As a student currently studying to receive my CNA, a very large part about that is learning and knowing all the body systems. Not only about the system and its function, but the parts of the system and what role each of those parts play in the body, the diseases associated with that body system, what normal findings versus abnormal findings are, what changes occur due to aging and last but not the least, the role that you, the CNA, will have in that body system. A system that I find highly important and vital is the Musculoskeletal System and that is what will be discussed here.
The Musculoskeletal System’s job is to provide structure and movement for the body. This system not only provides structure but its primary function include supporting the body, allowing motion, and protecting vital organs. The Musculoskeletal system is made up of the skeleton (bones), muscles, cartilage, tendons, ligaments, and joints. There is also other connective tissue that supports and binds tissues and organs together. The nerves also play a vital role within the Musculoskeletal System. The skeleton, more commonly known as the bones, is one of the most important components of the Musculoskeletal system. The bones are essential to the body along with all the tasks and jobs of the skeleton. The skeleton is made up of 206 bones, the framework of the body. The bones provide structural support for the entire body, store minerals and lipids, store energy as lipids in yellow bone marrow, produces blood cells, protects body organs, provide leverage and movement. Individual bones or groups of bones provide framework for attachment of soft tissue and organs. You have the tendons that attach muscles to the bones and then the ligaments which attach bone to bone. Originally said nerves are play a role in this system as well. Your nerves control the contraction of muscles, interpret sensory information and coordinate activity. Also in the Musculoskeletal system has over 600 muscles and they may be skeletal muscles or smooth muscles. The skeletal muscles are known are the voluntary muscles while the smooth muscles are involuntary. Another part of this body system is cartilage which is a flexible connective tissue found in many parts of the body. The main function is to connect bones together and it is found in the joints, the rib cage, the ear, the nose, the throat and between the bones of the back. There are three different types of cartilage, hyaline, flexible and fibrocartilage. Hyaline cartilage provides stiff support while elastic cartilage provides very flexible support. Fibrocartilage is the most significant because it fills most of the body. Its tasks consist of resisting compression, preventing bone to bone contact, and limiting relative movement. Lastly you have the joints and this is the point where the bones meet. The joints are made up of cartilage and connective tissue that cushion the bones. Joints may be movable like the ankles, slightly movable like the back, or immovable like the skull.
There are quite a few diseases and disorders associated with the Musculoskeletal system. Three of the larger, more common ones stand out and will be discussed here. First is arthritis which in simple terms is inflammation of the joints. There are two different types of arthritis, osteoarthritis and rheumatoid arthritis. Osteoarthritis affects weight bearing joints with aches, stiffness and limits motion while rheumatoid arthritis is a systemic disease causing deformities with painful, swollen joints. Another common disease is osteoporosis where the bones weaken due to, too much calcium being dissolved or not enough being replaced. This disease is also known as “Porous Bone” and is more likely to occur in women. With this disease hip fractures are a high risk factor. Some signs of osteoporosis are loss of height and bent posture. Lastly we have fractures which are just breaks in the bone. Depending on the severity, that will determine treatment. Normally treatment will involves resetting the bone in place and immobilizing it in a cast to allow it enough time to heal. If the fracture is too serious, this could result in surgery.
In the Musculoskeletal system, there a many changes that occur due to aging and those changes come with lots of effects if not handled properly. Bone mass or density is lost with aging, bones lose calcium and other minerals, in between the bones of the spine are disks, as you age these disks lose fluid and cause the spine to shorten, the muscles weaken and lose tone, bones lose density and therefore become brittle, joints stiffen causing decrease in range of motion and flexibility, body mass decreases caused partly because of loss of muscle tissue, muscles are less toned and less able to contract (these muscles may become rigid), the body has a poorer response to stimuli and slower muscle and nerve interaction. Many of these changes have negative effects on the elderly body. Bones are more brittle so they break very easily, the height decreases because of shorten spine, the spine curves causing posture to become more stooped, bone spurs may appear on the vertebrae due to aging or use of the spine, breakdown of the joints can lead to inflammation, pain, stiffness and deformity, movement slows and can sometimes eventually become limited, and ambulating patients can become risk for fall and injury.
The CNA plays a large role in a residents health care team in more ways that just what they are expected to do. As the person who spends the majority of the their time with the resident, it is your role to keep the patient safe and out of harm's way. With the Musculoskeletal system in mind, you will prevent falls by keeping pathways clear, keep furniture in the same location, let the resident know when things have been moved and most importantly always make sure walkers,canes, and all assistive devices are within reach of resident. You are the one who will be encouraging and assisting with regular movement, activities, self-care tasks along with encourage resident to walk, do light exercise, and have an active range of motion. You are to assist residents who are immobile with positioning, moving or body mechanics for themselves and for the patients who are not completely immobile, by assisting and encouraging these exercises, you are preventing further immobility. A huge role of the CNA is pain management whether it be acute or chronic pain. Report pain immediately, make patient feel as comfronale as possible when in pain, and try to help prevent the pain before it occurs.
To conclude on the Musculoskeletal system, you can see how important this system is and why you should always take all resident care very seriously. The CNA is the one who will best get the know the patient so it is important that the patient trusts you and you do your best to keep that patient happy. A lot of the pain comes from issues within the Musculoskeletal system and you are key in pain management. You need to be aware of the system, its parts, functions, diseases, disorders, changes due to aging, effects of those changes on residents and most importantly the CNA role in this system.