Report on the Human Musculoskeletal System and Related Disorders

This report provides a comprehensive overview of the human musculoskeletal system, detailing its structure and function, including the roles of bones, muscles, joints, ligaments, and tendons. The report highlights the skeletal region as a storage system for phosphorus and calcium. It then discus...Read More

Running head: REPORT
Healthcare
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Executive summary
The musculoskeletal system is responsible for providing support, shape and stability to the
human body and it also helps in movement. This report elucidated on the structure and the
function of the musculoskeletal system and elaborated on the fact that it comprises of joints,
cartilages, ligaments, bones, tendons, and muscles. Sarcopenia was identified as a common
musculoskeletal disorder that commonly affects the elderly people and causes physical
disability and mobility impairment. This disorder is treated typically with resistance training
and strength training. Three other musculoskeletal disorders discussed in the report were
tendonitis, Carpal Tunnel Syndrome (CTS), and rheumatoid arthritis.

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Table of Contents
Introduction................................................................................................................................3
Structure and function................................................................................................................3
Six major joints..........................................................................................................................5
One named musculoskeletal disorder.........................................................................................6
Three musculoskeletal disorders................................................................................................7
Treatments..................................................................................................................................7
Conclusion..................................................................................................................................8
References..................................................................................................................................9

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Introduction
The human musculoskeletal system refers to the organ system that offers the
capability to move, besides providing support, stability, form and structure to the body. It
comprises of the bones present in muscles, cartilage, skeleton, tendons, joints, and ligaments
that support and connect the organs and tissues together1. The skeletal region of this system
acts as the foremost storage system for phosphorus and calcium and encompasses vital
constituents of the hematopoietic system. This report will explain the anatomy and
physiology of the system and will also elucidate on three musculoskeletal disorders and their
treatment.
Structure and function
In addition to providing support to the entire weight of the human body, the bones
work together along with the muscles for maintaining the position of the human body and for
producing precise and controlled movements. Without the presence of the skeleton to pull
against, the muscle fibres will not help in sitting, running or walking. Individual bones
present in the system create a framework that helps in attachment of organs and soft tissues.
Calcium salts present in the bone act as a valuable reserve and the bones also store lipids in
the form of energy reserves in bone marrow2. The red bone marrow inside the bone cavity
helps in production of white blood cells, red blood cells and other elements. Several bones
also act as levers and alter the direction and magnitude of forces created by muscles.
Protection of organs and soft tissues are another important function such as, the heart and
lungs are protected by the rib cage, spinal cord is protected by the vertebrae and the
reproductive organs are shielded by the pelvis3.
1 K. Barrett and W. Ganong, Ganong's Review Of Medical Physiology New York, McGraw Hill, 2016.
2 G. Tortora and B. Derrickson, Principles Of Anatomy And Physiology New York, N.Y., Wiley, 2018.
3 S. Warhadpande, Anatomy of a Joint. In Essential Radiology Review (pp. 445-446). Springer, Cham, 2019

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Figure- Human musculoskeletal system
Source- 4
4 T. System, "The Musculoskeletal System" Scientific Publishing, [website] 2020,
https://www.scientificpublishing.com/product/the-musculoskeletal-system/ (accessed 12 February 2020).

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Six major joints
Synovial joints comprise of the synovial cavity, the articular cartilage and the joint
capsule. The cavity is a characteristic space that remains filled with synovial fluid. The joint
capsule contains two layers namely, inner fibrous membrane and outer fibrous membrane,
and there occurs a hyaline cartilage layer lining the epiphyses of the joint end of the bones.
The pivot joints help in rotation along an axis and move from side to side, thus enabling
rotation of the neck or the forearm. The hinge joints make it easy for the limbs to extend or
flex, along one particular axis. The bones perfectly fit together, one concave and other
convex and some common hinge joints are fingers, elbows and toes5.
Ball and socket joints have been identified as the most mobile joints, and permit a
wide extent of motion. The hip and shoulder joints belong to this class. Ellipsoidal or
condyloid joints are also ball and socket joints, which are round, rather elliptical, and help in
circular and/or bending movement nonetheless rendering rotation unmanageable. This helps
in movement along two planes: flexing and bending like hinge joint, in addition to some
rotation. Similar to condyloid joints, saddle joints connect the bones and have a shape of
interlocking saddles, thus permitting increased range of motion, but not complete rotation
such as, the thumb6. Gliding or plane joints are regions where the bones meet in the form of
flat surfaces and glide feely past one another like the ankles, wrists, and the spine. More than
regions where the bones connect, these synovial joints are a complex organisation of
cartilage, bone, and fluid, bound with tendons and ligaments that are connected to the
muscles, thus making motion conceivable.
5 K. Barrett and W. Ganong, Ganong's Review Of Medical Physiology New York, McGraw Hill, 2016.
6 S. Warhadpande, Anatomy of a Joint. In Essential Radiology Review (pp. 445-446). Springer, Cham, 2019

