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Health Assessment - Lecture > Assessment of Musculoskeletal > Flashcards

Assessment of Musculoskeletal Flashcards

1
Q

serve as storage sites for minerals such as calcium

A

bones

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2
Q

produces red blood cells

A

bone marrow

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3
Q

The junction of two or more bones is called a

A

joint

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4
Q

stabilize the bones and allow a specific type of movement

A

Joints

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5
Q

a smooth, fibrous tissue—cushions the end of each bone, and synovial fluid fills the joint space

A

Cartilage

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6
Q

This fluid lubricates the joint and eases movement, much as the brake fluid functions in a car

A

synovial fluid

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7
Q

the bones are connected by fibrous tissue, or cartilage.
the bones may be immovable

A

nonsynovial joints

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8
Q
  • move freely
  • the bones are separate from each other and meet in a
    cavity filled with synovial fluid (lubricant)
A

Synovial joints

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9
Q

Moving backward and forward

A

Retraction and protraction

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10
Q

Bending, decreasing the joint angle

A

Flexion

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11
Q

Straightening, increasing the joint angle

A

Extension

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12
Q

Moving away from midline

A

Abduction

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13
Q

Moving toward midline

A

Adduction

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14
Q

Turning toward midline

A

Internal rotation

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15
Q

Moving in a circular manner

A

Circumduction

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16
Q

Turning away from midline

A

External rotation

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17
Q

Turning downward

A

Pronation

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18
Q

Turning upward

A

Supination

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19
Q

Turning outward

A

Eversion

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20
Q

Turning inward

A

Inversion

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21
Q

are tough fibrous portions of muscle that attach the muscles to bone.

A

Tendons

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22
Q

Skeletal muscles contract and produce _________________when they receive a stimulus from the central nervous system (CNS) → both involuntary and voluntary muscle function.

A

skeletal movement

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23
Q

sacs filled with friction-reducing synovial fluid; they’re located in areas of high friction such as the knee.

A

Bursae

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24
Q

allow adjacent muscles or muscles and tendons to glide smoothly over each other during movement.

A

Bursae

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25
Q

location of Bursae

A

located in areas of high friction such as the knee

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26
Q

The mandible should be in the ______________, not shifted to the right or left.

A

midline

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27
Q
  • an abnormal grating sound.
  • This sound is different from the occasional crack that can be heard from joints.
A

crepitus

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28
Q

Ask the patient to try touching his right ear to his right shoulder and his left ear to his left shoulder. The usual range of motion is _________________ on each side

A

40 degrees

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29
Q

Ask him to touch his chin to his chest and then to point his chin toward the ceiling. The neck should flex forward _____________________and extend backward _________________.

A

45 degrees; 55 degrees

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30
Q

Finally, ask him to move his head in a circle—normal rotation is_________________

A

70 degrees.

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31
Q

To assess abduction, ask the patient to move his arm from the neutral position laterally as far as possible. Normal range of motion (ROM) is __________________

A

180 degrees

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32
Q

To assess adduction, have the patient move his arm from the neutral position across the front of his body as far as possible. Normal ROM is __________________

A

50 degrees

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33
Q

To assess flexion, ask the patient to move his arm anteriorly from his side over his head, as if reaching for the sky. Full flexion is

A

180 degrees

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34
Q

To assess extension, have him move his arm from the neutral position posteriorly as far as possible. Normal extension ranges from

A

30 to 50 degrees

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35
Q

Normal external and internal rotation is

A

90 degrees

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36
Q

Normal ROM is _________________ for both flexion and extension of the elbow

A

90 degrees

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37
Q

Elbow pronation and supination
■ Have the patient place the side of his hand on a flat surface with the thumb on top.
■ Ask him to rotate his palm down for pronation and
upward for supination. The normal angle of elbow rotation is _______________ in each direction.

A

90 degrees

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38
Q

Radial and ulnar deviation
■ Ask the patient to rotate each wrist by moving his entire hand—first laterally then medially—as if he’s waxing a car.
■ Normal range of motion is ________________________ (ulnar deviation) and __________________ (radial deviation).

A

55 degrees laterally; 20 degrees medially

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39
Q

Extension and flexion
■ Observe the wrist while the patient extends his fingers up toward the ceiling and down toward the floor, as if he’s flapping his hand. He should be able to extend his wrist ____________________ and flex it ________________

A

70 degrees; 90 degrees

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40
Q
  • Lightly percuss the transverse carpal ligament over the median nerve where the patient’s palm and wrist meet.
  • If this action produces numbness and tingling shooting into the palm and finger, the patient has _____________ and may have
A

Tinel’s sign; carpal tunnel syndrome

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41
Q

■ Have the patient put the backs of his hands together and flex his wrists downward at a 90-degree angle.
■ Pain or numbness in his hand or fingers during this maneuver indicates a positive _____________________. The more severe the carpal tunnel syndrome, the more rapidly the
symptoms develop

A

Phalen’s sign

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42
Q

Assessing finger range of motion

Normal hyperextension is ___________________; normal flexion, _______________________

A

30 degrees; 90 degrees

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43
Q

To test abduction,

A

have the patient spread his fingers apart

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44
Q

To test adduction,

A

have the patient draw the fingers back together.

