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Heal assessment Exam 3 > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

(116 cards)

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1
Q

Flexion

A

bending

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2
Q

Extension

A

straightening

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3
Q

Abduction

A

moving away from body

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4
Q

Adduction

A

moving toward the midline

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5
Q

Pronation

A

turning forearm so that palm is down

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6
Q

Supination

A

turning forearm so that palm is up

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7
Q

Circumduction

A

moving arm in circle around shoulder

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8
Q

Rotation

A

moving head around central axis

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9
Q

Inversion

A

moving sole of foot inward at ankle

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10
Q

Eversion

A

moving sole of foot outward at ankle

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11
Q

Protraction

A

moving body part forward parallel to ground (jaw)

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12
Q

Retraction

A

moving body part backward parallel to ground (jaw)

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13
Q

Elevation

A

raising a body part (shoulder)

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14
Q

Depression

A

lowering a body part (shoulder)

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15
Q

ROS

A

General and Chronic Diseases
Congenital joint/bone/muscle defects
Family history of arthritis
Chronic diseases: obesity, osteoarthritis, osteopenia, osteoporosis, cancer, gout, rheumatoid arthritis
Surgical history
Medications
Any changes to your ability to move around and participate in ADLs and IADLs
Amount of exercise, safety measures when exercising
Routine daily activities, job-related activities, risk of injuries
Diet, tobacco & alcohol use

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16
Q

Osteopenia

A

reduce bone mass

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17
Q

Osteoporosis

A

bones become brittle and fragile from loss of tissue, typically as a result of hormonal changes, or deficiency of calcium or vitamin D.

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18
Q

Osteoarthritis

A

degeneration of joint cartilage and the underlying bone, most common from middle age onward. It causes pain and stiffness, especially in the hip, knee, and thumb joints.

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19
Q

ADL (activities of daily living)

A

bathing, toileting, dressing, grooming, eating, mobility, communicating

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20
Q

IADL (instrumental ADL)

A

driving, cooking, using household devices

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21
Q

Joints: Five cardinal signs of inflammation

A

pain, swelling, heat, redness, ROM limitation (stiffness)

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22
Q

Myalgia

A

Muscle (pain or cramps),

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23
Q

Atrophy

A

loss of muscle mass and weakness

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24
Q

Bones subjective data

A

Pain, deformity, trauma/accidents (fractures)