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One named musculoskeletal disorder
Sarcopenia is a musculoskeletal disorder that is characterised by the degenerative loss
of mass of the skeletal muscles, strength and quality correlated with immobility and aging.
The rate of loss of muscle in this disorder is directly reliant on level of physical exercise,
nutrition, co-morbidities, and different factors. The condition occurs due to alteration in
satellite cell recruitment and changes in anabolic signalling. Inflammation, protein oxidation
and decline in quality of muscle tissues also cause this disorder7. Sarcopenia results in
physical disability. It affects movement by decreasing muscle strength, weakening of bones,
impaired mobility, frailty, fractures and falls, and reduction in physical activity. It leads to the
onset and progress of depression, reduces the health-related quality of life and also increases
recurrent admissions to clinical settings.
Corrective action for this disorder includes physical exercise, particularly strength
training or resistance training. The advantage of this treatment is that it increases muscle
endurance and strength with the usage of resistance bands or weights and also improves
hormonal balance and neuromuscular system. However, there might be a risk of injury due to
improper use of the weights. Alternative treatment methods include intake of proteins and
calories and administration of β-hydroxy β-methylbutyrate8. Nutritional modification is a
low-cost and simple treatment modality and does not have any side effects. The latter
decreases proteasome expression and stimulates mammalian target of rapamycin (mTOR),
however, its impact on muscle strength is not yet validated.
7 L. Chen and others, "Recent Advances In Sarcopenia Research In Asia: 2016 Update From The Asian
Working Group For Sarcopenia", Journal of the American Medical Directors Association, vol. 17, no. 8, 2016.
8 E. Marzetti and others, "Sarcopenia: An Overview", Aging Clinical and Experimental Research, vol. 29, no. 1,
2017.

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Three musculoskeletal disorders
Three common disorders include tendonitis, Carpal Tunnel Syndrome (CTS), and
rheumatoid arthritis. CTS occurs owing to compression of median nerve during its course
through the wrist, near the carpal tunnel, located at the palm base and surrounded by bony
prominence of trapezium and scaphoid tubercle. Common signs include burning and tingling
sensation in middle and index fingers, feelings of numbness, discomfort, and ache, gradual
decline of manual dexterity and loss of grip9.
The flexor tendons swell, and it weakens abduction and disrupts kinematics of thumb
at the time of circumduction and opposition. In contrast, tendonitis refers to the disorder that
causes pain on adductor and an impairment in function. While extensor tendonitis in hands
leads to stiffness and pain on the top of hand, flexor tendonitis leads to stress and unwanted
damage to tendon in palm, forearm or wrist. The pain gradually worsens with movement and
most affected regions are the elbow, shoulder, ankle, hip or wrist10. The disorder might occur
due to repetitive actions like tennis or an injury. Athletes, people involved in manual labour
and musicians are more likely to suffer from this condition. Rheumatoid arthritis affects the
joints and causes swollen, warm and painful joints that worsen with rest. This causes stiffness
in joints, necrotizing granuloma, and even atherosclerosis11.
Treatments
Nonsurgical therapies are generally recommended for management of CTS and splints
and wrist bands are most commonly accepted treatment. This non-invasive treatment is the
common choice of physicians during the initial stages since the splints temporarily restrain
the affected limbs for spasm and pain, reduce swelling, and also minimize further
9 L. Padua and others, "Carpal Tunnel Syndrome: Clinical Features, Diagnosis, And Management", The Lancet
Neurology, vol. 15, no. 12, 2016.
10 M. Varacallo and S.D. Mair, Rotator Cuff Tendonitis In StatPearls [Internet], StatPearls Publishing, 2019
11 J. Sokolove, Rheumatoid arthritis pathogenesis and pathophysiology In Lung Disease in Rheumatoid
Arthritis (pp. 19-30), Humana Press, Cham, 2018

