hyperextension and limit joint dislocation. An additional type of connective tissue is bursae. The latter is necessary to establish “cushions” between parts of the musculoskeletal system and prevent excessive adhesive friction.

Musculoskeletal System Physiology

From the point of physiology, the main purpose of the muscular system is to establish human movement and help the person in question perform all required tasks in the smoothest way possible. Given the fact that muscles are the only part of the human body that can contract, it means that they are moving all body parts. The second vital function of the muscular system is to maintain a specific body position and create a posture for the person that would keep the organism healthy. Most often, muscle contractions are aimed at causing movement or keeping the body still. As the literature on the subject suggests, the muscles that are responsible for posture are the most enduring and powerful in the entire human body, as they have to maintain an individual’s posture throughout the day with no interruptions (Griffith 324). One more specific function that has to be completed by the muscular system is to move various substances inside the human body. Muscles transport blood from one body part to another while also ensuring that a decent amount of body heat has been generated.

Another physiological point that has to be taken into consideration is the lever-like structure of skeletal muscles that work together with joints and bones. The bone is the lever, the joint is the pivot, and the muscle stands for the effort force. The majority of human body levers relate to third-class levers, meaning that the pivot may only be located at the end of the lever (Griffith 325). The idea behind the third-class levers is that the distance of muscle contraction is always smaller than the distance progressed by the load. The only tradeoff, in this case, is that the force applied to the load should be higher than the mass of the load itself.

The last physiological point related to the human musculoskeletal system is the presence of motor units. A motor unit is a group of muscle cells controlled by nerve cells that are also known as motor neurons. At the moment when a motor neuron accepts a signal from the brain, all muscle cells get stimulated at the same time, allowing the human to perform physical tasks. The variety of motor unit sizes depends on the list of functions that a muscle fulfills. For example, high-precision muscles such as finger- or eye-bound do not contain many muscle fibers in order to help the brain have stronger control of fine movements (Griffith 326). As for the muscles that require more strength, each motor unit contains much more muscle cells to ensure that there is enough power in the legs and arms to perform resource-intensive tasks. This is why the human body controls motor units and limits their activation depending on the complexity of the task (for instance, the same muscles may be used to pick up a 50 lbs. bag and a pen).

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Musculoskeletal System Disorders

Carpal Tunnel Syndrome

The main issue that causes carpal tunnel syndrome is the pressure applied to the median nerve that causes the latter to compress. The nerve can be found on the palm side of the hand, and it is in control of sensations located in the index finger, thumb, long finger, and a fragment of the ring finger. The syndrome causes an individual’s wrist to swell and affects the carpal tunnel, causing the nerve to compress (Padua et al. 1274). When exposed to carpal tunnel syndrome, a person may feel weakness and numbness near the thumb. One of the main causes for the development of carpal tunnel syndrome is the presence of excessive pressure applied to the wrist and the median nerve in particular. The issue of carpal tunnel syndrome may lead to the obstruction of blood flow as well. There are several frequent conditions that may be associated with the syndrome such as high blood pressure, diabetes, wrist traumas, and autoimmune disorders.

In the case where the wrist gets overextended from time to time, carpal tunnel syndrome may get even worse. The median nerve gets even more compressed, and repeated motions generate even more swelling. One of the most common reasons for the development of carpal tunnel syndrome is incorrect hand positioning during the utilization of computer keyboard and mouse. Nevertheless, piano players may also be exposed to the risk of carpal tunnel syndrome due to constant wrist overextension. It is important to mention that women are at least 30% more likely to suffer from carpal tunnel syndrome, with lifestyle factors having the biggest influence on the potential outcomes of the condition (Padua et al. 1276). People employed as construction workers or those who take on keyboarding occupations are at a much higher risk of exposing themselves to carpal tunnel syndrome.

Osteoarthritis

Osteoarthritis is a chronic joint condition that affects the cartilage and forces bones to rub together. Even though this condition is most likely to affect the elderly, it may also be found in adults of any age. Another name for osteoarthritis is the degenerative joint disease, and it is known as one of the leading causes of disability (da Costa et al. 23). Joint damage that forces the development of osteoarthritis may be a result of accumulated injuries. If a person had dislocated joints or torn cartilage in the past, they are at risk for the development of osteoarthritis as well. There are additional hazards that include obesity and poor posture.