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45
Q

knees that point out

A

bowlegged (genu varum)

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46
Q

knees that turn in

A

knock knees (genu valgum)

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47
Q

Normal ROM for internal rotation is _________________; for external rotation, _____________________.

A

40 degrees; 45 degrees

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48
Q

indicates excess fluid in the joint

A

bulge sign

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49
Q

What should you look for in the ankles and feet?

A

Swelling, redness, nodules, or other deformities.

50
Q

Normal range of motion (ROM) for plantar flexion is
about ______________________; for dorsiflexion, _________________

A

45 degrees; 20 degrees

51
Q

Ask the patient to demonstrate inversion by turning
his feet inward, and eversion by turning his feet
outward. Normal ROM for inversion is __________________; for
eversion, __________________.

A

30 degrees; 20 degrees

52
Q

describes muscular resistance to passive stretching

A

Muscle tone

53
Q

No evidence of muscle contraction

A

0/5

54
Q

Trace: Patient’s attempt at muscle contraction is palpable but without joint movement.

A

1/5

55
Q

Poor: Patient completes full ROM with gravity eliminated (passive motion)

A

2/5

56
Q

Fair: Patient completes ROM against gravity only

A

3/5

57
Q

Good: Patient completes ROM against gravity with moderate resistance

A

4/5

58
Q

Normal: Patient moves joint through full range of motion (ROM) and against gravity with full resistance.

A

5/5

59
Q

plantar flexion of the foot with the toes bent toward the instep

A

Footdrop

60
Q

It results from weakness or paralysis of the dorsiflexor muscles of the foot and ankle.

A

Footdrop

61
Q

is an abnormal crunching or grating you can hear and feel when a joint with roughened articular surfaces moves

A

Crepitus

62
Q

are strong, painful contractions. They can occur in virtually any muscle but are most common in the calf and foot

A

Muscle spasms

63
Q

muscle spasms commonly occur in

A

calf and foot

64
Q

typically result from simple muscle fatigue, exercise, electrolyte imbalances, neuromuscular disorders,
and pregnancy

A

Muscle spasms

65
Q

muscle atrophy or

A

muscle wasting

66
Q

results from denervation or prolonged muscle disuse

A

Muscle atrophy

67
Q

Some muscle atrophy also occurs with

A

aging

68
Q

It occurs in patients with rheumatoid arthritis or
osteoarthritis or when broken pieces of bone rub
together.

A

Crepitus

69
Q

can result from a malfunction in the cerebral hemispheres, brain stem, spinal cord, nerve roots, peripheral nerves, or
myoneural junctions and within the muscle itself.

A

Muscle weakness

70
Q

Traumatic injuries include

A

fractures, dislocations, amputations, crush injuries, and serious lacerations.

71
Q

To swiftly assess a musculoskeletal injury, remember the 5 P’s:

A

pain, paresthesia, paralysis, pallor, and pulse.

72
Q

Does the patient feel pain? If he does, assess its location, severity, and quality

A

Pain

73
Q

Assess for loss of sensation by touching the injured area with the tip of an open safety pin. Abnormal sensation or loss of sensation indicates neuro vascular involvement.

A

Paresthesia

74
Q

Can the patient move the affected area? If he can’t, he might have nerve or tendon damage.

A

Paralysis

75
Q

Paleness, discoloration, and coolness on the injured side may indicate neurovascular compromise.

A

Pallor

76
Q

Check all pulses distal to the injury site. If a pulse is decreased or absent, blood supply to the area is reduced.

A

Pulse

77
Q

pain anywhere from the hand to the shoulder

A

Arm Pain

78
Q

Arm pain (pain anywhere from the hand to the shoulder) and leg pain usually result from musculoskeletal
disorders, but they can also stem from neurovascular, cardiovascular, or neurologic disorders

A

Pain

79
Q

lateral deviation of the spine is present and the patient leans to the side. Other findings include:
■ uneven shoulder blade height and shoulder blade
prominence
■ unequal distance between the arms and the body
■ asymmetrical waistline
■ uneven hip height.

A

Scoliosis

80
Q

the thoracic curve is abnormally rounded

A

Kyphosis

81
Q

the lumbar spine is abnormally concave

A

Lordosis

82
Q

Lordosis (as well as a waddling gait) is normal in

A

pregnant women and young children

83
Q

Spine is S or C shaped

A

Scoliosis

84
Q

thoracic spine curves outward

A

kyphosis

85
Q

lumbar spine curves inward

A

lordosis

86
Q

a chronic deterioration of the joint cartilage that commonly
occurs in the hips, knees, and joints of the fingers

A

osteoarthritis

87
Q

are typically seen in patients with osteoarthritis, a chronic deterioration of the joint cartilage that commonly
occurs in the hips, knees, and joints of the fingers.

A

Heberden’s and Bouchard’s nodes

88
Q

are hard, bony, and cartilaginous enlargements that appear
on the distal interphalangeal joints.

A

Heberden’s nodes

89
Q

Heberden’s nodes appear on the

A

distal interphalangeal joints

90
Q

Usually hard and pain-less, these bony and cartilaginous enlargements typically occur in middle-aged and elderly patients with osteoarthritis.

