Association of Orthopaedic Nurses, 2013). • Seronegative Spondyloarthropathies: these are an interrelated group of multisystem inflammatory disorders that affect the axial spine, asymmetric peripheral joints, and peri-articular structures in the absence of serum rheumatoid factor (RF) (National Association of Orthopaedic Nurses, 2013). They include the following: o Ankylosing Spondylitis o Reactive Arthritis o Psoriatic Arthritis • Systemic Lupus Erythematosus: a condition that damages many parts of the body like joints, skin, kidneys, heart, etc., which occurs when the body’s defense system attacks healthy cells and tissues rather than viruses and bacteria (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2016). Page 11 of 196 References Bergeron, E., Blier, R., Cupec, P., Goff, R., Levin, B., Lowe, M., . . . Sarauer, N. (2018). An Introduction to Orthopaedic Nursing. Chicago: National Association of Orthopaedic Nurses. National Institutes of Arthritis and Musculoskeletal and Skin Diseases. (2016, April 30). Gout. (U.S. Department of Health and Human Services) Retrieved January 30, 2019, from National Institutes of Health: https://www.niams.nih.gov/health-topics/gout National Institutes of Arthritis and Musculoskeletal and Skin Diseases. (2015, June 30). Juvenile Arthritis. (U.S. Department of Health and Human Services) Retrieved January 30, 2019, from National Institutes of Health: https://www.niams.nih.gov/health-topics/juvenilearthritis National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2016, May 30). Polymyalgia Rheumatica. (U.S. Department of Health and Human Services) Retrieved January 30, 2019, from National Institutes of Health: https://www.niams.nih.gov/healthtopics/polymyalgia-rheumatica National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2016, June 30). Systemic Lupus Erythematosus (Lupus). (U.S. Department of Health and Human Services) Retrieved January 30, 2019, from National Institutes of Health: https://www.niams.nih.gov/health-topics/lupus Page 12 of 196 Muscle, tendon and ligaments Muscle is classified in three categories: cardiac muscle, smooth muscle, and skeletal muscle. Skeletal muscle is comprised of many cylindrical muscle fibers that often run from point of origin to point of insertion. Connective tissue binds the fibers and provides a path for blood vessels and nerves (National Association of Orthopaedic Nurses, 2013). Muscles contract and relax to bring about movement and perform three main functions: movement, maintenance of posture, and heat production (Begley, et al., 2014). Movement is produced by the skeletal muscles exerting force on tendons which in turn pull on bones. When a muscle contracts it draws one articulating bone toward the other. Levers are produced by the bones and joints (National Association of Orthopaedic Nurses, 2013). Ligaments and tendons are similar as they both serve as connectors. They contract and shorten or relax to allow two bones to move closer or further away from one another. Ligaments join bone to bone, and tendons join muscle to bone (National Association of Orthopaedic Nurses, 2013). Ligament elasticity allows stretch and stabilizes the joint to ensure that the movement remains normal. Ligaments, tendons and cartilage connect bones, joints, and muscles. Their purpose is to guide and protect the movement initiated by muscles (Begley, et al., 2014). Cartilage is formed by dense irregular connective tissue. There are two types of cartilage: hyaline, which provides flexibility and support, and fibrocartilage, which allows greater resistance to compression and tension. Unlike with ligaments and tendons, fibers are arranged irregularly, and therefore allow more stress than ligaments and tendons. There is no blood or nerve supply and minimal capability for healing (Begley, et al., 2014). Effects of mobility on the health and healing of muscles • Your skeletal muscles are responsible for the movements you make. Skeletal muscles are attached to your bones and partly controlled by the central nervous system (CNS). • You use your skeletal muscles whenever you move. Fast-twitch skeletal muscles cause short bursts of speed and strength. Slow-twitch