Speaking of the association between osteoarthritis and cartilage, the breakdown of the latter may easily cause bones to rub against each other, making bones rougher and bumpier. Broken cartilage generates enormous pain within joints and cannot restore itself. The problem is that there are no blood vessels in cartilage, forcing bone-on-bone contact over time (da Costa et al. 27). Most commonly, osteoarthritis affects the knees, hands, fingertips, and lower back. Advanced osteoarthritis causes even more acute pain that may also be accompanied by swelling in the nearby joints and surrounding body parts.

Tendinitis

When tendons get damaged by inflammation or irritation, it ultimately causes the condition called tendinitis. Tendons become tender and the individual starts feeling acute pain that averts them from moving affected joints. The most common body parts at risk of development of tendinitis are wrists, knees, elbows, and shoulders (Verstraelen et al. 425). The main cause of this condition is the presence of a specific repetitive action that puts a strain on a certain tendon that gets worn down quicker, especially in the case where the motion is performed the wrong way. Frequently, individuals develop tendinitis while working or playing sports. The highest level of risk is characteristic of professional basketball, tennis, and golf athletes.

There are numerous symptoms that could be investigated by any given person and help them prevent further development of tendinitis. Firstly, there will be a dull ache around the affected area. The pain is going to increase during movements involving the injured body part (Verstraelen et al. 425). The damaged zone will become tender and limit the person’s movements due to increased tightness. Swelling is also an important sign of tendinitis, and it may be recommended to visit the doctor if the symptoms did not go away after reasonable rest and application of ice.

Musculoskeletal System Disorder Treatments

Carpal Tunnel Syndrome

Carpal tunnel syndrome should be treated during the earlier stages in order for the treatments to be most effective. The most common recommendations include taking more breaks during work and avoiding activities that cause damage to the wrists. As for the medical approach to carpal tunnel syndrome, there are three general ways to treat it: medications, surgery, and wrist splinting. The latter is most likely to help in the case where symptoms did not exceed either mild or moderate. If a person has numbness in their hands, this is a serious reason to see the doctor. Wrist splinting is one of the most popular nonsurgical methods of dealing with carpal tunnel syndrome, as it may be used to fix a patient’s wrists during the night and relieve the sensations of numbness and tingling (Kleopa 3). Even though carpal tunnel syndrome splints are only worn during the nighttime, they could also serve as a preventive mechanism for daytime symptoms. For pregnant patients, nighttime splinting is the best option because it does not involve any medications but still tends to be effective.

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The pain from carpal tunnel syndrome may be effectively relieved by nonsteroidal anti-inflammatory drugs such as ibuprofen, for example (Motrin IB or Advil). There is no practical evidence in the literature that these drugs may improve carpal tunnel syndrome, but there are also corticosteroids that could be injected to relieve pain with the help of cortisone. After the inoculation, the contents may be guided with an ultrasound. The main benefit of corticosteroids within the framework of carpal tunnel syndrome consists in the ability to decrease swelling and reduce the pressure applied to the median nerve (Kleopa 6). There are also oral corticosteroids, but they are not as effective as their injected counterparts. If carpal tunnel syndrome is a comorbid condition for rheumatoid arthritis, for example, it would be reasonable to treat arthritis first to relieve the symptoms of the syndrome.

Surgery is another viable option in the case of carpal tunnel syndrome but it is only appropriate when other treatments do not help. The main objective of surgery with carpal tunnel syndrome is to cut the ligament that compresses the median nerve. There are two essential techniques used to perform surgery on carpal tunnel syndrome: endoscopic and open. Throughout endoscopic surgery, the surgeon tries to look inside the patient’s carpal tunnel with the help of a tiny camera attached to a stick. Instead of the endoscope, some surgeons may use ultrasound to guide the process of cutting the ligament (Kleopa 7). Open surgery, on the other hand, suggests that the surgeon is going to cut open the patient’s palm to free the nerve by cutting the pressing ligament.

Osteoarthritis

Even though the effects of osteoarthritis cannot be overturned, there are several methods of reducing pain in the patients and relieving some of the symptoms (with pain being the leading cause for applying any particular treatments). The first type of required medication is acetaminophen (for instance, Tylenol) that is expected to help those patients who only display mild to moderate symptoms of osteoarthritis. The doctor should carefully monitor the intake of acetaminophen, as improper dosage could lead to liver damage. Other types of medications are nonsteroidal anti-inflammatory drugs that may be gained over the counter. These include ibuprofen (Advil, Motrin IB) or naproxen sodium (Aleve) (Bruyere et al. 182). Recommended dosages could easily relieve the symptoms of osteoarthritis and reduce pain. Nevertheless, patients should be careful with this type of medication as nonsteroidal anti-inflammatory drugs could cause kidney damage and generate cardiovascular problems. The last type of medication expected to relieve the symptoms of osteoarthritis is an antidepressant such as duloxetine (Cymbalta), for example, which may be helpful when dealing with chronic conditions.

