Musculoskeletal Assessment

Question 1

Flexion

Answer 1

Bend limb at a joint

Question 2

Extension

Answer 2

Straighten limb at a joint

Question 3

Abduction

Answer 3

Move limb away from the midline of the body (abduct = move away)

Question 4

Adduction

Answer 4

Move limb towards the midline of the body (add = move together)

Question 5

Pronation

Answer 5

Turn forearm palm down

Question 6

Supination

Answer 6

Turn forearm palm up

Question 7

Circumduction

Answer 7

Move arm in circle around shoulder

Question 8

Inversion

Answer 8

Move sole inward at ankle

Question 9

Eversion

Answer 9

Move sole outward at ankle

Question 10

Rotation

Answer 10

Move head around a central axis

Question 11

Protraction

Answer 11

Move body part forward and parallel to ground

Question 12

Retraction

Answer 12

Move body part backward and parallel to ground

Question 13

Elevation

Answer 13

Raise body part

Question 14

Depression

Answer 14

Lower body part

Question 15

Health History Points

Answer 15

1. Joints
   a. pain
   b. stiffness
   c. swelling, heat, redness
   d. limitation in ROM
2. Muscles
   a. pain (cramps)
   b. weakness
3. Bones
   a. pain
   b. deformity
   c. trauma - fractures, strains, sprain, dislocation
4. Functional Assessment - impact of ADLs
5. Knee Joint (if injured)

Question 16

Temporomandibular Joint

Answer 16

Inspection: SEATED
-

Palpation: SEATED
- palpate TMJ with opening and closing –> feel
for smoothness, crepitation
- palpate temporalis and masseter muscles
for size, firmness and strength with teeth
clenched

Question 17

Testing CN V

Answer 17

Trigeminal Nerve
- ask the patient to move jaw forward and
laterally against resistance

Question 18

Cervical Spine

Answer 18

Inspection: SEATED
- alignment of head and neck (straight and
erect)

Palpation: SEATED
- palpate spinous processes
- palpate neck muscles for firmness, size,
symmetry

Question 19

Shoulders

Answer 19

Inspection: SEATED
- inspect and compare both shoulders
posteriorly and anteriorly

Palpation: SEATED
- palpate both shoulders –> note muscular
spasm, atrophy, swelling, heat, tenderness

Question 20

Elbow

Answer 20

Inspection: SEATED
- inspect for size and contour in flexed and
extended positions

Palpation: SEATED
- palpate the elbow when flexed 70 degrees
and relaxed

Question 21

Wrist and Hand

Answer 21

Inspection (dorsal and palmar side)
- note contour and shape
- coloration (no redness)
- no swelling, deformity, nodules

Palpation
- joints –> feel smooth, no swelling,
tenderness

Question 22

Wrist and Hand Strength Testing

Answer 22

position the patient’s forearm supinated on a table, stabilize by holding the patient’s arm with your hand
1. ask patient to flex hand up against
resistance
2. ask patient to extend hand down against
resistance

Question 23

Hip

Answer 23

Inspection: STANDING
- inspect hip joint WITH spine when
STANDING
- note symmetry bilaterally = levels of the iliac
crests, gluteal folds, equal sized buttocks
- note gait = even, smooth

Palpation: SUPINE
- palpate hip joints in a SUPINE position
- shoud feel stable, symmetrical
- no tenderness or crepitation

Question 24

Knee

Answer 24

Inspection: SUPINE
- legs extended fully –> legs should extend on
same axis as thighs
- skin intact, even colouration

Palpation: SUPINE
- quads should be completely relaxed
- joints are smooth –> NO warmth,
tenderness, thickening

Question 25

Ankle and Foot

Answer 25

Inspection: STANDING and SEATED - compare feet --> should align with long axis of lower leg, toes point forward - weight bearing should be borne on middle of the foot, from the heel, along the midfoot Palpation: SEATED - palpate metatarsophalangeal joints

Question 26

Ankle and Foot Strength Testing

Answer 26

with the patient sitting, support their lower leg with your hand - ask the patient to dorsiflex against resistance - ask the patient to plantarflex against resistance

Question 27

Thoracic and Lumbar Spine

Answer 27

Inspection: STANDING - inspect for spine curvature (abnormal) --> note normal convex thoracic curve and concave lumbar curve - ask the patient to toe walk a few steps, then heel walk --> assess stability and gait Palpation: STANDING - palpate spinous processes

Question 28

Rheumatoid Arthritis

Answer 28

Chronic, systemic inflammatory disease of the joints and surrounding connective tissue - Inflammation of the synovial membrane leads to thickening, then to fibrosis (which limits motion), and finally to bony ankylosis] - Disorder is symmetrical and bilateral, characterized by heat, redness, swelling, and painful motion of the affected joints

Question 29

Osteroarthritis

Answer 29

Noninflammatory, localized, progressive disorder involving deterioration of articular cartilages and subchondral bone and formation of new bone (osteophytes) at joint surfaces - Asymmetrical joint involvement commonly affects hands, knees, hips, and lumbar and cervical spine

Question 30

Osteoporosis

Answer 30

Decrease in skeletal bone mass occurring when the rate of bone resorption is greater than that of bone formation → this weakened bone state increases risk for stress fractures, especially at the wrist, hip, and vertebrae

Question 31

Older Adult Considerations (5)

Answer 31

1. Postural changes - decreased height - kyphosis 2. osteoporosis - bone breakdown surpasses bone deposition ( 3. distribution of subcutaneous fat changes - body contour changes, boney prominences more evident 4. loss of muscle mass occurs - some decrease in size, atrophy (weakness) - senile tremors normal 5. ROM and functional assessment normal if no musculoskeletal issues are present