Week 9 - MSK

Question 1

purpose of MSK system

Answer 1

body support and movement
to protect and encase the vital inner organs

Question 2

compromise = systemic effect

Answer 2

bone marrow produces RBCs, WBCs and platelets
a reservoir for storage of essential minerals in bone
- calcium and phosphorus

Question 3

myalgia

Answer 3

muscle pain (cramping or aching)

Question 4

crepitation

Answer 4

audible and palpable crunching or grating sounds that accompanies movement in the joint

Question 5

articular

Answer 5

inside joint capsule
i.e., arthritis is an articular disease

Question 6

contracture

Answer 6

shortening of a muscle leading to limited ROM of joint

Question 7

ankylosis

Answer 7

stiffness or fixation of a joint

Question 8

dislocation

Answer 8

one or more bones in a joint being out of position

Question 9

subjective data

Answer 9

Any pain in the joints?
Any stiffness in the joints?
Any swelling, heat, redness in the joints?
Any limitation of movement?
Any muscle pain or cramping?
Any deformity of bone or joint?
Any accidents or trauma to bones?
Ever had pack pain?
Any problems with the ADLs? Bathing, toileting, dressing, grooming, eating, mobility, communicating?

Question 10

If symptom reported use LOTTARRPP

Answer 10

Location: Which joints/muscle? On one side or both sides?
Onset: When did this pain start?
Timing: What time of day does the pain occur? How long does it last? How often does it occur?
Type: What does the pain feel like aching, stiff, sharp or dull, shooting? Severity: How strong is the pain?
Aggravating: Is the pain aggravated by movement, rest, position, weather?
Alleviating: Is the pain relieved by rest, medications, application of heat or ice?
Radiating: Does the pain radiate to any other part of the body? Compensation by other side/part of body now becoming sore?
Related symptoms: Is the pain associated with chills, fever, recent sore throat, trauma, repetitive activity?
Personal perception: What movements/activities cause a problem? How would you rate your pain? What do you expect could be the solution?
Precipitating event: What do you think caused the symptom/pain?

Question 11

osteoporosis screening

Answer 11

loss of bone mass, at risk population is women over age 65 yrs
Risk factors: lack of exercise, alcohol consumption, smoking, poor diet (lack of calcium)

Question 12

objective data

Answer 12

Inspection and palpation of joints, muscles, bones: AS NEEDED BASIS
What are you looking for?
Size
Color
Mass or deformity
Temperature
Pain
Swelling
Range of Motion (ROM)

Question 13

screening MSK

Answer 13

suffices for most patients, and includes:
- inspection and palpation of joints (do this simultaneously and observe for expressions of discomfort). Compare bilateral joints.
- observation of ROM
- age-specific screening measures (ie. Osteoporosis)

Question 14

comprehensive/complete MSK

Answer 14

MSK exam for patients with articular disease (ie. Arthritis), a history of MSK symptoms, or problems with ADLs

Question 15

CWMS

Answer 15

arterial blood supply is adequate to the limb
Colour (Should be pink or flesh AND check peripheral pulses)
- Always compare color of the nailbeds, temperature, ability to wiggle fingers or toes, and presence of swelling on bilateral limbs
Warmth (Are fingers and toes warm to touch?)
Movement (Can your patient wiggle fingers or toes?)
Sensation (Pinch fingers or toes. Any numbness or tingling?)

Question 16

muscle strength grading

Answer 16

0 - no contraction
1 - slight contraction
2- full ROM w/ gravity eliminated (passive)
3 - full ROM w/ gravity
4 - full ROM against gravity; some resistance
5 - full ROM against gravity; full resistance

Question 17

S&S of compartment syndrome

Answer 17

Compartment Syndrome – the 5 “P’s”
Pain
Pallor
Paresthesia - numbness
Paralysis
Pulselessness

puffiness - swelling
polar sensation - cool to touch

Question 18

peripheral neurovascular assessment

Answer 18

record Neuro Vascular (NVAx)
Used for postoperative patients, but also for any potential vascular/nerve compromising injury
Not to be confused with Neuro Vital Signs (NVS) – a neurological assessment

Question 19

mobility

Answer 19

does your patient have aids to assist in walking?
does your patient need help w/ mobility and ambulation?
- independent
- 1PA
- 2PA
- sabina lift
- golvo or ceiling lift

Question 20

use functional assessment history questions

Answer 20

identify any loss of function, self-care deficit, or safety risk:
-Do problems with your joints/muscles/bones impose any limits on your ADLs, and if so, which ones?
-Bathing – getting in and out of the tub, turning faucets
-Toileting – ability to get on an off, wiping self
-Dressing – pulling clothes over the head, typing shoes, manipulating buttons/zippers
-Grooming – shaving, brushing teach, doing hair/makeup
-Eating – preparing meals, pouring liquids, cutting up foods.
- Mobility – walking, stairs, getting in and out of bed, out of the home
-Communicating – talking, using phone or tablet, writing
For older adults, also assess:
-Any change in weakness over the past months or years
-An increase in falls or stumbling
-Use of mobility aids

Question 21

propulsive gait

Answer 21

parkinsons

Question 22

scissors gait

Answer 22

cerebral palsy

Question 23

steppage

Answer 23

foot drop

Question 24

hemiplegia

Answer 24

dragging a limb
CVA

Question 25

foot drop

Answer 25

Diseases that can cause foot drop include stroke, Amyotrophic lateral sclerosis (ALS or Lou Gehrig’s Disease), muscular dystrophy, multiple sclerosis, and it may also occur as a result of hip replacement surgery

Question 26

environmental assessment

Answer 26

Environmental hazards include:
Lighting
Rugs, carpet edges
Obstructed hallways
Cords
Lack of grab bars
Loose or low toilet seats

shoes and socks*

Question 27

after patient fall

Answer 27

primary assessment
head-to-toe assessment
full set of vitals

Question 28

MSK documentation

Answer 28

Your description of skeletal muscle movements will be helpful as you document using professional language
flexion and extension
abduction and adduction
pronation and supination
inversion and eversion
protraction and retraction
rotation
elevation and depression
circumduction
KATZ tool is to assess an individual’s level of independence with ADLs