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25
Patient-Centered Care Musculoskeletal issues affecting life
Self-esteem, independence, body-image, role performance, social isolation Effects on family and friends
26
Joints injury
(sprains, strains, dislocation) to any joint
27
6 Ps of Musculoskeletal Injury
``` Pain Paresthesia (numbness, tingling) Paralysis/Paresis Pallor Pulse (weak) Poikilothermia (cool) ```
28
Preparing the patient
General -Posture, Gait, Position Changes Preparing the Patient and Environment - Hygiene (environment, hands), Standard Precautions Always in Effect - Proper Room Temperature - Privacy - Proper Exposure of The Body Part (only as needed)
29
Would should you always do when getting objective information?
Inspection & Palpate for inflammation, masses (nodules), injury, deformity, atrophy
30
Skin
inflammation signs/symptoms may indicate skin problem and/or MS problems
31
Muscle
Use contralateral side for comparison (asymmetry) Muscle size (assess for atrophy) muscle tone (tension) Strength (0-5) paresis (weakness), paralysis (flaccidity or -plegia) Involuntary movement (tics, tremors)
32
Joints
Size and contour of every joint Swelling, effusion, deformity Range of motion (ROM)
33
Range of Motion (ROM): Health promotion
Passive ROM exercise prevents joint contracture
34
Range of Motion (ROM)
Active- When you move apart of your body using your muscles Passive- when a outside source causes the movement of a joint Full-The act of moving as far as anatomically possible during a given exercise Limited-when you can't move a joint as fully and easily as it should move
35
Normal ROM
“full active ROM” for each joint
36
Abnormal ROM
contracture (no ROM) full passive ROM limited active ROM rigidity
37
How do you assess Muscle Strength ?
1. Instruct to repeat the active 2. ROM against your resistance 3.Assess for symmetry Grading system
38
Muscle grading
0- No contraction of muscle (flaccid) 1-Slight contraction (flicker/trace movement) 2- Active ROM with gravity eliminated 3- Active ROM against gravity 4- Active ROM against gravity and some resistance 5- Active ROM against gravity and full resistance (normal)
39
How many stacked bones are in your spine?
33 stacked bones
40
Cervical vertebrae
7 bones at the top of the spine
41
Thoracic vertebrae
12 bones (below cervical)
42
Lumbar vertebrae
5 bones (below thoracic)
43
Sacral
5 bones (below lumbar)
44
Coccyx or coccygeal
4 bones ( below sacrum or sacral)
45
Where is the spinous processes felt?
felt in a furrow down the midline of the back
46
Cervical and lumbar curves
concave (inward or anterior)
47
Thoracic and sacrococcygeal curves
convex (outward)
48
You should inspect your spine to see?
Skin: smooth, even skin color, no lesions/inflammation Entire spine for abnormal curvature (kyphosis, lordosis, scoliosis) Equal horizontal positions for the shoulders, scapulae, iliac crests, gluteal folds Knees and feet alignment with the trunk and pointing forward
49
You should palpate your spine to see ?
Spinous processes, straight (alignment & symmetry), nontender Abnormal curvature: kyphosis, lordosis, scoliosis (see terminology slides) Paravertebral muscles firm, nontender, no spasm
50
What should you see with spine ROM ?
Flexion, extension, lateral bending, rotation (without moving hips) Assess normal gait (symmetry, rhythm, balance, alignment) may assess walking on heels Flexion: will allow better inspection of abnormal curvature you do not test muscle strength for your spine
51
Neck inspection
``` Symmetry Skin without any inflammatory changes, lumps, swelling, pulsation Alignment of head and neck, midline Neck: neutral position & posture Neck round, symmetric muscles ```
52
Palpate Nails
Spinous processes and neck muscles | Normal: no spasms, tenderness, lumps, muscle atrophy, swelling
53
ROM Neck
Supple (flexible) Flexion, extension (chin to chest & chin to ceiling) Right & left lateral bend (ears to shoulders) Right & left Rotation (chin to shoulders) Note any tenderness or limitation Motion is smooth and controlled Strength Assess strength by repeating the ROM against your resistance
54
TMJ Inspection
Skin: smooth, even skin color, no lesions/inflammation, swelling
55
TMJ palpation
Felt in depression anterior to tragus of ear Crepitus, tenderness with ROM
56
TMJ ROM 3 types
Hinge Action: 1- open/close the jaws Gliding Action: 2- Protrusion & retraction; 3- side-to-side movement
57
TMJ strength
Palpate masseter muscles while instructing to clench the teeth Instructing to open the jaw against resistance
58
Joint of 3 Bones for the shoulder
humerus, scapula, clavicle
59
Rotator Cuff
4 muscles & tendons that support and stabilize it
60
Inspection of shoulder
Skin: smooth, even skin color, no lesions/inflammation Bilaterally for round contour & symmetry Normal: no inflammatory changes, lumps, swelling, deformity, atrophy
61
Palpation of shoulder
Normal: no spasm, atrophy, swelling, heat, tenderness, adenopathy
62
ROM of shoulder
Normal: full active ROM bilaterally without any palpated crepitation
63
ROM strength
Assess strength by repeating the ROM against your resistance
64
Joint of 3 Bones for elbow
humerus, radius, ulna
65
Palpation for elbow
Normal skin, joint, biceps & triceps: no spasm, atrophy, symmetrical, nodules, lumps, Inflammatory changes, joint effusion, heat, tenderness
66
ROM for elbow
Flexion, extension (assessing the elbow) | Pronation, supination (assessing 2 radioulnar joints at elbow & wrist)
67
Strength for Elbow
Assess strength of biceps and triceps by repeating the ROM against your resistance
68
Wrist
radiocarpal (radius with 8 carpals)
69
Carpals
midcarpal Carpometacarpal metacarpophalangeal
70
Digits
Proximal interphalangeal | distal interphalangeal
71
Inspect, palpate for wrist, hand and elbow
Inspect Skin: smooth, even skin color, no lesions/inflammation Bilateral dorsal and palmar sides for position, shape, symmetry, contour Normal: skin without any inflammatory changes, lumps, swelling, deformity, nodules Palpate Each joint and compare bilaterally Normal: no atrophy, swelling, heat, tenderness, subcutaneous nodules/lumps ROM Flexion/extension of wrist & digits Deviation wrist (ulnar/radial) Abduction/adduction of fingers Strength Assess strength of wrist/fingers by repeating the ROM against your resistance
72
Joints of Hips