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neurovascular injuries in soft tissues due to contusions, lacerations, sprains, dislocations,
fractures, or painful joints12.
Doctors commonly emphasise on the administration of non-steroidal anti-
inflammatory drugs (NSAIDs) for management of tendonitis. This can be accredited to the
fact that the drug non-selectively inhibits the cyclooxygenase (COX) enzymes that are
responsible for catalysing formation of thromboxane and prostaglandin from arachidonic
acid, both of which trigger inflammation and pain13. In contrast, best treatment for
rheumatoid arthritis focuses on combined administration of conventional therapy with
glucocorticoids that has proven effective in decreasing rate of bone erosion. This is because
NSAIDs do not create an impact on the long term course of the disease, though it decreases
stiffness and pain.
Conclusion
Thus, it can be concluded that the musculoskeletal system incorporates cartilage,
skeletal muscles, bones and connective tissues and play a significant role in permitting human
movement and offering mechanical support to the body. This system not only acts as a lever
but also protects the internal organs of the human body. Three common musculoskeletal
disorders are CTS, rheumatoid arthritis and tendonitis and the common treatment modalities
for the three disorders are namely, splints and wrist bands, combination of conventional
therapy and glucocorticoids, and NSAIDs, respectively.
12 I. Atroshi and others, "Treatment Of Carpal Tunnel Syndrome With Wrist Splinting: Study Protocol For A
Randomized Placebo-Controlled Trial", Trials, vol. 20, no. 1, 2019.
13 N.J. Petty and K. Barnard (Eds.), Principles of Musculoskeletal Treatment and Management E-Book: A
Handbook for Therapists Elsevier Health Sciences, 2017

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References
Atroshi I. and others, "Treatment Of Carpal Tunnel Syndrome With Wrist Splinting: Study
Protocol For A Randomized Placebo-Controlled Trial", Trials, vol. 20, no. 1, 2019
Barrett K. and Ganong W., Ganong's Review Of Medical Physiology New York, McGraw
Hill, 2016.
Chen L. and others, "Recent Advances In Sarcopenia Research In Asia: 2016 Update From
The Asian Working Group For Sarcopenia", Journal of the American Medical Directors
Association, vol. 17, no. 8, 2016
Marzetti E. and others, "Sarcopenia: An Overview", Aging Clinical and Experimental
Research, vol. 29, no. 1, 2017
Padua L. and others, "Carpal Tunnel Syndrome: Clinical Features, Diagnosis, And
Management", The Lancet Neurology, vol. 15, no. 12, 2016
Petty, N. J. and Barnard, K. (Eds.), Principles of Musculoskeletal Treatment and
Management E-Book: A Handbook for Therapists Elsevier Health Sciences, 2017
Sokolove, J., Rheumatoid arthritis pathogenesis and pathophysiology In Lung Disease in
Rheumatoid Arthritis (pp. 19-30), Humana Press, Cham, 2018
System T., "The Musculoskeletal System" Scientific Publishing, [website] 2020,
https://www.scientificpublishing.com/product/the-musculoskeletal-system/ (accessed 12
February 2020).
Tortora G. and Derrickson B., Principles Of Anatomy And Physiology New York, N.Y.,
Wiley, 2018.
Varacallo, M. and Mair, S. D., Rotator Cuff Tendonitis In StatPearls [Internet], StatPearls
Publishing, 2019

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Warhadpande S., Anatomy of a Joint. In Essential Radiology Review (pp. 445-446). Springer,
Cham, 2019