Another conservative type of treatment for osteoarthritis is physical therapy that may be used to strengthen the patient’s muscles and reduce pain by increasing muscle flexibility. Regular exercises could lead to positive results, as the patient would gently increase their strength (Bruyere et al. 183). Another type of therapy is named occupational due to the ability of the patient to find ways to cause less damage to their joints when performing everyday tasks.

In the case where conformist treatments are not helpful, it may be recommended to perform special injections. The first type is cortisone injection that may be used to reduce joint pain and reduce swelling in the area. As the area around the joint is numbed by the doctor, medication is injected within the joint. There is a limited number of injections that may be performed annually (usually not more than four) due to the increased risk of damaging the joint (Bruyere et al. 184). Another type of injection involves lubricants such as hyaluronic acid that may be used to develop a cushion in the patient’s knee and alleviate the effects of osteoarthritis. While the existing research suggests that lubrication injections could be a placebo, hyaluronic acid is still deemed to be a helpful component in treating osteoarthritis.

Tendinitis

The main objective of tendinitis treatment is to make sure that inflammation is reduced together with the amount of pain. Even though rest and application of ice may be enough for certain patients to treat tendinitis in home conditions, there may be cases that require more specific attention and additional medications. The first category of medications is pain relievers that may include (but not be limited to) aspirin, ibuprofen (Motrin IB or Advil), and naproxen sodium (Aleve) (Krey et al. 82). All of these might be expected to dismiss the feeling of discomfort and help patients restore their regular condition. Another potentially effective method is to apply anti-inflammatory topical creams that are currently becoming much more popular across the United States due to their success in terms of relieving pain and the lack of potential side effects.

One more treatment method may be the application of corticosteroid medications that would be used to ease the pain and reduce inflammation in the damaged areas. Corticosteroid injections around the necessary tendons could only be helpful if the condition was not lasting for more than three months. In the case where the patient suffers from chronic tendinitis, repetitive injections could deteriorate the tendon and create premises for tendon rupture (Krey et al. 84). The ultimate tendonitis treatment is the application of platelet-rich plasma that is expected to help the organism separate healing factors and the platelets. The solution is inoculated into the area of irritation to reduce the symptoms of chronic tendonitis. Even though there is not enough evidence regarding the methods of optimal use of platelet-rich plasma, there is a tendency in tendonitis treatment to reduce chronic irritation with the help of platelet injections.

Works Cited

Boros, Katalin, and Tony Freemont. “Physiology of Ageing of the Musculoskeletal System.” Best Practice & Research Clinical Rheumatology, vol. 31, no. 2, 2017, pp. 203-217.

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Bruyere, Olivier, et al. “Can We Identify Patients with High Risk of Osteoarthritis Progression Who Will Respond to Treatment? A Focus on Epidemiology and Phenotype of Osteoarthritis.” Drugs & Aging, vol. 32, no. 3, 2015, pp. 179-187.

da Costa, Bruno R., et al. “Effectiveness of Non-Steroidal Anti-Inflammatory Drugs for the Treatment of Pain in Knee and Hip Osteoarthritis: A Network Meta-Analysis.” The Lancet, vol. 390, no. 10090, 2017, pp. 21-33.

Griffith, James F. “Functional Imaging of the Musculoskeletal System.” Quantitative Imaging in Medicine and Surgery, vol. 5, no. 3, 2015, pp. 323-331.

Kleopa, Kleopas A. “Carpal Tunnel Syndrome.” Annals of Internal Medicine, vol. 163, no. 5, 2015, pp. 1-16.

Krey, David, et al. “Tendon Needling for Treatment of Tendinopathy: A Systematic Review.” The Physician and Sportsmedicine, vol. 43, no. 1, 2015, pp. 80-86.

Padua, Luca, et al. “Carpal Tunnel Syndrome: Clinical Features, Diagnosis, and Management.” The Lancet Neurology, vol. 15, no. 12, 2016, pp. 1273-1284.

Verstraelen, Freek U., et al. “Surgery for Calcifying Tendinitis of the Shoulder: A Systematic Review.” World Journal of Orthopedics, vol. 8, no. 5, 2017, pp. 424-430.

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