acetabulum and femur, ball-and-socket
73
Inspect Palpate ROM for hips
Inspect Skin: smooth, even skin color, no lesions/inflammation Symmetric level of iliac crest, gluteal folds, buttocks Equal leg lengths (assessed by smooth and even gait) Palpate Bilateral hips for symmetry and stability Normal: no swelling, heat, tenderness, deformity, crepitus with motion ROM Abduction/adduction Flexion/extension (with extended knee) Flexion/extension (with flexed knee) should increase ROM Internal/external rotation Strength Assess strength by repeating the ROM against your resistance
74
Joint of 3 bones in the knew
femur, tibia, patella; hinge joint
75
Inspect Palpate ROM Strength for knee
Inspect Skin: smooth, even skin color, no lesions/inflammation Contour, symmetric shape, lower leg same axis as the thigh Quadriceps (anterior thigh), hamstrings (posterior thigh) for atrophy No locking, giving way (buckling), local pain Palpate Bilateral knees for symmetry, smoothness Normal: no swelling, heat, tenderness, deformity, crepitus with motion ROM Flexion/extension Strength Assess strength of quadriceps and hamstrings by repeating the ROM against your resistance
76
Inspect Palpate strength for feet and ankle
Inspect Skin: smooth, even skin color, no lesions/inflammation, callus Position, joints contour, symmetric shape, feet alignment with axis of leg Toes straight forward and flat (abnormal: hammertoe) Medial/ lateral malleoli smooth Palpate Ankles, feet (dorsum/plantar surfaces), toes (interphalangeal joints) for symmetry, smoothness Normal: no swelling, heat, tenderness, deformity, crepitus with motion Strength Assess muscle strength by repeating the ROM against your resistance
77
Joints of 3 bones Ankle
Tibia , Fibula, Talus
78
Ankle
Joint of 3 bones: tibia, fibula, talus Hinge joint ROM: Flexion (Dorsiflexion) & Extension (Plantar Flexion)
79
Feet
Many bones and joints | ROM: Inversion (Supination) & Eversion (Pronation)
80
Toes
ROM: Flexion & Extension
81
Morse Fall Risk Assessment Tools
1. History of Falls 2. Secondary Diagnosis 3. Ambulatory Aids 4. IV Therapy 5. Gait 6. Mental Status
82
Phalen Test
Hold both hands back-to-back while flexing wrist for 60 seconds Normal (negative): No symptoms Abnormal (positive): Numbness and burning
83
Tinel Test
Directly percuss on the median nerve at the wrist Normal (negative): No symptoms Abnormal (positive): tingling and burning
84
Bone Remodeling
cyclic process of: resorption by osteoclasts and deposition by osteoblasts
85
How to measure for Bone Mass Density
X-Ray imaging test, measure bone mineral mass
86
What is osteopenia and osteoporosis
``` low BMD (osteopenia) -1 to -2.25 porous bone (osteoporosis) < -2.25 higher risk of fractures ```
87
Cultural and Genetic Considerations for Osteopenia and Osteopenia
Bone resorption occurs more rapidly than bone deposition more common in Caucasian women The function of osteoblasts (bone deposition) is estrogen dependent estrogen decreases with age in both sexes Abnormal: low BMD (bone mass density) Higher risk of complications associated with falls
88
Muscle Atrophy
loss of muscle mass due to disuse, nerve/muscle disorders
89
Dislocation
often caused by trauma the articulating bones are out of their appropriate place Results in joint deformity, severe pain, ROM limitation
90
Sprain
damaged (stretching/tearing) ligament Ligament connects bone to bone, surrounding a joint Ankle is a common site
91
Strain
damaged (stretching/tearing) tendon Tendon connects a muscle to a bone Lower back is a common site
92
Joint Effusion
swelling from excess fluid in the joint capsule
93
Crepitation
palpable crunching or grating in the joint while performing ROM may be audible if severe
94
Weight-Bearing Exercise
exercise against gravity | walking, hiking, jogging, climbing stairs, dancing
95
Non-Weight-Bearing Exercise:
exercise without supporting your weight swimming, rowing, bicycle riding using resistant bands while seated ROM exercise
96
Isometric Exercise
tensing the muscle without moving the joint pushing the heels into the bed holding a posture exercise while a limb is in a cast exercise while on bedrest
97
Isotonic Exercise
active ROM exercise
98
Kyphosis
abnormal increase in the thoracic curve Ex: hump back
99
Lordosis
abnormal increase in lumbar curve
100
Scoliosis
lateral curvature of thoracic and lumbar spine
101
Contracture
develops when the normally stretchy (elastic) tissues are replaced by non-stretchy (inelastic) fiber-like tissue often due to disuse Ex: Foot drop
102
Children and Adolescents
Children Assess for any bone deformity, particularly scoliosis Hight and weight (growth range) History of increasing falls or balance problems Adolescents Assess for any bone deformity, particularly scoliosis Assess for risk of injuries related to sports and extracurricular activities
103
Aging Adults
Decrease in muscle mass (less strength & elasticity) Bone resorption occurs more rapidly than bone deposition Postural changes & decreased height/ROM Loss of subcutaneous fat leaves bony prominences more observable Get-Up-&-Go Test Time the client as they rise from an armchair, walk 10 feet (3m), turn, walk back, and sit down again Normal: < 10 sec High risk for fall: >10 sec
104
Health Promotion
``` Safety Diet Tobacco Products Alcohol Exercise Osteoporosis Screening ```
105
Functions of MS
``` Posture Movement Protect organs Production of blood cells Ca++ & phos- storage ```
106
Joints function
functional units where two or more bone surfaces come together
107
Synovial
freely movable, hip
108
Cartilaginous
slightly movable, vertebra
109
Fibrous
immovable, sutures in skull
110
cartilage
resilient tissue covers the surface of opposing bones in synovial joints Absorb stress and weight
111
Ligaments
Strong, dense, flexible, fibrous band of connective tissue | holding bones to bones at the joint and providing support
112
Tendon
flexible, non-elastic, strong fibrous collagen tissue attaching muscles to bones Support bone movement in response to skeletal muscle contraction
113
Bursa
enclosed sac filled with synovial fluid prevent friction
114
Skeletal
voluntary connected to bones by tendons (fibrous cords) Facilitate movement
115
Smooth
autonomic, airways, vasculature, GI organs
116
Cardiac
Striated

Heal assessment Exam 3 (4 decks)

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