COMMUNITY NUTRITION 3 (1+2)

Lesson 4 : Clinical Assessment of Nutritional Status

Muscular and Skeletal Systems

Craniotabes	:	Softening of the skull, usually involving the occipital and parietal bones. The sign is positive only in infancy.
Frontal and Parietal Bossing	:	Localized thickening and heaping up of the frontal and parietal bones of the skull.
Persistently open anterior fontanelle	:	This may be defined as an anterior fontanelle which is open on palpation after the age of eighteen months.
Epiphyseal Enlargement	:	Enlargement of the epiphyseal ends of long bones particularly affecting the radius and the tibia and fibula at the level of the ankle. In wasted persons, the ends of the long bones appear unusually prominent.
Beading of the Ribs	:	A symmetrical nodular enlargement of the costo-chondrial junctions, producing a “rosary” effect. It is essentially a special localized form of epiphyseal enlargement.
Bow-legs	:	Legs are bent because they cannot withstand the weight of the body.
Deformities of the Thorax	:	The two most important are Harrison’s sulcus – an indentation running laterally around both sides of the chest and pigeon chest and musculo – skeletal haemorrhages.