Exam 2: Musculoskeletal Assessment Flashcards by Ashley Lau

Subjective data for Musculoskeletal

Joints
—Pain, stiffness, swelling, limiting ROM
Muscles
— Trauma/pain, deformity, gain/loss
Exercise program
Weight gain and loss
ADLs
— Bathing. toileting, dressing, grooming, eating
Mobility/ADL aids
Occupational Hazards
— Lifting, repetition of joint movement, uneven surfaces

How well did you know this?

Not at all

Perfectly

When obtaining objective data, INSPECT

Gait
mobility
balance
obvious deformities of muscles and bones
skin
spinal curvatures (lordosis, kyphosis, scoliosis)
Symmetry: size, structure, function of muscle mass

How well did you know this?

Not at all

Perfectly

When obtaining objective data, palpate each join and note

Heat, edema, tenderness, swelling, masses

How well did you know this?

Not at all

Perfectly

When assessing ROM, note

resistance and presence of pain

Any crepitation vs. discrete crack/pop

How well did you know this?

Not at all

Perfectly

Active ROM assessment

Patient performs

How well did you know this?

Not at all

Perfectly

Passive ROM assessment

nurse performs

— DO NOT FORCE into a painful position, mild stretching/discomfort OK, but we do not want to tear soft tissue

How well did you know this?

Not at all

Perfectly

Crepitation

grinding in joints roughened joins as with rheumatoid arthritis

How well did you know this?

Not at all

Perfectly

Cracking and popping in the joins is when

Fluid and gasses shift in the joint

How well did you know this?

Not at all

Perfectly

Muscle testing during objective data assessment

Compare both sides at the same time if able

- Flex as you hold opposing force or resist that opposing force

How well did you know this?

Not at all

Perfectly

Hypertonicity

increased tone/resistance

How well did you know this?

Not at all

Perfectly

Hypotonicity

decreased tone/resistance… very relaxed, floppy or flabby

How well did you know this?

Not at all

Perfectly

Atrophy

Reduced size, feels soft/boggy

How well did you know this?

Not at all

Perfectly

Assessing cervical spine

Checking the alignment of head and neck

Palpate for spasms and tenderness

How well did you know this?

Not at all

Perfectly

testing ROM of cervical spine

Flexion (chin to chest) 
Hyperextension (look upward)
Lateral bend (ear to shoulder) 
Rotation (turn head to shoulder) 
--- then repeat with opposing force

How well did you know this?

Not at all

Perfectly

Inspecting the lower spine (person should stand if able) and inspect

If spine is straight

shoulder evaluation, uneven scapula, iliac crest, gluteal folds, spacing between arm and lateral thorax

How well did you know this?

Not at all

Perfectly

ROM assessment for lower spine

Bend and touch toes, bend sideways, backwards

Twist side to side

How well did you know this?

Not at all

Perfectly

The vertebral column has four curves that are

Anterior-posterior curves

How well did you know this?

Not at all

Perfectly

The cervical and lumbar curves are

Concave (inward)

How well did you know this?

Not at all

Perfectly

The thoracic and sacrococcygeal curves are

Convex (outward)

How well did you know this?

Not at all

Perfectly

What allows the spine to absorb shock

balance of the curves with the resilient intervertebral discs

How well did you know this?

Not at all

Perfectly

Scoliosis

LATERAL S-shape curvature of the thoracic and lumbar spin

How well did you know this?

Not at all

Perfectly

A normal spine has a double s-shape that is

Anterior/posterior, not lateral

How well did you know this?

Not at all

Perfectly

Scoliosis ribs

Study These Flashcards

Rib hump on forward flexion

Scoliosis is more prevalent in

Study These Flashcards

adolescence, especially girls

what should be noted for scoliosis

unequal shoulders, scapular height, obvious curvature, unequal elbow level, etc.

Kyphosis

Exaggerated posterior curvature of the thoracic spine, associated with aging. HUMPBACK

Lordosis

Normal lumbar concavity is further accentuated forward towards the belly

Lordosis is often associated with

pregnancy and obesity, can be present secondary to kyphosis without obesity

Shoulder assessment

Inspect - redness, deformity-swelling | Palpate - heat, spasm, atrophy, tenderness

When assessing upper extremity, test the

Strength of the shoulder muscles and cranial nerve XI: Spinal accessory

Assess upper extremity for

Asymmetry Pain with motion Crepitus with motion Bilateral/unilateral weakness

When assessing elbow

Size and contour both flexed and extended

When assessing elbow, palpate

redness, swelling, deformity

When assessing elbow ROM

bend and straighten elbow - flexion and extension Repeat with resistance ---- Supination/pronation

When assessing wrist and hand, inspect

swelling, redness, deformity, nodules, skin

When assessing wrist and hand, palpate

Joint surfaces, smooth, nodules, tenderness

When assessing ROM for wrist and hand

``` Bend hand up and down at wrist bend fingers up and down turn palms outward and inward spread fingers, make a fist touch thumb to each finger ----repeat with opposing force ```

When assessing Hip, inspect

When standing | Symmetrical iliac crest, gluteal folds, buttock size and gait

When assessing hip in supine position

Raise each leg with knee extended bending knee to chest increases hip flexion Internal/external rotation Straighten knee swing leg lateral and medial

Adduct

TOWARDS the body

Abduct

AWAY from body

Testing Hip movement

Squat and raise knee as high as possible (flexion) leg cross body plane (adduction) swing leg away from body (abduction) When standing swing leg behind body (hypertension) point toe in and out (internal/external rotation) DUCK walk !!

When assessing knee, inspect

skin, lesions, edema, shape/contour

When assessing knee, assess

Quadriceps for atrophy

ROM knee

Bend each knee (flexion) extend each knee (extension) ----- Repeat with opposing force

Abnormal knee issues

Pain, limps, popping, clicking, weakness, instability

When assessing ankle and foot, inspect

feet, toes, joints, skin, alignment | --- bunions, hammer toes, swelling, inflammation, calluses, ulcers

ROM ankle and foot

point toes to floor (Plantar flexion) toes to nose (Dorsiflexion) soles in and out (Eversion and inversion) flex and straighten toes

Developmental considerations for infants

Normal C curve spine Support head: the neck isn't developed ROM of extremities, toes up to the shin!

Assess preschoolers

Observe crawling, walking, jumping

Assessing toddlers

Protuberant abdomen broad based gait use arms of balance

Assessing adolescents

Kyphosis with poor posture Screen for scoliosis Growth spurts can result in poor coordination

Development in pregnant women

Lordosis | Waddle type gait due to relaxation of the hip joints in anticipation of childbirth

Development in older adults

Loss of bone mass Weaker bones Smaller base of support so they shuffle feet Increased risk for falls and also for fracture

Common adaptations to aging

``` Shuffling Holds on to rails, leads with favored leg Holds rail, lowers weak leg first bends at waist pushes off chair rolls from one side pushes with arms ```

Exam 2: Musculoskeletal Assessment Flashcards

(55 cards)