A

Heberden’s nodes

91
Q

are similar but less common and appear on the proximal
interphalangeal joints.

A

Bouchard’s nodes

92
Q

Bouchard’s nodes appear on the

A

proximal interphalangeal joints.

93
Q

A chronic, systemic inflammatory immune disorder

A

rheumatoid arthritis

94
Q

Spontaneous remissions and unpredictable exacerbations mark the course of this potentially crippling disease. Swollen, painful, and stiff joints, especially of the
hands, are typical in

A

acute rheumatoid arthritis

95
Q

rheumatoid arthritis commonly affects

A

bilateral joints of the fingers, wrists, elbows, knees, or ankles
as well as surrounding muscles, tendons, ligaments, and blood vessels.

96
Q

hyperextension of the proximal interphalangeal joints with flexion of the distal interphalangeal joints

A

Swan-neck deformity

97
Q

flexion of the proximal interphalangeal joint with hyperextension of the distal interphalangeal joint

A

boutonnière deformity

98
Q

is a metabolic disorder in which uric acid deposits in the joints cause the joints to become painful, arthritic, red, and swollen. Skin temperature may be elevated due to the irritation and inflammation.

A

Gout

99
Q

a round, enlarged, fluid-filled cyst commonly found on the dorsal side of the wrist

A

Ganglion

100
Q

is a group of congenital disorders characterized by progressive symmetrical wasting of skeletal muscles without neural or sensory defects

A

Muscular dystrophy

101
Q

The most common form of Muscular Dystrophy is

A

Duchenne’s (pseudohypertrophic) muscular dystrophy

102
Q

occurs during early childhood; onset is insidious and occurs between ages 3 and 5. The disorder initially affects
the legs, pelvis, and shoulders. Findings include:
■ enlarged, firm calf muscles
■ waddling gait, toe-walking, lumbar lordosis, and positive Gower’s sign
■ difficulty climbing stairs
■ history of frequent falls.

A

Duchenne’s (pseudohypertrophic) muscular dystrophy

103
Q

an inability to lift the trunk without using the hands and arms to brace and push

A

Gower’s sign

104
Q

indicates pelvic muscle weakness, as occurs in muscular
dystrophy and spinal muscle atrophy

A

positive Gower’s sign

105
Q

Assessing Neck ROM

A

lateral (on each side): 40 degrees
flexion: 45 degrees
extension: 55 degrees
rotation: 70 degrees

106
Q

Assessing the Range of Spinal Movement

length of the spine from neck to waist usually increases by at least _______________ when patient bends forward

A

2 inches (5 cm)

107
Q

Shoulders
Abduction:
Adduction:
Flexion:
Extension:
Internal and External Rotation:

A

Abduction: 180 degrees
Adduction: 50 degrees
Flexion: 180 degrees
Extension: 30-50 degrees
Internal and External Rotation: 90 degrees

108
Q

Elbow

Flexion and Extension:
Pronation and Supination:

A

Flexion and Extension: 90 degrees
Pronation and Supination: 90 degrees

109
Q

Assessing Wrist ROM

Ulnar Deviation =
Radial Deviation =
Extension =
Flexion =

A

Ulnar Deviation = 55 degrees laterally
Radial Deviation = 20 degrees medially
Extension = 70 degrees
Flexion = 90 degrees

110
Q
  • where the palm and wrist meet
A

Transverse Carpal Ligament

111
Q

if there is numbness and tingling then it indicates

A

Tinel’s Sign —> Carpal Tunnel Syndrome

112
Q

put backs of hands together and flex wrists downward at 90 degrees angle

A

Phalen’ s Maneuver

113
Q

Assessing Finger ROM

Hyperextension:
Normal Flexion:

A

Hyperextension: 30 degrees
Normal Flexion: 90 degrees

114
Q

Assessing Hip ROM

Flexion:
Extension:
Internal Rotation:
External Rotation:
Abduction:
Adduction:

A

Flexion: 120 degrees
Extension: 30 degrees
Internal Rotation: 40 degress
External Rotation: 45 degrees
Abduction: 45 degrees
Adduction: 30 degrees

115
Q

Assessing Ankle and Foot ROM
Plantar Flexion:
Dorsiflexion:
Inversion:
Eversion:

A

Plantar Flexion: 45 degrees
Dorsiflexion: 20 degrees
Inversion: 30 degrees
Eversion: 20 degrees

116
Q

Earliest sign and is often out of proportion to what might be expected from the extent of injury

A

Pain

117
Q

Refers to the skin tone of the affected limb. Any deviation from the individual’s typical skin tone, especially blue or purple in color, can be indicative of compromised blood flow.

A

Pallor

118
Q

Refers to the sensation of numbness and tingling. which can be indicative of neurological trauma.

A

Paresthesias

119
Q

Refers to the inability to move the affected limb

A

Paralysis

120
Q

Specifically the radial, dorsalis pedis, and posterior tibial pulses. are checked to ensure proper blood flow.

A

Pulselessness

Health Assessment - Lecture (17 decks)

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