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Musculoskeletal disorders (MSDs) are a leading cause of disabilities worldwide that affects mobility and dexterity. This conditions affect muscles, bones, and joints. The most common include joints, such as osteoarthritis, rheumatoid, psoriatic arthritis, gout, ankylosing spondylitis; bones, such as osteoporosis, osteopenia and associated fragility fractures, traumatic fractures, sarcopenia; the spine, such as back and neck pain; multiple body areas or systems, such as regional and widespread pain disorders and inflammatory diseases such as connective tissue diseases and vasculitis that have musculoskeletal manifestations, for example systemic lupus erythematosus. (World). The patients with, recurrent pain, stiff joints, swelling, dull aches, limited mobility (“Musculoskeletal Disorders: 

A metabolic disorder occurs when abnormal chemical reactions in your body disrupt the normal function of the liver or pancreas. E.g. diabetes, Phenylketonuria, Wilsons disease etc. (“Metabolic Disorders”) common symptoms include Hepatic encephalopathy, Low muscle tone (Hypotonia), Liver enlargement (Hepatomegaly),Diarrhea and vomiting, Seizures and convulsions (occasional) (“Metabolic Disorders : Overview, Causes, Types, Symptoms, & Treatment”) musculoskeletal , metabolic diseases and affect the patient socially, financially, emotionally and mentally .this symptoms interfere with performance of daily routines due to pain and stiffness. Diabetes associated complications such as benign paroxysmal positional vertigo, neuropathy and retinopathy causes loss of balance, blurred vision that can lead to falls resulting in fractures (D’Silva et al.) and increased need for sick days causing and financial impact due to cost of medication and disease management, such as joint replacement surgery. socially the patient fells isolated due to the fact that they cannot participate in common activities due to joint stiffness and pain, having to choose and be careful about what they eat which further leads to anxiety and depression thus affecting their quality of life.

Multisystem health dysfunctions also referred to as Multiple Organ Dysfunction Syndrome MODS is a characterized by failure of several (at least two) major organ systems i.e. Acute renal or kidney system Liver system, Heart system, Respiratory system, Blood system, and Neurologic system, in a critically ill individual that can make it impossible to maintain homeostasis without some type of medical intervention. MODS normally occur as a complication of sepsis which results in high mortality. The signs and symptoms of end-organ dysfunction in the above organ systems consist of: dysfunction of normal exchange of gas(hypoxemia), fluid and electrolyte imbalance, abnormal liver function test, altered level of consciousness (“Multiple Organ Dysfunction Syndrome – Symptoms, Treatment, Pathophysiology”) Tachycardia, hypotension, brady /tachypnea, pallor, Metabolic acidosis, Anuria Hypo/hyperthermia ,elevated or decreased PT/PTT, hypoglycemia ,decreased platelets and

‌ D’Silva, Linda J, et al. “The Impact of Diabetes on Mobility, Balance, and Recovery after Repositioning Maneuvers in Individuals with Benign Paroxysmal Positional Vertigo.” Journal of Diabetes and Its Complications, vol. 31, no. 6, 1 June 2017, pp. 976–982. ScienceDirect, lopes.idm.oclc.org/login?url=search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S1056872716310297&site=edslive&scope=site, 10.1016/j.jdiacomp.2017.03.006.

“Metabolic Disorders.” Medlineplus.Gov, medlineplus.gov/metabolicdisorders.html.

“Metabolic Disorders : Overview, Causes, Types, Symptoms, & Treatment.” FactDr, 24 July 2018, factdr.com/health-conditions/metabolic-disorders/. Accessed 9 Aug. 2020

“Multiple Organ Dysfunction Syndrome – Symptoms, Treatment, Pathophysiology.” Syndrome.Org, syndrome.org/multiple-organ-dysfunction-syndrome/.

‌“Musculoskeletal Disorders: Definition and Patient Education.” Healthline, 21 Mar. 2018, www.healthline.com/health/musculoskeletal-disorders#symptoms. Accessed 9 Aug. 2020.

World. “Musculoskeletal Conditions.” Who.Int, World Health Organization: WHO, 15 Feb. 2018, www.who.int/news-room/fact-sheets/detail/musculoskeletal-conditions.

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Most common muscolosckeletal conditions include:

• Osteoporosis or Degenerative Joint Disease(DJD). This condition is basically wear and tear of synovial joints.
• Osteoporosis
• Rhematoid Arthritis(RA) is an overactive immune system that attacks healthy tissue such as synovial joints.When it progresses it causes inflammation that eventually destroys the connective tissues and if untreated causes deformity and limitations to mobility and function.

These conditions may lead a pateint to develop joint deformities and limitation and lack of mobility and pain. Traumas or fractures can occur when bones are no longer firm and become week.

Some contributing factors to these musculoskeletal diseases include: genetics, obesity, hypertension, alcohol use, drug use, tobacco use but some are caused by autoimmune disease such as RA.

Most common metabolic conditions include:

• Diabetes
• hyothyroidism
• Cushings Disease
• Addison’s Disease and many more…

When diabetes is uncontrolled and unmanaged it impacts multiple organs throughout the body. It can cause other serious diseases such as:

• Cardiovascular Disease
• Coronary Artery Disease
• Cerebrovascular Accident
• Renal damage

Other conditions that are common with diabetes is Infection.

Multiple system Response, Sepsis and shock

Septicemia is usually caused by an untreated infection or trauma injury that travels to the bloostream. Septicemia in a hospital setting can be difficult to notice because of the subtle changes in a patients condition. Nurses observe these changes and adress them in a fast pace. If undiagnosed and/or medically not intervened within 3 hours of developing symptoms, the patient will develop organ failure.

Reference: Falkner, A., & Green, S. Z. (2018). Musculoskeletal, Metabolism, and Multisystem Complexities. Retrieved August 10, 2020, from https://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-client-health/v1.1/